African researchers reveal how viral 'vaginal wellness' products are causing more harm than good
An African-led research project is exposing dangerous myths about vaginal health whilst developing life-changing treatments for millions of women.
What you need to know:
- Scientists from Kemri and University of Cape Town warn women against inserting garlic or using apple cider vinegar for vaginal douching.
- Their Kisumu research has collected over 700 bacterial samples to develop African-led probiotic treatments for the condition that recurs in more than half of treated women.
In the age of social media health trends, a dangerous practice is quietly spreading across women's communities worldwide. From inserting garlic cloves to douching with apple cider vinegar, millions of women are unknowingly putting their health at risk in pursuit of better vaginal hygiene.
Now, a team of leading scientists from the Kenya Medical Research Institute (Kemri) and the University of Cape Town are sounding the alarm, armed with compelling research that challenges everything we thought we knew about vaginal health.
The self-cleaning myth busters
"The vagina is a self-cleansing organ," explains Dr Serah Gitome from Kemri, the lead co-author of a study currently underway in Kisumu County. Her research, conducted through the Vagina Microbiome Research Consortium for Africa (VMRC4A), is investigating how vaginal microbes—both helpful and harmful—shift following treatment for bacterial vaginosis (BV).
The scientists are particularly concerned about the proliferation of so-called 'vagina scented products' being hawked on social media, including yoni pearls, which they have found to be increasingly upsetting vaginal pH and intensifying the spread of bacterial vaginosis.
Vaginal douching—washing or cleansing the inside of the vagina with a liquid solution often for personal hygiene or aesthetic reasons—is particularly problematic. "This is very wrong," Dr Gitome emphasises. "Not even scented sprays should end up inside the vagina."
The delicate balance
To understand why these practices are so harmful, one must first appreciate the complexity of vaginal health. A vaginal pH test, which can be conducted at home or in a clinic, measures the acidity level of the vaginal environment. The pH scale ranges from zero to 14, with seven being neutral. A vaginal pH of 4.5 or higher signals bacterial vaginosis.
"The vagina has its own natural community of bacteria that make up the vaginal ecosystem—or scientifically, the vaginal microbiome," Dr Gitome explains. "When in balance, this ecosystem is dominated by 'good' bacteria like Lactobacillus, which help maintain a healthy pH and prevent harmful bacteria from taking over."
When this balance is disturbed—whether by infections, hygiene habits, or hormonal changes—harmful bacteria can multiply, leading to BV, a condition that causes unusual discharge, odour, itching, or burning.
More than just discomfort
The implications of bacterial vaginosis extend far beyond immediate discomfort. "BV also increases the risk of sexually transmitted infections, poor pregnancy outcomes, and even sub-fertility," Dr Gitome warns.
The condition is surprisingly common, with higher BV risk observed in women who have sex with fellow women compared to women who have sex with men.
"The risk of getting BV increases when having sexual contact with new partners, and from not using condoms correctly and consistently," she adds.
Although BV occurs globally, it is more prevalent in low-resource settings and areas with limited access to healthcare—precisely why the research team, which includes Prof Jo-Ann Passmore, Prof Elizabeth Bukusi, and Dr Katherine Gill, has focused their efforts on Kisumu.
Dr Godfrey Mutakha, a consultant obstetrician-gynaecologist and chair of the department of obstetrics and gynaecology at Masinde Muliro University, provides additional clinical insight into the condition.
"BV is not classified as a sexually transmitted infection. However, sexual activity can influence its development," he explains. "Unlike a typical yeast infection, which is often caused by an overgrowth of Candida, BV stems from a disruption in the normal flora, leading to an increase in certain types of bacteria and a decrease in others."
The symptoms can vary but often include thin, greyish-white vaginal discharge with a distinct fishy odour, particularly after sexual intercourse. Some women may also experience itching or irritation in the vaginal area.
"Diagnosing BV typically involves a pelvic examination and laboratory tests, including a microscopic examination of the vaginal discharge," Dr Mutakha notes. "By recognising the symptoms and seeking appropriate medical advice, women can take proactive steps towards treatment and recovery."
