By Monazza Ahmad, B.Pharm, MSc
A healthy genital tract makes some of the most important phases in a woman’s life more enjoyable and easier to manage. Menstruation, intimacy, giving birth, and embracing menopause are all significant milestones. But you may not realize that good vaginal health plays a fundamental role in reaching these milestones with minimum hurdles.
Importance of gut health is well-researched and well-understood for our overall health, concluding that the gut is vital to the health of most organs in our body. Gut health is defined by the microbiome that resides in it and influences the absorption and digestion of everything we consume. These microorganisms constantly and selectively translocate to different parts of the body, creating a unique microecosystem in each organ.1
Curious how the vaginal microbiome differentiates from the gut microbiome? To understand this concept better, we will briefly explore the diversity of the microbiome in the human body.
Diversity of human microbiomeMicrobiome diversity in our body depends on factors like diet, environment, genetics, and early exposure to microbiota, meaning at birth. Just like skin and scalp, the female genital tract is also represented by its own community of microorganisms. The vaginal microbiota is evolved through a continuous translocation of species from gut to vagina or from a mother to child at birth.1
Driven by hormonal changes, the complex vaginal microbiome is continuously transformed throughout various cycles of the female lifetime—from birth to puberty, menstruation, pregnancy, menopause, and postmenopause.1
Difference between gut and vaginal microbiomeSimply put, gut microbiota is more diverse while vaginal microbiota is more selective in healthy bacterial strains. This means using the same interventions to protect vaginal flora as that for the gut may not always be optimal. Recognizing the difference between the native microbiome of gut and vagina helps us find the right and safe solutions to help avoid undesirable genital conditions.1
It is important to understand that the physiological and biochemical characteristics of microorganisms remain the same in the gut and vagina; however, their immune responses vary considerably between the two environments.1 In other words, the way each environment detects a substance as harmful or safe is different.1
For example, where the by-products of bacterial fermentation (such as short-chain fatty acids) have shown to prevent damage to the gastrointestinal tract, they have shown unfavorable effects in the genital tract, leading to negative outcomes in the reproductive and gynecological system.1
When the undesirable bacteria from the gut invade the vaginal or urethral area, they create an imbalance that may lead to various female concerns.
What is the gut-vagina axis?Modern research has revealed a collection of intricate pathways, namely gut-vagina axis, which connects the vaginal tract to our gut.
Despite the difference between intestinal flora and the vaginal flora, the former is found to be involved in the development of some vaginal imbalances. For example, bacteria from the gut pass to the rectum, from where they can travel to the vagina due to the close proximity, resulting in unfavorable conditions. Therefore, it is important to keep the communication smooth between the gut and vagina.2
Effects of vaginal microbial imbalanceVaginal microbial imbalances may result in several unfavorable conditions.

1. The vaginal tract is dominated by specific species of bacteria. Loss of these particular bacteria can lead to imbalances that may cause vaginal discomfort.3
2. A woman’s reproductive health also depends on feminine microbial balance. The depletion of beneficial bacteria can cause microbial imbalance that can extend to fallopian tubes affecting reproductive outcomes.4
3. Vaginal microbiome disruptions may also affect sexual health and female organ health.5,6

It is evident that there could be some serious consequences associated with poor vaginal health. Taking care of feminine health should be the top priority for every woman and shouldn’t be overlooked.
Factors affecting the vaginal microbiomeThe intricate and dynamic female genital tract requires special attention to care. Here are some of the factors that can create imbalance in the vaginal microbiome.

1. Menstrual cycle and hormones: Fluctuations in reproductive hormones, especially estrogen, throughout the menstrual cycle influence the composition of vaginal organisms.4 Clinical evidence shows that elevated estrogen levels are linked to increased chances of vaginal microbial disruption.7 Estrogen is involved in a process important for healthy microbial colonization and maintaining low vaginal pH. Any alteration in this process can affect vaginal health.8 Therefore, women with higher estrogen levels, such as women in reproductive years, those taking high doses of birth control pills, or those undergoing hormone therapies, are more prone to vaginal microbial imbalances.9

1. Contraceptives: Some birth control methods have shown to alter the healthy vaginal microbiome. Hence, it is advised to use contraceptive methods under the care of a physician.10

