What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring

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In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a cardiac arrest.

Many media outlets incorrectly referred to the event as a “heart attack” or used the terms interchangeably.

A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.

With some background in how the heart works, we can see how they differ and how they’re related.

Explode/Shutterstock

Understanding the heart

The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.

For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.

This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.

Heart attack or cardiac arrest?

Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.

A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.

In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.

Why do they happen? Who’s at risk?

Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.

The underlying cause in about 75% of people is a process called atherosclerosis. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.

Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.

Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.

Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.

Heart attack vs cardiac arrest
Here’s a simple way to remember the difference. Author provided

But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to electrical malfunctions in the heart. There are four distinct types:

  • ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than 100 beats per minute (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately
  • ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute
  • pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse
  • asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.
Aystole heart rhythm showing no electrical activity
Remember this flat-line rhythm from the movies? It’s asystole, when there’s no electrical activity in the heart. Kateryna Kon/Shutterstock

Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a congenital heart defect, a heart condition he was born with.

But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting for 70% of all cases.

So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.

So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.

What do they look like?

Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.

But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.

What’s the take-home message?

While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.

A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.

Despite their different nature both conditions can have severe consequences and require immediate medical attention.

Michael Todorovic, Associate Professor of Medicine, Bond University and Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • How To Recover Quickly From A Stomach Bug

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How To Recover Quickly From A Stomach Bug

    Is it norovirus, or did you just eat something questionable? We’re not doctors, let alone your doctors, and certainly will not try to diagnose from afar. And as ever, if unsure and/or symptoms don’t go away or do get worse, seek professional medical advice.

    That out of the way, we can give some very good general-purpose tips for this one…

    Help your immune system to help you

    So far as you can, you want a happy healthy immune system. For the most part, we’d recommend the following things:

    Beyond Supplements: The Real Immune-Boosters!

    …but you probably don’t want to be exercising with a stomach bug, so perhaps sit that one out. Exercise is the preventative; what you need right now is rest.

    Hydrate—but watch out

    Hydration is critical for recovery especially if you have diarrhea, but drinking too much water too quickly will just make things worse. Great options for getting good hydration more slowly are:

    • Peppermint tea
      • (peppermint also has digestion-settling properties)
    • Ginger tea
    • Broths
      • These will also help replenish your sodium and other nutrients, gently. Chicken soup for your stomach, and all that. A great plant-based option is sweetcorn soup.
      • By broths, we mean clear(ish) water-based soups. This is definitely not the time for creamier soups.

    ❝Milk and dairy products should be avoided for 24 to 48 hours as they can make diarrhea worse.

    Initial dietary choices when refeeding should begin with soups and broth.❞

    Source: American College of Gastroenterology

    Other things to avoid

    Caffeine stimulates the digestion in a way that can make things worse.

    Fat is more difficult to digest, and should also be avoided until feeling better.

    To medicate or not to medicate?

    Loperamide (also known by the brand name Imodium) is generally safe when used as directed.

    Click here to see its uses, dosage, side effects, and contraindications

    Antibiotics may be necessary for certain microbial infections, but should not be anyone’s first-choice treatment unless advised otherwise by your doctor/pharmacist.

    Note that if your stomach bug is not something that requires antibiotics, then taking antibiotics can actually make it worse as the antibiotics wipe out your gut bacteria that were busy helping fight whatever’s going wrong in there:

    A gentler helper

    If you want to give your “good bacteria” a hand while giving pathogens a harder time of it, then a much safer home remedy is a little (seriously, do not over do it; we are talking 1–2 tablespoons, or around 20ml) apple cider vinegar, taken diluted in a glass of water.

    ❝Several studies indicate apple cider vinegar (ACV)’s usefulness in lowering postprandial glycemic response, specifically by slowing of gastric motility❞

    (Slowing gastric motility is usually exactly what you want in the case of a stomach bug, and apple cider vinegar)

    Source: Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review

    See also:

    Take care!

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  • The Great Cholesterol Myth, Revised and Expanded – by Dr. Jonny Bowden and Dr. Stephen Sinatra

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The topic of cholesterol, and saturated fat for that matter, is a complex and often controversial one. How does this book treat it?

    With strong opinions, is how—but backed by good science. The authors, a nutritionist and a cardiologist, pull no punches about outdated and/or cherry-picked science, and instead make the case for looking at what, statistically speaking, appear to be the real strongest risk factors.

    So, are they advocating for Dave Asprey-style butter-guzzling, or “the carnivore diet”? No, no they are not. Those things remain unhealthy, even if they give some short-term gains (of energy levels, weight loss, etc).

    They do advocate, however, for enjoying saturated fats in moderation, and instead of certain polyunsaturated seed oils that do far worse. They also advocate strongly for avoiding sugar, stress, and (for different reasons) statins (in most people’s cases).

    They also demystify in clear terms, and often with diagrams and infographics, the various kinds of fats and their components, broken down in far more detail than any other pop-science source this reviewer has seen.

    Bottom line: if you want to take a scientific approach to heart health, this book can help you to focus on what will actually make the biggest difference.

