Dr. Jane Levesque [00:00:00]: Been struggling with infertility, like miscarriages or not being able to get pregnant. You should be getting a vaginal microbiome, but, like, everyone needs to get a gut microbiome done. There's so much value in that test, and obviously you need someone who's going to help you interpret that. I do that for all my patients. I do that in the fertility 101 group where I help clients under like, I help my members understand how to read the tests, and then obviously they can jump on office hours and we can take them through it. But there's so much value in running these tests. So you can stop spending endless amount of money on supplements and not seeing any results. We need to get very specific in terms of what will work for you, and I can't do that if I have no idea what's going on. Pregnancy is a natural process, so if it's not happening or if it's not sticking, something is missing. After having a family member go through infertility and experiencing a miscarriage myself, I realized how little support and education women have around infertility. I want to Change that. I'm Dr. Jane Levesque. I'm a naturopathic doctor and a natural fertility expert. Tune in every Tuesday at 9am for insightful case studies, expert interviews, and practical tips on how you can optimize fertility naturally. If you've been struggling with infertility, pregnancy loss, women's health issues, or you just want to be proactive and prepare yourself for the next big chapter in your life, this show is for you. All right, ladies, Today I want to help break down the vaginal microbiome test for you. So one of the members in the fertility 101 group, she came on a call and she had a vaginal microbiome test and she wanted some help interpreting. And as we went through the interpretation, I gave her steps to do in order to correct what we were finding. And then also some other tests that she needs to do in order to help us understand why she has the findings that she has, which I will share with you shortly. But then I thought, oh, my goodness, this information is so valuable and it's so helpful. So if you guys find this episode really helpful, please rate it. Please literally send me a message and let me know that this information is really helpful because I want to give you more specific advice, but I cannot give you specific advice without knowing what's going on for you. And this is something that I teach through all of my programs in the fertility one on one. Obviously, when you're working with me one on one. We are doing testing not because we want to just spend money on testing, but because it literally guides the treatment. And so before you go to do another IVF cycle, or you go for an IVF cycle, or even you take supplements or do a detox, parasite cleanse, I don't care. The next thing that you have lined up for yourself being marketed as, this is the thing that's going to help to support your fertility. Just know that there isn't a one thing. It's very individual for couples. And testing is what will allow you to see what your next right step is. And if you don't have testing, you are literally guessing and hoping that it works. There's always general things that we need to do, and I talk about those all the time. And that's improving your sleep, improving your food digestion, hydration levels, movement, and then stress management. When you have those pillars and you're working on those things, then the rest is going to be very personalized. And even with the pillars, there's personalization because don't get me wrong, if you are doing the best things that you can to sleep, but you still can't sleep, it's usually because there's an infection and maybe that's parasitic, maybe that's a herpes infection or something, or a toxin like a heavy metal that's preventing you from being able to sleep deeply. So once you've, quote, unquote, mastered the basics and you've already done the basics and they're not working, it's not that you're broken and sorry it didn't work for you, it's that you actually have to get more specific. And so with this patient, she comes on a call and I'm going to take you through the vaginal microbiome. So vaginal microbiome is something that I recommend to get for my patients who definitely have symptoms of bacterial vaginosis if there is any discharge that's questionable, itching, pain with intercourse, dryness, we def were like brown spotting. So for her, she didn't have huge signs of infection. She had two miscarriages back to back at around five weeks each. And then she started to get brown discharge during ovulation and then brown discharge after she finished her period. And it was like dark brown. So having brown discharge or brown spotting, even without the itching, the pain, the inflammation is a sign of infection. And so I'm so glad that she was like, yep, I'm just going to go ahead and get that tested. So we want to test that if you definitely have symptoms, but in reality, if you've had a failed IVF cycle, a failed IUI cycle, you don't have an explanation as to why you can't get pregnant. You should be looking at the vaginal microbiome. And for my patients who have been struggling for a long time and have diagnoses of endometriosis or PCOS or anything else, we're going as far as looking at an M. Analysis analysis where we're actually taking a biopsy of the endometrium, and we're looking to see the health of the endometrium, if there's any infections in there, because that is the environment where the baby will grow. And if there's hostile bacteria, it literally is a hostile environment for the fertilization to happen, let alone implantation, and then for that baby to be able to thrive and grow. And it will absolutely impact the quality of the egg. Because when have this infection that you might not be aware of because you don't have symptoms like discharge or painful periods, but your symptoms are that you cannot get pregnant. That is a symptom of an infection, whether it's in the vaginal microbiome or in the endometrium. But if you've been struggling for a long time, you need to be assessing. You need to be looking at these things instead of just doing another IVF cycle, because this is not something IVF can bypass. IVF cannot get rid of infection for you. And