1. Menopause and aging: As much as we wouldn’t like to admit it, aging impacts vaginal health negatively. Vaginal aging is associated with low levels of estrogen that can cause changes in the microbiome. In postmenopausal women, the decrease in vaginal flora results in lesser microbiome diversity and higher pH levels.4,11

1. Lifestyle: Personal hygiene practices seem to affect the vaginal microbiome composition, such as the type of cleansing agents, undergarments, and body sprays used. Types of intimate activities and absence of protection have all been associated with the reduction of healthy vaginal bacteria.6 Stress is another lifestyle factor that may result in microbial disruption by increasing cortisol levels that ultimately cause estrogen changes, leading to higher pH levels.4

1. Diet: Poor eating habits are associated with almost all chronic conditions. Highly processed food rich in dietary fat and carbohydrates negatively impact the vaginal environment, whereas dietary fiber intake seems to support vaginal health. Micronutrients such as vitamins A, C, E, beta carotene, calcium, and folate also play an important role in improved vaginal health.12,13

Overall, eating a well-balanced diet that contains phytonutrients and healthy proteins can support vaginal microbial health. Using proper hygiene products, practicing safe intimacy, managing stress and taking a high-quality probiotic can help women can enjoy each phase of their lives with optimal health.
References:
1. Amabebe E et al. Front Immunol. 2020;11:2184.
2. Brannon JR et al. Nat Commun. 2020;11:2803.
3. Han Y et al. Front Micriobiol. 2021;12:643422.
4. Lehtoranta L et al. Front Micriobiol. 2022;13:819958.
5. Gholiof M et al. Front Reprod Health. 2022;4:963752.
6. Lewis FMT et al. Obstet Gynecol. 2017;129(4):643–654.
7. Cheng G et al. Eukaryot Cell. 2006;5(1):180–191.
8. Mirmonsef P et al. PLoS One. 2014;9(7):e102467.
9. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999. Accessed December 5, 2022.
10. Gupta K et al. J Infect Dis. 2000;181(2):595-601.
11. Szymański JK et al. Int J Environ Res Public Health. 2021;18(9):4935.
12. Neggers YH et al. J Nutr. 2007;137(9):2128-2133.
13. Tohill BC et al. Am J Clin Nutr. 2007;85(5):1327-1334.

Every BODY and every age have unique nutritional needs. However, with every stage of life, there are common nutritional inadequacies that women are most likely to experience. Learn what supplements are best for YOU!

20s
You may find yourself strapped for time and cash during these exciting transitional years, which could result in an unbalanced diet. What supplements should you consider taking?

• Calcium and vitamin D! Your 20s are a great time to invest in your bone health when your bone mass is still reaching its peak.1 Add vitamin D3 to enhance calcium absorption.2*
• Iron is important for menstruating women, as excessive menstrual blood loss is the most common cause of iron deficiency in women.3*

30s
In your 30s, you may be expanding your family and/or career, so you need all the energy you can get!

• B vitamins are often recommended to support healthy energy and mood.4 Taking a B complex will also include B9, also known as folate, which helps protect against neural tube defects during pregnancy.5*
• Omega-3s are important for heart health, fetal development, and maternal health.6-8*

40s
Your 40s are filled with possibilities; whether you are starting a new business, climbing the corporate ladder, juggling older kids, or welcoming a new addition, women in their 40s are thriving!

• Omega-3 is key to supporting your immune system, heart health, and mood to take on your 40s!9-11*
• Vitamin B12 plays a crucial role in regulating the nervous system, cognitive function, and mood.12-13*

50s
Your 50s and beyond can be a great time to reconnect with yourself and maybe your spouse too. Make sure to support all the amazing years ahead of you with high-quality supplements.

• Calcium is important from 50 on to protect the bones you built in your 20s and early 30s.14*
• Vitamin D is also important, as postmenopausal women are more likely to develop vitamin D insufficiency.15*
• Omega-3s are a great choice to support your cardiovascular, brain, and cognitive health.16*

To ensure you’re getting the nutrients you need at every stage of your life, consider adding nutritional supplements like Wellness Essentials® Women or Wellness Essentials Women’s Prime to your daily regimen.

