Community Conversation > Post operative life

Vaginal microbiome and odour

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_cassie_:
hi everyone!

i wondered what people's experiences were with vaginal odour post grs, and whether people did anything to encourage an appropriate vaginal microbiome?

i had grs three months ago with James Bellringer - some unpleasant complications afterwards but everything seems to be healing well now, and i don't think there's any reason to think anything is wrong. but I'm a little bothered by the smell! it's mildly unpleasant - in a slightly sulfurous/sweaty/bad breath kind of way - and just doesn't smell like a vagina. and this is with dilating and therefore douching three times per day. i brought this up in my final consult with JB and his answer was just, well neovaginas are made of different tissue to cis vaginas so can't be expected to have the same microbiome or smell the same. which is trivially true but not helpful ;)

i had a look and came across a paper, in summary, no-one knows what a "healthy" neovaginal microbiome should look like, but if you compare samples from cis and trans women's vaginas, they don't resemble each other. samples from trans women were highly variable, not dominated by lactobacillus (the main healthy culture in cis vaginas), some resemblance to vaginal bacteriosis in cis women, some to penile microbiomes, some just idiosyncrasy. this basically makes sense - it's normal skin, not mucosal tissue, so not the same ph and not friendly to the same bacteria.

so my questions are -

* is there other research anyone knows of?
* have others done anything to reset their microbiome e.g. using a (gentle!) antibacterial product when douching? obviously this is highly advised against for cis vaginal care, but for the same reasons that cis women are advised not to douche at all - messes up naturally generated ph balance, mucosal tissue is self-cleaning anyway, products can make their way further up into the reproductive system - none of which apply to us
* do others do anything to encourage low ph, e.g. using a mildly acidic solution when douching?
* has anyone tried introducing bacterial cultures that more resemble those of a healthy cis vagina, e.g. using vaginal probiotic suppositories? i guess you'd also have to be taking regular steps to maintain a good environment / ph balance to expect this to have any effect long-term
* what have other people's experiences been with smell post grs, and what affects it?
thanks very much in advance for any thoughts you can offer! 😊

_cassie_:
(...these questions apply to penile inversion technique - obviously for sigmoid technique, or any other approach that uses tissue that creates mucus, the situation would be completely different!)

Devlyn:
Hi Cassie, welcome to Susan's Place! My wife went to Bellringer, too. I've spent a bit of time at the Putney office. At three months you might still be sloughing off skin particles or internal stitches. Of course, Dr Bellringer is always available for post op care if you are concerned with your progress.

Here is our welcome pamphlet to get you off to a good start. See you around the site!

Hugs, Devlyn

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Oldandcreaky:
Cassie, based upon the nomenclature you're using, I'm assuming you know more than me. However, the thing that struck me was the frequency of your douching. I had my surgery 35 years ago and I never douche. There's this:

"Douching can cause an overgrowth of harmful bacteria. This can lead to a yeast infection or bacterial vaginosis."

My vagina has an earthy smell. I don't mind it. I don't think there's a standard smell, but I have observed in some public bathrooms that a congregation of women with their knickers down can scent the air and it ain't perfume.

_cassie_:
Thank you both for your replies! And thanks Devlyn for the welcome info 😊

Devlyn, good point that three months is very early still and things won't yet be settled - I'm certainly not worried at this point, just interested and thinking really!

Oldandcreaky, out of interest, does the quote come from something intended for trans women or something more general? But yes, I'm sure you're right, three times a day is a lot - it's what I've been told to do in the literature from JB at the hospital, but I assume at some point it will be sensible to go down to a lower frequency... At the moment I'm just doing it every time I dilate, but I'm hoping to go down to dilating twice a day soon.

And indeed, good advice not to aim for no smell - bodies smell and that's fine! :)

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