    Click here to check out The Great Cholesterol Myth, and learn about the greater dangers that it hides!

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  • What Most People Don’t Know About HIV

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    What To Know About HIV This World AIDS Day

    Yesterday, we asked you to engage in a hypothetical thought experiment with us, and putting aside for a moment any reason you might feel the scenario wouldn’t apply for you, asked:

    ❝You have unprotected sex with someone who, afterwards, conversationally mentions their HIV+ status. Do you…❞

    …and got the above-depicted, below-described, set of responses. Of those who responded…

    • Just over 60% said “rush to hospital; maybe a treatment is available”
    • Just under 20% said “ask them what meds they’re taking (and perhaps whether they’d like a snack)”
    • Just over 10% said “despair; life is over”
    • Two people said “do the most rigorous washing down there you’ve ever done in your life”

    So, what does science say about it?

    First, a quick note on terms

    • HIV is the Human Immunodeficiency Virus. It does what it says on the tin; it gives humans immunodeficiency. Like many viruses that have become epidemic in humans, it started off in animals (called SIV, because there was no “H” involved yet), which were then eaten by humans, passing the virus to us when it one day mutated to allow that.
      • It’s technically two viruses, but that’s beyond the scope of today’s article; for our purposes they are the same. HIV-1 is more virulent and infectious than HIV-2, and is the kind more commonly found in most of the world.
    • AIDS is Acquired Immunodeficiency Syndrome, and again, is what it sounds like. When a person is infected with HIV, then without treatment, they will often develop AIDS.
      • Technically AIDS itself doesn’t kill people; it just renders people near-defenseless to opportunistic infections (and immune-related diseases such as cancer), since one no longer has a properly working immune system. Common causes of death in AIDS patients include cancer, influenza, pneumonia, and tuberculosis.

    People who contract HIV will usually develop AIDS if untreated. Untreated life expectancy is about 11 years.

    HIV/AIDS are only a problem for gay people: True or False?

    False, unequivocally. Anyone can get HIV and develop AIDS.

    The reason it’s more associated with gay men, aside from homophobia, is that since penetrative sex is more likely to pass it on…

    • If a man penetrates a woman and passes on HIV, that woman will probably not go on to penetrate someone else
    • If a man penetrates a man and passes on HIV, that man could go on to penetrate someone else—and so on
    • This means that without any difference in safety practices or promiscuity, it’s going to spread more between men on average, by simple mathematics.
    • This is why “men who have sex with men” is the generally-designated higher-risk category.

    There is medication to cure HIV/AIDS: True or False?

    False (though there have been individual case studies of gene treatments that may have cured people—time will tell).

    But! There are medications that can prevent HIV from being a life-threatening problem:

    • PrEP (Pre-Exposure Prophylaxis) is a medication that one can take in advance of potential exposure to HIV, to guard against it.
      • This is a common choice for people aren’t sure about their partners’ statuses, or people working in risky environments.
    • PEP (Post-Exposure Prophylaxis) is a medication that one can take after potential exposure to HIV, to “nip it in the bud”.
      • Those of you who were rushing to hospital in our poll, this is what you’re rushing there for.
    • ARVs (Anti-RetroVirals) are a class of medications (there are different options; we don’t have room to distinguish them) that reduce an HIV+ person’s viral load to undetectable levels.
      • Those of you who were asking what meds your partner was taking, these will be those meds. Also, most of them are to be taken in the morning with food, so that’s what the snack was for.

    If someone is HIV+, the risk of transmission in unprotected sex is high: True or False?

    True or False, with false being the far more likely. It depends on their medications, and this is why you were asking. If someone is on ARVs and their viral load is undetectable (as is usual once someone has been on ARVs for 6 months), they cannot transmit HIV to you.

    U=U is not a fancy new emoticon, it means “undetectable = untransmittable”, which is a mathematically true statement in the case of HIV viral loads.

    See: NIH | HIV Undetectable=Untransmittable (U=U)

    If you’re thinking “still sounds risky to me”, then consider this:

    You are safer having unprotected sex with someone who is HIV+ and on ARVs with an undetectable viral load, than you are with someone you are merely assuming is HIV- (perhaps you assume it because “surely this polite blushing young virgin of a straight man won’t give me cooties” etc)

    Note that even your monogamous partner of many decades could accidentally contract HIV due to blood contamination in a hospital or an accident at work etc, so it’s good practice to also get tested after things that involve getting stabbed with needles, cut in a risky environment, etc.

    If you’re concerned about potential stigma associated with HIV testing, you can get kits online:

    CDC | How do I find an HIV self-test?

    (these are usually fingerprick blood tests, and you can either see the results yourself at home immediately, or send it in for analysis, depending on the kit)

    If I get HIV, I will get AIDS and die: True or False?

    False, assuming you get treatment promptly and keep taking it. So those of you who were at “despair; life is over” can breathe a sigh of relief now.

    However, if you get HIV, it does mean you will have to take those meds every day for the rest of your (no reason it shouldn’t be long and happy) life.