​References

1. Walsh JS et al. Lumbar spine peak bone mass and bone turnover in men and women: a longitudinal study. Osteoporos Int. 2009;20:355–362.
2. Vitamin d fact sheet for health professionals. Nat Inst of Health. Available at: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional. Accessed January 26, 2023.
3. Abbaspor N et al. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–174.
4. Young LM et al. A systematic review and meta-analysis of b vitamin supplementation on depressive symptoms, anxiety, and stress: effects on healthy and ‘at-risk’ individuals. Nutrients. 2019;11(9):2232.
5. Bixenstine et al. Folic acid supplementation before pregnancy: reasons for non-use and association with preconception counseling. Matern Child Health J. 2015;19(9):1974–1984.
6. DeFilippis AP et al. Omega-3 fatty acids for cardiovascular disease prevention. Curr Treat Options Cardio Med. 2010;12:365–380.
7. Nordgren TM et al. Omega-3 fatty acid intake of pregnant women and women of childbearing age in the United States: potential for deficiency? Nutrients. 2017;9(3):197.
8. Lauritzen L et al. DHA effects in brain development and function. Nutrients. 2016;8(6).
9. Calder PC. Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology?: omega-3 fatty acids and inflammation. Br J Clin Pharmacol. 2012;75: 645–662.
10. DiNicolantonio JJ et al. The benefits of marine omega-3s for the prevention and treatment of cardiovascular disease. Mo Med. 2019;116(5):404-408.
11. Parker G et al. Omega-3 fatty acids and mood disorders. Amer J of Psych. 2006;163(6): 969-978.
12. Gropper S et al. Advanced Nutrition and Human Metabolism. Cengage Learning; 2012.
13. Linus Pauling Institute of Science and Medicine. Linus Pauling Institute of Science and Medicine. Palo Alto, CA: The Institute, 1991.
14. Jin J. Vitamin D and calcium supplements for preventing fractures. JAMA.2018;319:1630.
15. Matyjaszek-Matuszek B et al. Clinical implications of vitamin D deficiency. Meno Rev/Przegląd Menopauzalny. 2015;14(2):75-81.
16. Dyall SC. Long-chain omega-3 fatty acids and the brain: a review of the independent and shared effects of EPA, DPA and DHA. Front in aging neurosci. 2015;7(52).

By Monazza Ahmad, B.Pharm, MSc

One of the symptoms of menopause that women wish had a permanent cure is hot flashes! The most uncomfortable and rather embarrassing aspect of hot flashes is that they visit unexpectedly. It doesn’t matter if you’re in a work meeting with executives, teaching to kindergarteners, at an intimate dinner, or just by yourself, there is no time and place for its occurrence.1
The sudden attack of heat and an outburst of sweating is enough to make anyone nervous. Prescription treatment options are usually costly and not suitable for some health conditions,2,3 leaving many women with no choice but to ignore it despite the distressful effect hot flashes have on their quality of life.4,5

But don’t be disappointed. In this post, you will find various natural ways and nonhormonal options to find relief from hot flashes until they disappear after completing their course. The severity and duration vary from woman to woman, so let the treatment take its time.5
Let’s understand what’s going on behind the scenes with hot flashes so we can mitigate the chaos it creates based on our body’s bioindividual needs.

How do I know it’s a hot flash?
During a hot flash, there is a sudden burst of heat from chest up that may result in red blotches on your skin and uncontrollable sweat. The untimely sweating, flushing, heat, and chills a few times a week or several times in a day is normal during menopause but definitely frustrating.

A single episode of hot flashes can last anywhere from one to five minutes and up to an hour. The hot flashes range anywhere from 1 to 10 daily with the duration from a few years to a couple of decades.5

What’s causing this gush of sweat?
Research suggests that hot flashes are a possible result of hypothalamus activity in regulating body’s temperature due to estrogen fluctuation.
Here’s what that means: Reduced estrogen levels can cause blood vessels near the skin to dilate, increasing the blood flow that elevates body temperature. This increase in temperature triggers hypothalamus (your body’s thermostat) to detect warmth so it starts to cool down the body by a process called sweating.4,5

We all know that sweat is an important mechanism of temperature control in the body. It helps dissipate body heat by turning heat vapors into liquid (sweat) to keep the body cool. So you really don’t want to stop a hot flash, since it’s protecting our bodies from getting overheated. What is needed is hormone regulation so the hot flashes are less severe.

How to squash hot flashes
While hot flashes subside on their own and may not require treatment, those experiencing severe effects may want to seek safe relief options. Here are some lifestyle improvements and natural remedies that might be helpful in tackling hot flashes safely.
Make sure to consult with your healthcare practitioner before taking any action; they will advise you on the best options and the right dosage for your specific health needs.

