EPISODE SUMMARY:

In this solo episode, I share what I’ve been seeing in clinic lately, specifically how certain bugs like Enterococcus faecalis are showing up in the vaginal microbiome and impacting fertility. I walk you through why gut and vaginal health are deeply connected, why testing matters, and yes… why it might be time to say goodbye to your thongs. If you’re struggling with unexplained infertility, recurrent loss, or endometriosis, this is a must-listen.

ABOUT DR. JANE’S PRACTICE:

Dr. Jane is a Naturopathic Doctor and a Natural Fertility Expert. She and her team of expert practitioners help couples navigate infertility for 1+ years, get to the root cause of their struggles, heal, and bring healthy babies home.

After having a family member struggle with infertility and experiencing a miscarriage herself, Dr. Jane realized how little support and education women receive. She is on a mission to change that. Since 2020, she has dedicated her practice to fertility, where she and her practitioners work with couples 1:1, running functional lab work, customizing treatment plans and providing her couples with the support they need to get pregnant, have a stress free pregnancy and a healthy baby.

Learn more about Dr. Jane’s practice: www.drjanelevesque.com/practice

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CHAPTERS:

00:00:01 Introduction to Vaginal Microbiome

00:00:29 Clinical Observations and Case Studies

00:01:25 Impact of Enterococcus Faecalis

00:02:19 Thongs and Bacterial Transfer

00:03:42 Clothing and Microbiome Health

00:04:39 Comprehensive Testing and Treatment

00:06:05 Case Studies and Treatment Plans

00:08:34 Endometriosis and Microbiome Testing

00:10:56 Infections and Fertility Challenges

00:14:09 Holistic Approach to Fertility

TAKEAWAYS:

High levels of infection in the vaginal microbiome are alarming.

Infections can travel to the cervix and endometrium.

CA125 is a key marker for endometrial inflammation.

Elevated CA125 can indicate issues beyond endometriosis.

Some women are misinformed about their fertility health.

Fertility clinics may overlook important health markers.

Patients deserve transparency in fertility treatments.

Understanding one's health is crucial before procedures.

Injustice in healthcare can lead to unnecessary procedures.

Awareness of health markers can empower women.

ABOUT NATURAL FERTILITY:

Pregnancy is a natural process, so if it’s not happening or it’s not sticking, something is missing.  Join Dr. Jane, a naturopathic doctor and a natural fertility expert, every Tuesday at 9am for insightful case studies, expert interviews and practical tips on optimizing your fertility naturally. 

If you’ve struggling with infertility, pregnancy loss, women’s health issues or just want to be proactive and prepare yourself for the next big chapter in your life… this show is for you.

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Individualized care is essential for effective treatment of chronic fertility issues.

Hi, thanks so much for tuning in to another episode of Natural Fertility with Dr. Jane. I of course am Dr. Jane and today I'm recording a solo podcast and I'm gonna talk to you about the vaginal microbiome yet again because I just received two tests in the last week with vaginal microbiome test results and I need to talk you through what I'm seeing in clinic, in practice, how it's connected to fertility and I'm gonna make my case of why I think you should stop wearing thongs.

in order to optimize your vaginal microbiome and to improve your fertility. So stay with me. I'm going to walk you through, but I know I've had a couple of episodes that I've talked about the vaginal microbiome and I've had some specialists who specialize in the vaginal microbiome. And I just always want to bring the clinical experience because these are the things that I'm seeing every day. So just in the last week, and honestly, every week I see a vaginal microbiome test and whether that's

you know, my patients or patients that are coming through my practice with other clinicians, but in not everybody gets a vaginal microbiome test, but to be honest, I'm leaning more towards getting it for everyone because it can, it gives us so much insight. So these last two tests that we've received is these women had very high levels of a bug called enterococcus fakialis. This is a bug that is found in the gut microbiome.