when they give you two or three days, maybe five days max of doxy or a Z throw right after they do the retrieval, that's not going to touch the infection if it's at the levels that I'm seeing it at. And you're going to need not just five days, you're going to need 10 days of antibiotics, and then you're going to need four, six, potentially eight weeks of antimicrobials. And then we need to be retesting. If you're feeling overwhelmed, the goal is not to overwhelm you, but to help you understand that what you're doing is just a drop in the ocean. And that's why you haven't had the results that you want. And so the hope with these podcast episodes and everything that I do with my patients and, you know, information that I share, is that it opens up your eyes to the fact that there is so much that we could be doing to preventing miscarriages, to supporting natural conception, to supporting IVF cycles, to supporting healthy pregnancies. And therefore healthy babies. And we're just not taught this information. We're just told that there's nothing we can do about it and it's bad luck. And when I have data like I'm going to share with you today, I'm like, it is not bad luck. This is just a raging infection. And we don't even know if it's high up in the endometrium because in the vaginal microbiome, if it's raging like that, chances are it's going up even higher. And no wonder you have all the symptoms that you have. And no wonder there is the body is not capable of carrying the pregnancy. There is always an explanation, ladies. And it just drives me nuts when doctors are like, nope, there is nothing that we can do. It's just bad luck. You should do another round of ivf. So today I'm going to break down the vaginal microbiome. But like I said, if you guys are finding this information helpful, literally send us a message, Rate this episode. So then I know I will make more of these episodes. I want to get this information out there. And it's not that you're going to need someone's help to treat this, but at least you'll become aware that, oh my God, this is what I need to be doing. And if we're the right people to help, then you can jump on a call book, the fertility clarity call and we'll see if what's the right next step for you. But the goal is that you become aware of how many more things you should be doing. So the first thing that came up on this vaginal microbiome is her vaginal PH was extremely high. It was 5.7. The ideal is 3.5 to 4.5. And honestly, I like to see it that 3.5 to 4 as we're starting to climb up higher. Usually it's an imbalance in the microbiome. She had basically no beneficial bacteria in the vaginal microbiome. Like none of the Lactobacillus, the Crispastis, the Gatseri, the gen side, the rimnosis, like none of them were in there. Like some not detected and some just very low numbers. And as soon as I see that, I know that there is opportunistic bacteria, there is a pathogen that's not allowing the good bugs to populate. And the good bugs, if you're really research based, the amount of research that we have on the beneficial bacteria and how they're associated with not just fertility outcomes, but pregnancy outcomes and like baby health and development and growth is huge. So Lactobacillus crispastus is really big. The Geisseri and the Janseni. There is of course, the Ineris as well. But Ineris is one of those where the research. We don't want to see too much of it. We want to see some, but we don't want to see too much of it. Lots of research showing that we need these beneficial bacteria to support fertility, to support implantation, to support fetal growth, and then to help with the baby's microbiome development as well. Not to mention all the symptoms of PMS and like painful periods, clotted periods, it's everything can basically be tied to the microbiome. Now, she doesn't have any opportunistic fungal pathogens, so there was no Candida that showed up and there was no sexually transmitted infections that showed up. Hooray. Check, check, check. We don't want those things. But in the opportunistic bacteria, The Enterococcus faecalis, 150 times the amount that it should be. So this is a raging infection. Now, she does not have raging symptoms besides her spotting, her dark brown spotting in the right before around ovulation and I think right after the cycle. And maybe there is a little bit of a smell, but it's not much. It's not like she's itching. It's not like there's an insane amount of discharge or inflammation. But she's probably going to become more aware of those symptoms now, now that she sees these results. Now, the first thing, because Enterococcus faecalis is one that we find in the stool, the first thing that I'm thinking is anal sex. Something that we need to rule out and educate around anal sex. Hygiene. Anal sex was not a thing that she practices. So that was. We ruled that out right away because obviously we want to make sure we're not switching the bacteria between what we find in the anal canal versus in the vaginal microbiome. Like, that's going to be a hot mess for us ladies. So we want to make sure that we educate on that. That was not a problem. Okay, check. The next thing we're going to talk about is hygiene. So making sure we're wiping properly, we're cleaning ourselves properly. And then the underwear that we use is, number one, we're replacing it. And number two, I talked about songs with her, so I'm sorry if I'm going to ruin songs for you, but it's just time to do that because basically this is what I learned. When the thong is like this bridge for bacteria to travel from the anus to the vagina, it creates this perfect bridge for the bacteria to go back and forth. And the bacteria that we have in the anus should not be anywhere close to the vagina. And this is why women are more predisposed to infections like urinary tract infections, because of this kind of shorter space in between the vagina and the rectum versus the males, obviously. And then we have these things, the thongs, that have been popularized in the beauty industry. And it provides this little bridge that can travel now for her, especially when she's healing. If she is wearing thongs, it's like, you got to get those out. It's cotton full bomb underwear, and we need to make sure you're