NUTRITIONAL SUPPORT

Vitamin D: Reduced levels of vitamin D are associated with many health conditions, including hot flashes. Try getting at least 15 minutes of sun every day and eat vitamin D-rich foods.6,7

Vitamin E and curcumin: Both these supplements have shown to reduce the severity and number of hot flashes. The dose of 200 to 400 IU for vitamin E and 500 mg for curcumin is found to be effective.8,9 Give at least four weeks to curcumin and up to eight weeks to vitamin E to work.3

Folic acid: About 1 mg of folic acid, a form of vitamin B, has shown weekly gradual improvement in severity. It may take about 3-4 weeks to reduce frequency and the duration of hot flashes.10

Vitamin B6 and oily fish: The impact of this vitamin on brain health, immune system, nerve function, and the breakdown of macronutrients explains its positive effect on vasomotor symptoms of menopause.11,12 To avoid pills, taking this vitamin in the form of oily fish has shown great results, too.13

ALTERNATIVE APPROACHES

Plant-derived solutions: Black cohosh,14,15 phytoestrogens, and some other herbs are commonly used for hot-flashes relief.16 Read more about these options on our blog: “Consider Using Plant-Derived Solutions to Treat Menopausal Symptoms.”

ERr 731®:* An extract of Siberian rhubarb, is the nonhormonal and generally safe solution16 to have shown significant improvements in all 11 major menopausal symptoms.17* It also has a high recommendation rate not only from providers but also from women who use it.

Acupuncture: This form of complementary therapy, in addition to usual care, has shown marked improvement in hot flashes and other menopausal symptoms. Acupuncture is commonly used for stress management, pain relief, and overall wellness with neurological stimulation.3,18,19

LIFESTYLE FACTORS

Resistance training: Lifting safe weights and isometric and plyometric exercises helps reduce hot flashes. In a study of menopausal women, hot flashes reduced by more than 40% in less than four months in women who performed these exercises regularly for at least three times per week. Active women experience less severe symptoms than inactive women.20,21

Eating: Food intake at regular intervals can reduce hot-flash frequency. So have a healthy snack between meals to avoid letting your blood glucose levels fall too low.22

Diet: A low-fat, plant-based diet including half cup of cooked soybeans 3-4 times daily along with TLC diet can significantly reduce the frequency and severity of hot flashes and other menopausal symptoms.23,24

Stress management: Anxiety and stress are the common triggers for many health conditions. Stress reduction techniques such as meditation, yoga, deep breathing, and resting can all help with hot flashes.25

Also of vital importance: Avoiding alcohol, smoking, spicy food, caffeine, and sugar, along with physical exertion and managing weight all contribute toward reducing the severity of hot flashes.26,27

Menopause and its symptoms are unavoidable, but you can definitely take these steps to minimize the discomfort and enjoy your daily activities.

A piece of advice for younger women and those who haven’t reached menopause yet: Start taking care of your body early on in life. Eat healthy food and do regular physical activity to keep your hormones regulated. So when menopause hits, your body will be prepared to handle the ups and downs of aging and can recover faster. 