and more so in the rectum microbiome in the stool. And it is normal to see it in the gut, but it is abnormal to see it in the vaginal microbiome and it can cause a lot of issues. These two particular cases, I'm going to give you a little bit of a background. One of them, her numbers of the enterococcus faecalis where I always get the quantitative tests. So I want to see how much of the bug versus just positive or negative because it does dictate treatment. If someone has

five times the amount versus a hundred times the amount, the treatment length, or how hard we're gonna hit it with the herbs and which herbs we're gonna hit it, or potentially pulling an antibiotic to help the body clear the infection faster. It all matters. So I do really like if you are getting vaginal tests done, vaginal microbiome tests done, to make sure that there is a quantitative number of what is the infection and not just.

the percentage, sometimes I think, yeah, okay, the percentage, but like, what is the actual quantitative number of the bug? Because that does dictate treatment. So anyways, the first lady that I'm thinking about, struggling with infertility, really full belly, difficulty losing weight, blood sugar dysregulation. She has confirmed pinworms just through like seeing them. She hasn't done the stool analysis yet, or at least we haven't received the results yet. It's not common to find

Pinworms usually during the stool analysis, to be honest, unless you literally pass them during the time that you collected the test. And that's not necessarily the case. It's not like your body is constantly getting rid of pinworms. It's only getting rid of them typically around the full moon, typically when the load is high, depending on what you ate, depending on where you are in your cycle as well that can vary. But point being is...

Her enterococcus faecalis in the vaginal microbiome was 130 times more than what it should be. So this is a pretty big, big infection. And so because I know that she also has some gut infections and some gut issues that she's dealing with, and then she is wearing thongs, and here's how I'm gonna connect this for you. It's basically this bug will travel from the rectum to the vagina very easily when we're wearing things like thongs, because the thong just provides

this bridge for the bugs to travel. When I learned this information, and you probably have heard me talk about it, maybe this is the first time you're hearing me talk about it, but when I heard this information that the thong provides this bridge for the bugs to go from the rectum to the vagina, I stopped wearing thongs immediately. And to be honest, I didn't have any vaginal symptoms. I had some bladder symptoms, but once I went to cotton, full bum underwear,

And sorry, fellas, but we like it is not good for our microbiomes. We have to switch to cotton full bomb underwear. The vaginal microbiome changed. I had less discomfort. I had less odor, even though I didn't have what I thought was bad odor in the first place. And the vaginal microbiome test, when I've done it, it has come clear. This is the same for these ladies. When we get them, when I get them to stop wearing thongs.

It is amazing how much that moves the needle. The other piece that I find is really important is the plastic pants that we were trained to wear. I'm a Lulugirl. I was obsessed with Lululemon when I first started university. It was this big thing. was like Lulupants are amazing. And then now we know that they're full of plastic. Now what I'll say is, this is a side note, but I went to Lululemon and I said, Hey, I don't want any plastic.

Can you give me more natural, like I don't want any polyester. Do you have any natural materials? And they did. They had wool, they had cotton for both tops and bottoms. And so that's really exciting because you see that these big brands are changing what they're producing because of the demand. So point being is the thong is going to provide this bridge for the bugs from the rectum to travel to the vagina. And they're not supposed to be in the vagina.

This person does have some discharge and some discomfort, but of course she also has so much discomfort in the gut microbiome that she's not even really noticing what's going on in the vaginal microbiome because the gut is causing her more issues. And then of course there's the blood dysregulation, the liver enzymes that are elevated, the brain fog that comes with it. It's not just obviously about stopping the thongs and then the infection is gonna clear.

Her body is dealing with a lot and that's why we don't just test one test. Obviously, if you're curious and you just want to test the vaginal microbiome, you can, but if we want to be effective in our treatment, we have to look at the gut, we have to look at all of the blood markers so we can see what is the level of inflammation, what is the blood sugar doing, how much energy does this person have, what are the nutrient levels at, is she going to be able to overcome this infection, and then is she going to be able to handle some of the killing and when do we introduce it?

because the body has to have enough energy to overcome the infection. when that was case number one, it's very high levels of the enterococcus fichalis. What I'm gonna get her to do is, I mean, obviously we're waiting for the guts to analysis, but we're gonna work on decreasing inflammation. We're gonna work on improving her drainage to make sure that her body can actually get rid of things and then really boosting her energy. So when I'm looking at like methylation or nutrient panels,

these people are really, really depleted because the bugs are taking up so much energy and they're jacking up the immune system. Once that energy is up, the drainage is up and inflammation is down, and I'm talking about sometimes that's a week, sometimes it's two weeks, sometimes I do that for a month before I introduce the killing. But generally as, if there's a lot of infections, the way that the body is gonna start to feel better is if we get rid of these infections. But like I said, the caveat is,

