It is very common for women in their reproductive years to experience vaginal irritation, infections and pain. Some common conditions that can be at the root of the problem include:

Vaginal Imbalance (Dysbiois), Recurrent Infections: In a healthy vagina, an acidic environment provides natural protection against infection. Disruption in the vaginal environment leads to an overgrowth of "bad" bacteria, causing dysbiosis, vaginal irritation and Bacterial Vaginosis. Symptoms include itching, burning and odorous discharge. 30% of women suffer from chronic Bacterial Vaginosis, and 75% experience at least one yeast or bacterial infection in their lifetime, with a higher likelihood of recurrence after use of antibiotics. Hormonal shifts, unprotected sex, antidepressants, soaps, and long-term use of hormonal contraceptives contribute to vaginal imbalance and dysbiosis.

Low Fertility: A balanced mildly acidic vaginal ecosystem pH (3.5-4.5) helps maintain the quality of cervical mucus essential for sperm transport, providing nutrients for sperm survival and aiding mobility while preventing inflammation and lowering the risk of premature births. Maintaining a balanced vaginal environment boosts fertility and supports a healthy pregnanacy.

Postpartum vaginal pain:  90% postpartum women experience vaginal pain and irritation:

• Pelvic muscle trauma: Pelvic floor muscles elongate during pregnancy and with vaginal delivery, leading to overextension in 30% of women who require postpartum pelvic floor strengthening and tightening. Difficult or prolonged vaginal deliveries can also result in involuntary pelvic floor spasms, incontinence, and leaks.
• Vaginal tears and scarring: Vaginal tears and scarring are common post-delivery issues. Tears to the perineum and vaginal wall may occur during vaginal birth, and an episiotomy might be necessary. Scar tissue can form at the vaginal opening from tears or stitches, causing discomfort, tightness, and painful sex.
• Vaginal irritation during breastfeeding: Low estrogen during breastfeeding facilitates lactation but affects vaginal health. The vagina becomes less acidic, dry, and more prone to infections, such as bacterial and yeast infections. Vaginal atrophy is also common, contributing to painful sex.

Endometriosis: Endometriosis, a chronic condition where endometrial tissue migrates outside the uterus, can cause vaginal pain during menstrual cycles due to shifts in estrogen levels. Treatments to control estrogen and prevent tissue flare-ups, such as hormonal therapies, may lead to vaginal dryness and painful sex. Effective management of endometriosis involves balancing symptom relief and minimising treatment-related side effects, including addressing vaginal discomfort.

Perimenopause: Perimenopause is the transition to menopause when the ovaries begin to slow down, typically in a woman's late 40s. During this phase, irregular periods, hot flashes, vaginal dryness, sleep issues, mood swings, and decreased libido are common due to shifting hormone levels and decreasing estrogen. This phase can last months to years, eventually leading to menopause, marked by the absence of menstrual periods. Managing vaginal symptoms and maintaining overall sexual health is crucial during perimenopause.