References:
1. Mayo Clinic. Hot flashes: symptoms & causes. https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790. Accessed February 14, 2023.
2. Rosenberg V et al. Hormone-replacement therapy and its association with breast cancer subtypes: a large retrospective cohort study. Int. J Womens Health. 2021;1:1207-1216.
3. Mayo Clinic. Hot flashes: diagnosis & treatment. https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795. Accessed February 14, 2023.
4. Bansal R et al. Menopausal hot flashes: a concise review. J Midlife Health. 2019;10(1):6-13.
5. Freedman RR. Menopausal hot flashes: mechanisms, endocrinology, treatment. J Steroid Biochem Mol Biol. 2014;142:115-120.
6. Arslanca T et al. The relationship between vitamin D and vasomotor symptoms during the postmenopausal period. Clin Lab. 2020;66(7).
7. Religi A et al. Estimation of exposure durations for vitamin D production and sunburn risk in Switzerland. J Expo Sci Environ Epidemiol. 2019;29(6):742-752.
8. Ataei-Almanghadim K et al. The effect of oral capsule of curcumin and vitamin E on the hot flashes and anxiety in postmenopausal women: a triple blind randomised controlled trial. Complement Ther Med. 2020;48:102267.
9. Ziaei S et al. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Invest. 2007;64(4):204-207.
10. Bani S et al. The effect of folic acid on menopausal hot flashes: a randomized clinical trial. J Caring Sci. 2013;2(2):131-140.
11. Harvard T.H. Chan School of Public Health. Vitamin B6. https://www.hsph.harvard.edu/nutritionsource/vitamin-b6. Accessed February 14, 2023.
12. National Institutes of Health. Vitamin B6 fact sheet for consumers. https://ods.od.nih.gov/factsheets/VitaminB6-Consumer. Accessed February 14, 2023.
13. Odai T et al. Severity of hot flushes is inversely associated with dietary intake of vitamin B6 and oily fish. Climacteric. 2019;22(6):617-621.
14. National Institutes of Health. Black cohosh. https://www.nccih.nih.gov/health/black-cohosh. Accessed February 14, 2023.
15. Geller SE et al. Botanical and dietary supplements for menopausal symptoms: what works, what does not. J Womens Health (Larchmt). 2005;14(7):6340649.
16. Chang JL et al. Rheum rhaponticum extract (ERr 731): postmarketing data on safety surveillance and consumer complaints. Integr Med (Encinitas). 2016;15(3):34-39.
17. Kaszkin-Bettag M et al. Confirmation of the efficacy of ERr 731 in perimenopausal women with menopausal symptoms. Altern Ther Health Med. 2009;15(1):24-34.
18. Kim KH et al. Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women–a multicenter randomized clinical trial. Menopause. 2010;17(2):269-280.
19. Mayo Clinic. Acupuncture. https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763. Accessed February 14, 2023.
20. Berin E et al. Resistance training for hot flushes in postmenopausal women: A randomised controlled trial. Maturitas. 2019;126:55-60.
21. Dabrowska-Galas M et al. High physical activity level may reduce menopausal symptoms. Medicina (Kaunas). 2019;55(8):466.
22. Dormire S et al. The effect of dietary intake on hot flashes in menopausal women. J Obstet Gynecol Neonatal Nurs. 2007;36(3):255–262.
23. Barnard ND et al. The Women’s Study for the Alleviation of Vasomotor Symptoms (WAVS): a randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women. Menopause. 2021;28(10):1150-1156.
24. Welty FK et al. The association between soy nut consumption and decreased menopausal symptoms. J Womens Health (Larchmt). 2007;16(3):361-369.
25. Freeman EW et al. Anxiety as a risk factor for menopausal hot flashes: evidence from the Penn ovarian aging cohort. Menopause. 2016;23(9):942–949. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993654/
26. NIH. Hot flashes: what can I do? https://www.nia.nih.gov/health/hot-flashes-what-can-i-do. Accessed February 14, 2023.
27. Herber-Gast GCM et al. Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study. Am J Clin Nutr. 2013;97(5):1092-1099.

You’ve probably heard that vitamin C supports your immune system. This essential micronutrient seems to be everywhere! And it’s a good thing because, unlike most mammals, humans can’t synthesize vitamin C on their own.1 Also, vitamin C is water-soluble, which means the body quickly loses this essential vitamin through urine, so it’s important to make vitamin C a daily part of your diet.1
Having extremely low levels of vitamin C for prolonged periods can result in scurvy, a historical disease linked to pirates and sailors who faced long journeys at sea without fresh fruits and vegetables. While cases of scurvy in the United States are rare, a recent study reported that 31% of the US population are not meeting the daily recommended intake of vitamin C.1 Greater than 6% of the US population are severely vitamin C deficient, while low levels of vitamin C, associated with weakness and fatigue, were observed in 16% of Americans.2 As a whole, 20% of the US population showed marginally low levels of this essential micronutrient.2
How much vitamin C do I need?The US recommended daily dietary allowance of vitamin C is 75 mg for women and 90 mg for men.3 Experts recommend an estimated 200 mg of vitamin C daily for favorable health benefits.4 Adults can take up to 2,000 mg of vitamin C per day; however, high doses of vitamin C may cause diarrhea, nausea, and stomach cramps.5 Due to the varying health needs of individuals, it’s always a good idea to work with your healthcare practitioner to ensure that you are getting the right amounts of micronutrients in your daily diet.
Where can you find this marvelous, multifaceted micronutrient?