Hey, if the body is super tanked, for example, if we have to do antibiotics, and I have had to, especially for urea plasma, we'll do antibiotics, of course, depending on the person, but to clear it faster, that's what we need. If the person doesn't have enough energy, like they will just tank. And I'm thinking about this one patient a year ago where we found out, I only gave her about a week of boosting her energy because she just wanted to get going. She wanted to start the killing phase.

But as soon as we started the probiotics, her energy just, the antibiotics, sorry, her energy just tanked. She was so, so tired. And we did all the things that we could to support, but basically she just had to sleep for seven days before then we introduced the antimicrobials and then she started to feel better. She was able to clear the infection, but it was very, very difficult those first seven to 10 days where she was just basically out and we could tell that her body was really fighting.

So that's 130,000. The next patient, she had about 86,000 more or 86 times more than what it should be. So 86,000 is the like how many bugs, the quantitative number that they found and we want it under a thousand. So this also wears thongs, has probably endometriosis that's been undiagnosed. She's in Canada, so she's having a hard time.

getting any kind of diagnosis because they just don't tend to quote unquote take it seriously. And she doesn't have enough symptoms besides this inability to get pregnant. And they kind of just labeled her with unexplained infertility, even though she gets the bloating, the PMS, the acne, the heavy periods, the painful periods, but they're not terribly painful. They're just, you know, they're painful. She still needs some kind of pain medication. For her,

When we have endometriosis, I'm like, if you have endometriosis, you need to test the gut microbiome. You need to look at the vaginal microbiome. It's not a matter of if there is an infection, it's a matter of what it is. And I think that in the endometriosis, the body is very good at hiding the infections as well, because there's a lot of biofilm that starts to form, the blood vessel formation that happens, the estrogen dominance that happens, the proliferation of that infection.

and where it can go through into the lymphatic system versus the blood, all of these things. There is a microbial imbalance and there is an infection that's driving this inflammation. And what I'll say is, and again, we look at the gut and she doesn't have a lot in the gut, but she has a really suppressed immune system. And so when the immune system is suppressed, you know that that microbiome is really struggling and usually there's this pathogen. So we're gonna...

get rid of the thongs, and then we're gonna obviously treat it. And I find that when you don't understand what's going on in the gut, just treating the vaginal microbiome is usually not enough because the gut tells us how we need to support the body, and it's typically a reflection of what's gonna happen in the vaginal microbiome. But the last story that I kinda wanna tie this into is I've seen this enterococcus faecalis in an Emma Alice analysis.

which is done when you are having multiple recurrent pregnancy losses, you have a difficulty time getting pregnant, obviously there's implantation issues, endometritis, endometriosis. So then my Alice analysis is done to assess the infections within the endometrium and that is a way more invasive test. you're essentially taking a biopsy of the tissue and then seeing.

if there's any infection within the endometrium, within the uterus. And I've seen this enterococcus faecalis in the endometrium, which means it is a sign of endometritis. In this person, she had a hard time getting pregnant. She did have one miscarriage, but essentially she had just a hard time getting pregnant, period. She had a lot of hives and immune system dysregulation. And this...

It's not the only place where this bug is. We've dealt, you know, her gut was super inflamed. She had a leaky gut. I don't think I've ever seen so many inflammatory markers be that elevated within the gut. So there was just a lot going on. And I think when you are going to a fertility clinic and she did end up going through IVF, we had a beautiful retrieval, like so many.

eggs for the age. She was 40 at the time, so like really great retrieval. Even all the doctors were super impressed, but it did take her, I think it was three transfers. So the first two failed and then the third one stuck and she's pregnant now. And part of that I think was just the immune system dysregulation that we continued to work through and implement. And then you add the environmental toxins and you add the stress and you know, life is just not static.

