Bacterial vaginosis (BV). Not exactly the kind of thing you chat about over brunch, but if you’ve ever had it, you know how frustrating it can be. That tell-tale fishy odour, weird discharge, and general discomfort—urgh. And while BV is common, there’s still a lot of mystery around why some women get it repeatedly while others breeze through life blissfully unaware of the culprit- Gardnerella bacteria – that exists within their natural vaginal microbiome.

What’s even more interesting? Emerging research suggests that diet and metabolic factors—like insulin resistance—might be playing a sneaky role in BV. So, if you’re someone who regularly battles with BV, your diet and blood sugar levels might be worth a second look. Let’s dive in!

The Link Between BV & Diet: What You Eat Matters

We all know that what we eat affects everything from our skin to our gut, but did you know it can impact your vaginal microbiome too? A balanced vaginal environment thrives when Lactobacillus (the good bacteria) is in charge. This creates a low or acidic pH. But when the balance tips and harmful bacteria take over, boom—BV strikes.

So, how does diet come into play? Here are some key findings:

• High-Fat Diets & BV – Research suggests that diets high in fat, particularly unhealthy fats, may increase the risk of BV. Basically, living off takeaways and ultra-processed snacks could be tipping your vaginal flora out of whack.
• Glycaemic Load & BV – Eating a lot of refined carbs (think white bread, cakes, sugary drinks) can spike blood sugar levels, which may be linked to a higher risk of BV. Keeping blood sugar stable with protein and fibre-based whole foods and complex carbs might help keep BV at bay.
• Micronutrients Matter – Low levels of folate (found in leafy green veg, citrus, beans and avocados) vitamin A, vitamin E, and calcium (high levels in dairy and red meat) have been linked to more severe cases of BV. So, getting your five-a-day isn’t just good for your skin and overall health—it might be a game-changer for your vaginal health too!
• Fibre Is Your Friend – A fibre-rich diet can promote good bacteria in both your gut and vagina. So, if your diet is a little light on fruit, veg, and safe carbs like sweet potatoes, potatoes and brown rice, you might want to rethink that.

Insulin Resistance & BV: The Blood Sugar Connection

Insulin resistance is when your body struggles to regulate blood sugar properly, often linked to conditions like PCOS and type 2 diabetes. It is NOT the same as prediabetes or diabetes though. It’s more like pre-pre-diabetes! We can’t detect insulin resistance with blood sugar testing alone, but doing a blood glucose challenge can often reveal borderline and predictive changes. But what does that have to do with BV? Well, quite a bit, actually.

• Diabetes & BV – Women with diabetes are more prone to BV and other vaginal infections. Blood sugar imbalances can weaken the immune system and alter vaginal pH, making it easier for bad bacteria to take over.
• PCOS & BV – PCOS (polycystic ovary syndrome) often goes hand-in-hand with insulin resistance. Research suggests that women with PCOS may experience more vaginal microbiome disruptions, potentially making them more susceptible to BV.

Essentially, if your blood sugar levels are all over the place, your vaginal health might be suffering too.

What Can You Do to Support Vaginal Health?

If you’re dealing with BV more often than you’d like, tweaking your diet and lifestyle might help keep things in check. Here are some tips:

• Cut Back on Sugar & Processed Foods – A lower glycemic diet (fewer refined carbs- that’s pasta, bread, anything made from dough/pastry, cereal, cereal bars, snack foods – and more whole foods) will help balance blood sugar, reduce or reverse background insuline resistance and support vaginal health.
• Eat More Fibre – Load up on fruit, veg, potatoes, beans and legumes to promote good gut (and vaginal) bacteria.
• Boost Your Micronutrients – Make sure you’re getting enough folate, vitamin A, vitamin E, and calcium from food or supplements.
• Stay Hydrated – Water is key for overall health, including keeping your vaginal environment happy.
• Manage Insulin Resistance – If you have PCOS or struggle with blood sugar issues, speak to your GP, or book an appointment with me, about managing insulin resistance through diet, exercise, or medication like metformin if needed.

The Bottom Line

While BV can be an annoying and persistent issue, there’s growing evidence that diet and metabolic health might play a bigger role than we previously thought. So, if BV keeps making an unwelcome return, looking beyond antibiotic treatments and considering lifestyle changes might be worth a shot. At the very least, your body (and your vagina) will thank you for the extra TLC!

Have you noticed any links between your diet and BV? Let’s chat in the comments!