The VMRC4A team's work represents a paradigm shift in vaginal health research. One of their major goals is to build an African-led vaginal microbiome biorepository—a valuable resource for developing new vaginal probiotics, known as live biotherapeutic products, to treat BV and prevent its recurrence.
"These products aim to harness the beneficial effects of Lactobacillus species found in women with consistently healthy vaginal microbiota," Dr Gitome explains.
The progress has been remarkable. In the last three years, VMRC4A researchers have collected hundreds of vaginal samples and achieved significant milestones: 704 bacterial isolates identified, 127 bacterial genomes sequenced, and 71 bacterial species characterised.
The menstruation connection
Building on this foundation, VMRC4A has launched the Menstruation and Menstrual Hygiene Management (MMHM) Study. This research will follow 100 women—50 in Kenya and 50 in South Africa—over 10 weeks, closely monitoring how menstrual cycles, hygiene products, and dietary habits influence the bacteria and immune responses in the vagina.
By collecting simple samples such as vaginal swabs and cervicovaginal fluid using soft cups, the team hopes to identify early signs—whether microbial or immune—that predict who is more likely to maintain a healthy vaginal environment versus those at risk for BV.
"Menstruation is one of the key factors that naturally alters the vaginal environment, including its pH and hormone levels," the researchers observe. "Whilst menstrual products and hygiene practices are essential for comfort and cleanliness, they may also impact the vaginal microbiome in ways we're just beginning to understand."
Why Kisumu?
The choice of Kisumu County as a research focus is strategic. "BV is associated with an increased risk of HIV acquisition and higher levels of HIV in the genital tract of women with HIV," Dr Gitome explains.
"BV on its own is a highly recurrent problem, and we are seeing it recur in more than half of the women treated. It predisposes women to HIV risk, which is why it is important to look at Kisumu, which has a high HIV prevalence."
This connection underscores the importance of maintaining good vaginal hygiene, using barrier methods like condoms, and getting regular STI screenings to help reduce the risk of both BV and HIV.
For women who test positive for BV, treatment typically involves Metronidazole (Flagyl, Metrogel-Vaginal, among others), which are antibiotics available as pills or topical gels. The oral form is usually taken twice daily for seven days, whilst the gel is typically used once daily for five days.
However, Dr Mutakha cautions that whilst antibiotics are effective in treating BV, women must complete the full course as prescribed, even if symptoms resolve before finishing the medication. "This helps prevent the infection from returning and reduces the risk of developing antibiotic resistance."
The research team is also examining antimicrobial resistance (AMR) to determine which antibiotics remain effective.
"So far, Flagyl is working fine as we examine things like inflammation changes and drug levels in the urine after we administer it," Dr Gitome notes.
Surprisingly, the team has also discovered that most women examined in Kisumu had chlamydia during STI screening, leading to additional treatment protocols.
Psychological toll
Perhaps most significantly, the research is highlighting the often-overlooked psychological impact of BV. Dr Mutakha warns that the long-term health implications of untreated bacterial vaginosis extend far beyond immediate discomfort.
Persistent BV may contribute to pelvic inflammatory disease (PID), which can lead to chronic pelvic pain and ectopic pregnancies. "Additionally, there is emerging research suggesting a possible link between BV and an increased risk of certain gynaecological cancers," he reveals.
The psychological impact, however, should not be underestimated. "Women suffering from BV often experience feelings of embarrassment, anxiety, and diminished self-esteem due to the foul odour, which they still produce even after taking a shower," Dr Mutakha explains.
"This can affect interpersonal relationships and sexual health, leading to avoidance of intimacy and social interactions. The chronic nature of recurrent BV can lead to frustration and hopelessness, further exacerbating mental health concerns."
The ultimate goal of this ground-breaking research extends far beyond treating individual cases. "We want to build smarter, earlier, and more effective interventions that support women's health in Africa and beyond," Dr Gitome states.
The findings reveal that despite the high burden of BV, many women in Kenya and South Africa have stable, Lactobacillus-dominated microbiomes over a 10-week period. The samples from women aged 18-40 provide a strong foundation for isolating regionally-representative probiotic strains that could improve vaginal health for women worldwide.