Point being is, if we see, like it's so alarming to me to see really high levels of infection within the vaginal microbiome, because if we don't deal with it, it will travel up to the cervix, it will travel up to the endometrium. And when it's in the endometrium, a great way for you to test to see if there is any inflammation within the endometrium is to test the marker called CA125. It's a cancer antigen marker, but it does get elevated when there's inflammation in the endometrium.

and a lot of women with endometriosis will have it elevated. But I have a couple of patients that I'm thinking about right now that have never had the diagnosis of endometriosis, but they have this marker elevated. And they're told by their fertility clinics that they're fine to try. It's not that elevated. We can just see what happens. And you're signing up for a procedure, and whether that's IUI or IVF, you're signing up with...

this injustice, if you will, in my opinion, where it's like, they're just setting you up for failure. You're not, we can't, I can't tell you how many patients came in and said, oh, my IUI failed. And it's like, well, your uterine lining is at four millimeters. Of course your IUI failed. What you're seeing one to five is at 120. Of course your IVF is not gonna stick. You have inflammation in the endometrium and the uterus is going, don't touch me. So every time.

there, even if there's fertilization that's happening, every time the, the blastocyst needs to burrow itself into the uterus. And I mean like burrow, burrow, burrow itself into the uterus. When the uterus is going, don't touch me, it's just not really able to do that. And that's, you know, what we call in the fertility world, implantation failure. So, and then of course, once you are pregnant, we want to be very careful about any infections in the vaginal microbiome.

obviously any infections period because they can travel out there. The amniotic fluid, is that we know that the amniotic fluid is not sterile. It is very much a reflection of the mom's microbiome. So we want to protect the mom. want to make sure that the mom has really good nutrient levels for that immune system. And if there is any lingering things of infection, we want to address it quickly and appropriately because whether that's, you know, a Candida infection or

UTI or I mean anything and you have a fever or a virus, you're getting a cold sore outbreak. We want to address those things as quickly as possible because the body does a pretty good job at trying to protect the babe. But if the load of that infection is too high, it is going to travel and will impact the way that that baby is developing. And some of those things are very minor and you're not going to notice it until that baby is growing older and older.

And some of those things can be detrimental where they can cause a miscarriage, can cause stillbirth, can cause complications for the mother, the preeclampsia, the gestational diabetes, the preterm labor. So we want to really start to understand the microbiome and stop looking at things so fragmented. I think the conventional system does that very well where the care for women is so fragmented.

Even some of my clients, my patients who went through IVF and they would have their IVF specialist, but then they would need an embryologist to help them make a decision because the IVF specialist don't feel comfortable talking about the embryo. And it just seems like they go to this one appointment and get this information. And then the IVF specialist is telling them a little bit of this. then it's like, it's so fragmented. And this whole process is very intertwined and very interconnected.

And even as a fertility specialist, say like, yeah, my specialty is fertility. But when the person is sitting in front of me, I'm actually just trying to figure out what's preventing them from getting pregnant. Is it their thyroid? Is it their nervous system? Is it their estrogen and progesterone? Is it their, you know, disconnect between the brain and the ovaries? What caused that? It's never just one thing because the body doesn't work in asylum. If you think about what needs to happen during pregnancy, it's not just the reproductive system that's working.

It's the entire body that has to make this happen in the nutrients that need to be delivered to the baby. And then the immune system down regulation, you know, the breakdown of all the foods to make sure that, you know, we get it to the baby and to of course the mom. So she has those nutrients. So all that to say, please stop wearing thongs. And I mean that because I mean, I've just seen too many tests now where this bug is

very, very high. It is found in stool and we're seeing it in the vaginal microbiome. And I'm seeing these women who are struggling to conceive and it's not the only component, but it is an easy thing that you can fix. So even if you don't do the vaginal microbiome and you're not struggling with fertility as a female for the health of the reproductive system, it is the thongs have no place in

that space. And I remember when it became popular and it's probably because of the song song back, you know, back when, how many ever, maybe 20, 20 years ago now, maybe even 25. And it's, there's like, it travels from the rectum to the vagina. There's no room for that. And of course there is things around hygiene. If you do have anal sex that we want to make sure that the way

that we have anal sex and that there is no crossover between going from anal to vaginal sex in the same time. We want to make sure that we're wiping properly as women, that front to back washing if necessary, if you have a lot of sticky poops, we need to address that because that's usually a microbiome issue, the gut microbiome, and maybe that's Candida or maybe that's parasites or whatever, but like a microbial imbalance, we need to make sure that we address that.

and that cotton underwear is breathable, then you want to wear breathable clothing. So wear cotton, wear natural fibers because we're supposed to, like, we're not supposed to be packed into a plastic container all day. And then we live in a plastic container all day as well in our homes. It seems really simple, but I see it make a really big difference. Now with these women, always wanted something that's a really big infection like that. I do get them to retest.

