The importance of prebiotics and fermented foods cannot be overstated when it comes to supporting your vaginal microflora and reproductive health. Your bowels affect not only your microbial communities, but your hormone levels.

You can swallow as many of the highest-quality probiotics you can afford but if the bacteria don’t have anything to eat, it is a waste of money. You just poop them straight out, dead. Soluble fibre makes an ideal food source, and is called a prebiotic.

The simple and obvious answer is to make sure you are getting enough fibre, particularly inulin-containing foods. You should be getting 25-30 grams (0.85-1.0 ounces) of fibre per day, and to figure this completely and utterly boring sum out, you can find fibre information on or other websites that have food information broken down into nutrient categories. There are many to choose from, and none is better than the other – find one you like and bookmark it until you understand what you are doing.

Inulin, although often too strong by itself, is good as part of a meal and can be bought as a supplement. Other sources are bananas, Jerusalem artichokes and wheat. Look online for more options if these don’t suit. If you have IBS caused by FODMAPs, avoid inulin. It is a FODMAP. If you have ongoing digestive issues, you may be FODMAP intolerant – onion, garlic, beans, milk, etc. are your key clues. If they upset you, check out the low-FODMAP diet from Australia’s Monash University.

Here are good sources of 6 grams (0.2 ounces) of inulin
  • Garlic 6 cloves
  • Onion 1 onion
  • Asparagus 9 spears
  • Leek 1.2 cups

But what about probiotic capsules?

Shop-bought probiotics can get very expensive, and nobody wants to keep taking them forever. The point of this entire exercise is to increase your friendly bacteria count in as many cheap and effective ways as possible, ongoing, so you never have to spend money on probiotics made in a lab when you can just eat them. Food is simply a far better source of probiotics than any pill, unless of course you need specific strains for other purposes. Probiotics are great, but they had to be invented because our food supply is dead.

The importance of ferments

You can keep your bacterial count up using daily kefir and other fermented foods.

Fermenting a food involves the chemical breakdown of a substance by microbes, usually bacteria and/or beneficial yeasts. Fermentation is a good way to preserve foods, but is less common since the invention of the refrigerator. Americans can’t even find live yoghurt. This means making foods yourself (or finding someone else who does) is going to probably be the only way you can get live foods in.

Many of these foods will be completely foreign to you, which is an opportunity to try something new. If you have a good source of alive, organic ferments near you, and can afford them, by all means use those. No point making life harder than it needs to be, though it is true that fermenting your own foods and drinks is really fun and can be very satisfying for those who are so inclined.

Proper fermentation is an art form that has gone out of fashion somewhat because we have mass-produced food supplies: in real fermentation, if you leave the lid on for too long, it will burst off as the pressure of the gas produced by the bacteria fermenting (feeding and breeding) becomes too great. This isn’t allowed to happen on a supermarket shelf for obvious reasons. Supermarket products are pasteurised to stop them all exploding. One of the issues with fermented foods is that they can vary wildly in their actual microbe count and it is very difficult to measure without a laboratory test. It depends on the raw materials used (vegetable, milk, etc.), freshness, temperature, starter culture and other critical aspects. This shouldn’t deter you though.

For vaginas, milk kefir, unless you have a dairy issue, is going to be your first port of call. The part of fermentation that gives these foods their characteristic tang is the production of lactic acid by lactobacilli. The beauty of these foods is that they contain a huge variety of microbes, not just a couple of Lactobacillus strains like a probiotic does. Store-bought milk kefir is made in a vat, and only contains a few strains of bacteria that remain constant, so home-fermenting is far superior. You get the wild cards.

Vegetables contain microbes found in the ground which you won’t find in fermented dairy products, adding another element to your microbe diet. Variety is excellent, and even if a microbe simply passes through from one end to the other of your digestive tract, it eats and wages war as it goes, so isn’t wasted. Others cling to the walls, and colonise certain areas of your digestive tract. This part is massively complex, so don’t get too tied up in it – as previously mentioned, researchers still don’t understand the human gut biome very well at all.

To get plenty of microbes, you could have your daily milk kefir shots, yoghurt for breakfast, sauerkraut with lunch, and tempeh for dinner, all washed down with water kefir. Think of all the good germs in your day then! The greatest anti-BV diet there ever was. Fermented food is also already a ‘bit digested’ so it makes your system work far less than if you ate the raw version, with some vitamins actually being released or created as a by-product of fermentation including vitamin C and Bs. Interestingly, fermented cabbage (sauerkraut) has 20 times more vitamin C than raw cabbage – the C in raw cabbage is bound by the plant fibres, making it much harder for our digestive system to extract whole.

