Dr. Jen Gunter

But do you need it?

No, that's a different story.

Most women have low iron because of menstruation.

So it's complicated.

So with bacterial vaginosis, there's absolutely a menstrual association for a lot of people.

And that's probably partly related to the blood.

iron can act the iron in the blood can actually change the micro environment the red blood cells that come out lactobacilli bind to that so your lactobacilli counts are basically the lowest and your ph is slightly elevated right from the blood so that creates an environment where where if you've

kind of got a little bit of a dysbiosis where it could blossom.

So that's why some people definitely report an exacerbation or a recurrence of their BV after every period.

And one way we can actually help them with that is put them on hormonal contraception so they don't get a period.

And the extra estrogen in the birth control pill may also help the good bacteria.

So that's that.

With yeast, it's different.

And while low iron seems to be a risk factor for yeast infection, it's probably more related to the immune system.

And the biggest thing is that probably the hormonal fluctuations are actually having that effect on the immune system or potentially on your itch threshold.

That's also a possibility.

And so people can certainly report often their itchings worse right before their period starts.

And so that could be due to dropping levels of progesterone, dropping levels of estrogen.

It's hard to know.

But so we often see these cyclic variations.