wearing breathable fabric. Right. We're not sitting in yoga pants all day because those yoga pants are not allowing for any circulation. So cotton is for underwear, but also for your clothing to make sure that you're not wrapping yourself in plastic and, you know, in something that the body basically can't breathe. I have seen women get rid of their bacterial vaginosis, their chronic yeast infections, their chronic. Any urinary tract infections just by changing the type of underwear they wear and the type of pants that they wear. Okay, let that sink in. We didn't have to do anything else. They just had to change because the body has mechanisms to work through these infections. It just can't do it when you're literally suffocating it and then creating this bridge for the bacteria to travel back and forth. So that was the hygienic piece that we chatted about. And then the next piece is really, how are we going to address it? Number one, we need to see what's going on in the gut. Okay. If there's a lot of hypermeability in the gut, meaning the gut is leaky. And if you think about the reproductive system and the gut and all the small intestines in the uterus and how closely everything is intertwined, we think of those. Those two systems as separate systems, but they're actually, like, just smashed together in the abdominal cavity and often separated by just a few cells. So the bacteria can travel. And blood flow, obviously, is there. Nutrients need to be there to travel. So it's like the good things travel, but also the bad things. What she's doing next is she is running a gut stool analysis. She has some blood work that she's also going to run because there's been some inflammation, liver issues, all of the stuff that she's been working on and it just hasn't made a difference. And honestly a lot of it is because she hasn't had enough testing and it's just kind of been poking in the dark. So we need to look at the gut because we cannot impact the vaginal microbiome without impacting the gut, where we can impact the gut and vaginal microbiome. So I would say that if you have symptoms or if you've been struggling with infertility, like miscarriages or not being able to get pregnant, you should be getting a vaginal microbiome. But like everyone needs to get a gut microbiome done. There's so much value in that test and obviously you need someone who's going to help you interpret that. I do that for all my patients. I do that in the fertility one on one group where I help clients like I help my members understand how to read the tests. And then obviously they can jump on office hours and we can take them through it. But there's so much value in running these tests. So you can stop spending endless amount of money on supplements and not seeing any results. We need to get very specific in terms of what will work for you. And I can't do that if I have no idea what's going on. So we're going to start with treating this infection because it's really, really important. But she's going to get her gut stool analysis done asap, so we can see and make sure we're not missing anything. Because this is a bacterial infection. I want to make sure there's nothing higher up. There is no fungus or yeast overgrowth in the gut that's going on. Just because it didn't show up in the vaginal microbiome doesn't mean that there isn't potential exposure that can happen down the road. Or parasitic infections, obviously that's something that we need to deal with first because they're just going to cause a lot of issues. So when I see numbers this high. So for the enterococcus faecalis, 149, you know, it's 10 to the power of five. So like literally millions where it's supposed to be one or below. So 150 times the amount that it should be. We need to bring the big guys in here. And this is where I bring antibiotics. Something like doxycycline twice a day for 10 days is going to be really great for her. And then I also recommended some antimicrobial treatment that's pretty strong. With like berberine and garlic and oil of oregano, just some formulas. While we're supporting drainage, while we're supporting immune system with some zinc and glutathione. To help the body overcome this infection, she will need to retest the vaginal microbiome about six weeks time. So once she's done the first round of the antibiotics and four weeks of antimicrobial treatment, we retest, then she'll continue on the antimicrobials until we get the results from the vaginal microbiome. Just to make sure that we kind of like don't leave the body hanging, if you will. It's just as a precautionary. And then we can see where her vaginal PH is and where the opportunistic bug is. Because if your body responds really well, then we're just going to see all those numbers go into the green. So no opportunistic bacteria, but we'll probably still see the beneficial bacteria be really low because we haven't done anything to repopulate it. It depends. Sometimes the beneficial bacteria will start to grow just because she's eating well, she's having enough fiber, she has good antioxidants, she has good, you know, prebiotics and probiotics in her diet. But you're just going to retest? Yeah, we just need to retest and make sure that this is out of the system. What I will say about the vaginal ph, there is some therapies that we could do to help support the vaginal ph. So doing some flushes with ascorbic acid and some minerals, essentially we cannot do that until the infection is out because otherwise you're just flushing everything up and then we can cause a whole big mess. The reason that we want to retest as well is if that infection budges, but not enough. She might need another round of antibiotics. She might needs to do some suppository therapy as well. And so I don't want to say like, well, why not just do and throw everything at it. You want to find the right amount of dose and not overwhelm the body. Because if you say start doing garlic vaginal suppositories and you're doing antimicrobial, and now her gut is a mess and then her energy tanks because we're basically attacking it too much without supporting the energy, she's not going to be able to overcome that pathogen. So personally, anyways, it's like I'm going to start with pretty aggressive stuff. She's already