Doesn’t stomach acid kill the good bacteria?

There have been valid queries regarding the ability of Lactobacillus to make it through stomach acid into the intestinal tract. Fortunately, Lactobacillus are acid-loving bacteria, and they easily survive stomach acid and pass through to the intestines. Other acid-loving bacteria that aren’t so great are the likes of E. coli, which as you may already know, is a dreaded intestinal microbe that causes food poisoning.

Stomach acid is an effective weapon against most microbes entering our digestive tract, however, and by an incredible stroke of biological genius, the good bacteria get through and almost all the bad bacteria die.

Pure stomach acid, however, will kill your probiotics, so take probiotics with food after or during as you wish) to buffer the stomach acid somewhat. Avoid probiotics on an empty stomach.

How to find ‘alive’ fermented foods

You will find real fermented food containing live bacteria difficult, if not impossible, to find in supermarkets, so check out your local markets, the old lady that lives down the road, or online suppliers that offer starter kits to make your own. Fancy health food stores also often have a local supplier, so ask around.

You need to make sure that the food is fermented and still ‘alive’ as opposed to simply pickled in vinegar or pasteurised (heated to a high temperature to kill all the bacteria to avoid explosions and infections). Look for things like ‘traditionally fermented’ and ‘containing live probiotics’ on labels, and don’t be shy to ask the shopkeeper or contact suppliers. They will know the answers to your questions and always provide a phone number you can contact them on the label.

Don’t be afraid to ask suppliers. It’s important.

All of these foods have so many health benefits you could write several books on each, however all we are interested in at this point are the microbes. Some of these foods you won’t like at all, but try them out in different ways. Following are some (arguably) tasty fermented foods that you can start adding to your diet immediately.

Although the worst of it should be over after the milk kefir, adding in further friendly microbes to your gut flora could cause gaseous wind storms to flare up. They will pass unless you are legitimately intolerant, keeping in mind that your body may need an adjustment period to start greater production of certain enzymes – give it a chance of a few weeks. If it doesn’t improve, try something else.

Check out recipes online for these foods, because they can be eaten in a plethora of ways to suit your palate. Keep in mind that heating fermented foods to high temperatures kills the germs, so cooking with these foods should be avoided. Do not microwave them. You will find these fermented foods in the fridge, since the bacteria goes dormant when cooled, coming back to life when heated, including inside your warm body. This means these bacteria can tolerate some gentle warming.


Sauerkraut is finely chopped cabbage plus salt fermented with Lactobacillus. The Germans love it on their sausages, pork and other meats, and you can layer it on just about anything you like including sandwiches and vegetables. It is a tangy favourite straight out of the jar with a fork.


Miso is a traditional fermented food made from soy and grains. It is a paste, and is most often seen in miso soup offered with your bento box wherever you get your sushi. You can cheaply buy miso at your local Asian grocer and make your own soups with it, but don’t stop there. You can make thousands of dishes and sauces with miso – the internet is full of great recipes. Go nuts, but remember to make sure it is alive when you buy it! You will probably kill the bacteria by boiling in soups, so add afterwards or use in different ways.


Tempeh is originally from Indonesia, and is made from soybeans. It is a good source of protein, particularly for vegetarians and vegans, because it uses the whole bean. Tempeh, like tofu, tends to take on the flavours of whatever you cook it with which makes your options endless. Recipes abound. Edible raw.


Kimchi is Korea’s national dish, and is a side of fermented vegetables in seasoning. There are a great many varieties of kimchi, and a lot of dishes contain kimchi such as pancakes, soups and fried rice.


Yoghurt is an average source of probiotics, but you must find a brand that takes care to ensure as many live bacteria as possible make it to your mouth. Alternatively, you can buy DIY yoghurt makers and buy the dried powder, and ferment overnight just like milk kefir. Easy-Yo is one brand, but there are many. Search for home yoghurt makers.


Kombucha is available in some health food store fridges and you can grow your own SCOBY (which is like the home base for the bacteria) from one bottle bought at the shop.

Water Kefir Grains

Water kefir grains are very similar to milk kefir grains, and are available online and make a delicious fizzy drink when made with fruits.


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