I think it's important to make sure that that infection is out. And then if I do suspect issues with the endometrium, I do recommend going and doing like an analysis because again, depending on how far the infection and how long it's been there, how aggressive do we need to be with the treatment? And is there anything else that we potentially might be missing? Because usually what happens is bugs, they like buddies. And so this is kind of that negative spiral.

you get one bad bug in there and then there's another one that starts to feed and then it creates the space for Candida to overgrow. So one of the patients, she has that high enterococcus and there's that Candida and then she craves sugar and she's tired and that bowels are not moving as well. And then she's craving more sugar because she's tired and this just keeps feeding and feeding and feeding these quote unquote bad bugs, which just continues to escalate the situation. But then you're not.

making the connection of like, well, what does that have to do with my fertility? What has everything to do with your fertility? The Candida is now, or any of the infections is now depleting your nutrients. It's jacking up your immune system, which means there's more inflammation in your body. That means there's more nutrient demands. Your cortisol is going to be elevated. It's going to impact the progesterone and estrogen, the LH and FSH. So it impacts everything. I hope that after today,

I have convinced you, but this is kind of my recommendation. You know, as a naturopathic doctor, a natural fertility expert is to switch to that full cotton bum, full bum cotton underwear to make sure that we're organic pads, preferably pads versus tampons, especially when you have infections because we're trying to get the uterus to empty and we don't want to plug anything up. We just want the natural gravity to fall.

And then we want to wear natural fibers all the time to make sure that it's, you know, the skin can actually breathe, the vagina can breathe. And then I would recommend working with a practitioner like myself. And we do this one-on-one. We do this in our group programs where you get to see, you run some tests and see what's going on and you can work. I mean, we have so many women who are working through chronic bacterial vaginosis.

And the problem is they've been given antibiotics for seven days and then nothing else. And nobody looked at their liver and nobody looked at their drainage, nobody looked at their gut, nobody looked at their mitochondria function, and of course the body is stuck. So sometimes we still do need those antibiotics, but we also need to follow it by some antimicrobials for three to four months, sometimes longer, but we just test and see what this person needs. And so of course changing the diet, optimizing your sleep.

taking the right supplements, cleaning up your environment, drinking, hydrating really well. All of these things really do matter. And it is this additive effect. But if you want to start anywhere, just get rid of those thongs, start wearing the full-bump cotton underwear, get those breathable materials in there. You'll see that you'll start to feel better. And then if you want to know more information, then it's time to test. And...

when you're going to test, just make sure you have somebody who is actually going to interpret those results for you. Because I always say that your test is only as good as the interpreter. So if you're the one interpreting it or Chad GPT is, don't get me wrong, Chad GPT is going to point out the things that are wrong, but Chad GPT is only as good as the person that's asking the questions and the knowledge. So if you don't ask about the gut or if you don't ask about mitochondria or if you didn't test those things,

that product that you're gonna get, the spit out, the information that ChadGPT is gonna spit out at you is probably going to be missing because you have blind spots that you're not aware of and so you're only punching that into the bot and then the bot is spitting it out. So at least that's been my experience with ChadGPT, the more that I can bring in all the information that I need to.

the better answers I get, but then I still have to filter it with my clinical experience and I still have to filter it with the knowledge that I know because let's face it, it's not always right. All right, hope, ladies, I hope you enjoyed this episode. If you have any questions, please feel free to reach out on Instagram and if you're interested in working with either myself or one of my team members, please fill out an application and we'll get back to you as soon as we can. Thanks so much for being here. I appreciate you all and I'll see you next week.