has a good hydration Movement, you know, she's working on stress management, because who isn't? We're going to look at the gut and then we can kind of round out the treatment from there, but we're always going to retest. So it's a very simple one, pager, if you will, of a test, but it shows us a lot of information. And so when she jumped on the call yesterday and she had these labs, I'm able to help her very quickly. So when you guys are asking me questions through the chat, right, Instagram, sending emails, that kind of stuff, and you feel like you're grasping at straws, it's because you are grasping at straws. You're grasping at straws. You have no idea what's going on. And so my hope is that we change and we shake up the fertility space, the conventional space, but also the natural fertility care space, that we need to rely on testing to provide us with treatment. I couldn't have known that's what she needed just based on the symptoms, because she didn't have really bad symptoms around. And someone in the office hours asked that. She's like, oh, my God. Did you have, like. Because this is a raging infection. Do you have pain? Do you have inflammation? Do you have a lot of discharge? She's like, no, I just have some symptoms around ovulation. I have just some symptoms at the end of my cycle, but that's it, you know. And so sometimes the symptoms can be very, very subtle. But if you can't get pregnant or you can't stay pregnant, or your energy is always low, that is a symptom of having an infection. It's just figuring out where that infection. And so my hope is in educating you and helping you understand the value of these tests, because when you have these tests, you can have a more solid action plan. I've been on the. I believe she's in New Zealand, so she used Nutripath on the Canadian side. And on the American side, I've been using Evie. I believe My code is Dr. Jane. I can't remember. I don't. You can always run these tests on your own. I don't recommend you running them on your own because, like, how are you going to know to interpret them? But just know that these tests are easily accessible, especially the vaginal microbiome now. And this space is going to only explode because there is so much more research coming out around these beneficial bacteria and how women who are struggling with infertility are missing this bacteria. And that is, in fact, the driving force behind the Poor quality egg and the endometritis and the, you know, pcos, endometriosis, all of that is coming down to the microbial factors. So science is catching up to the wisdom of the body. But the testing, like I said, is just so valuable because now she has a path. And if she had ureoplasma, her treatment would be very different than what it is. When I see the enterococcus fascialis and there's some crossover, but depending on the different bug or even Candida, that would be a very different treatment. And so that's why we don't just say, oh, I'm assuming that this is what it is. You don't have no idea what it is. You have no idea what it is until you test. So I hope you guys find this helpful. Like I said, if you find this valuable, read this episode. Literally send me a message and I'll walk you through more labs and why I do them and what they tell me and how they change the treatment. But I'm excited to check in with her. She'll be checking in probably once a week. I run my office hours every week in the fertility one on one membership. But, like, within the first 10 days of being on the antibiotics, she's going to notice a huge difference. And then every week after that, she's going to notice a big difference as well. So I hope you guys find this helpful. If you do, let us know. I will continue to break down these labs. I want to get the information and the answers into your hands so you stop grasping at straws, you stop wasting money, and you stop digging yourself into a hole. I want you to make sure that your fertility journey is your healing journey. And you're literally becoming a better, different version of yourself as you're going through this journey. You're becoming more energized, more vital. You have stronger boundaries. You're more confident in who you are and why you are the way that you are. The more that I can get you to solidify yourself through this process and to truly heal and then connect with your partner. I know you're moving in the right direction, and I know that you will have peace through this journey. You will be able to make decisions from a place of peace and having that information versus feeling like you're cornered and you don't have an option. I just think you have so many more options. We're spending our resources in the wrong place and then driving ourselves, driving the body, the place, the. The first place the baby will grow is your body. We want to make sure that it is the best possible place for that baby to thrive. But that means, ladies, you have to be thriving in order for your baby to thrive. I know it's a crazy concept and I know it makes sense to you, but how backwards is it to drive ourselves into the ground, deplete ourselves of energy, have nothing left, and then hope that we can make a healthy baby? We have to start changing the language and we have to start changing the movement because it is not how it works. You are the first place that the baby will grow. So I need you to have all the energy, vitality and confidence in the world so then you can do the thing that you want to do, which is, you know, bring another soul into this world. And testing gives you clarity and clarity gives you, you know, that step by step plan. Thanks so much for being here, you guys. I'll see you next week. Thank you so much for listening. To read the full show notes of this episode, including summary, timestamps, guest quotes and any resources that were mentioned on the episode. Visit doctorjanelevec.com podcast and if you're getting value from these episodes, I'd love it if you took 2 minutes to share it with a friend. Rate and leave me a review@ratethispodcast.com Dr. Jane the reviews will help with the discoverability of the show. And who knows, I might share your review on my next episode. Thank you so much for tuning in and let's make your fertility journey your healing journey.