    So, HIV is definitely still something to avoid, because it’s not great to have to take a life-saving medication every day. For a little insight as to what that might be like:

    HIV.gov | Taking HIV Medication Every Day: Tips & Challenges

    (as you’ll see there, there are also longer-lasting injections available instead of daily pulls, but those are much less widely available)

    Summary

    Some quick take-away notes-in-a-nutshell:

    • Getting HIV may have been a death sentence in the 1980s, but nowadays it’s been relegated to the level of “serious inconvenience”.
    • Happily, it is very preventable, with PrEP, PEP, and viral loads so low that they can’t transmit HIV, thanks to ARVs.
    • Washing will not help, by the way. Safe sex will, though!
      • As will celibacy and/or monogamy in seroconcordant relationships, e.g. you both have the same (known! That means actually tested recently! Not just assumed!) HIV status.
    • If you do get it, it is very manageable with ARVs, but prevention is better than treatment
    • There is no certain cure—yet. Some people (small number of case studies) may have been cured already with gene therapy, but we can’t know for sure yet.

    Want to know more? Check out:

    CDC | Let’s Stop HIV Together

    Take care!

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  • The Problem With Sweeteners

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The WHO’s new view on sugar-free sweeteners

    The WHO has released a report offering guidance regards the use of sugar-free sweeteners as part of a weight-loss effort.

    In a nutshell, the guidance is: don’t

    They make for interesting reading, so if you don’t have time now, you might want to just quickly open and bookmark them for later!

    Some salient bits and pieces:

    Besides that some sweeteners can cause gastro-intestinal problems, a big problem is desensitization:

    Because many sugar substitutes are many times (in some cases, hundreds of times) sweeter than sugar, this leads to other sweet foods tasting more bland, causing people to crave sweeter and sweeter foods for the same satisfaction level.

    You can imagine how that’s not a spiral that’s good for the health!

    The WHO recommendation applies to artificial and naturally-occurring non-sugar sweeteners, including:

    • Acesulfame K
    • Advantame
    • Aspartame
    • Cyclamates
    • Neotame
    • Saccharin
    • Stevia

    Sucralose and erythritol, by the way, technically are sugars, just not “that kind of sugar” so they didn’t make the list of non-sugar sweeteners.

    That said, a recent study did find that erythritol was linked to a higher risk of heart attack, stroke, and early death, so it may not be an amazing sweetener either:

    Read: The artificial sweetener erythritol and cardiovascular event risk

    Want to know a good way of staying healthy in the context of sweeteners?

    Just get used to using less. Your taste buds will adapt, and you’ll get just as much pleasure as before, from progressively less sweetening agent.

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  • How worried should I be about cryptosporidiosis? Am I safe at the pool?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    You might have heard of something called “cryptosporidiosis” recently, closely followed by warnings to stay away from your local swimming pool if you’ve had diarrhoea.

    More than 700 cases of this gastrointestinal disease were reported in Queensland in January, which is 13 times more than in January last year. Just under 500 cases have been recorded in New South Wales this year to-date, while other states have similarly reported an increase in the number of cryptosporidiosis infections in recent months.

    Cryptosporidiosis has been listed as a national notifiable disease in Australia since 2001.
    But what exactly is it, and should we be worried?

    What causes cryptosporidiosis, and who is affected?

    Cryptosporidiosis is the disease caused by the parasite Cryptosporidium, of which there are two types that can make us sick. Cryptosporidum hominis only affects humans and is the major cause of recent outbreaks in Australia, while Cryptosporidium parvum can also affect animals.

    The infection is spread by spores called oocysts in the stools of humans and animals. When ingested, these oocysts migrate and mature in the small bowel. They damage the small bowel lining and can lead to diarrhoea, nausea, vomiting, fever and abdominal discomfort.

    Most people develop symptoms anywhere from one to 12 days after becoming infected. Usually these symptoms resolve within two weeks, but the illness may last longer and can be severe in those with a weakened immune system.

    Children and the elderly tend to be the most commonly affected. Cryptosporidiosis is more prevalent in young children, particularly those under five, but the disease can affect people of any age.

    A 'pool closed' sign in front of a swimming pool.
    A number of public pools have been closed lately due to cryptosporidiosis outbreaks.
    LBeddoe/Shutterstock

    So how do we catch it?

    Most major outbreaks of cryptosporidiosis have been due to people drinking contaminated water. The largest recorded outbreak occurred in Milwaukee in 1993 where 403,000 people were believed to have been infected.

    Cryptosporidium oocysts are very small in size and in Milwaukee they passed through the filtration system of one of the water treatment plants undetected, infecting the city’s water supply. As few as ten oocysts can cause infection, making it possible for contaminated drinking water to affect a very large number of people.

    Four days after infection a person with cryptosporidiosis can shed up to ten billion oocysts into their stool a day, with the shedding persisting for about two weeks. This is why one infected person in a swimming pool can infect the entire pool in a single visit.

    Cryptosporidium oocysts excreted in the faeces of infected humans and animals can also reach natural bodies of water such as beaches, rivers and lakes directly through sewer pipes or indirectly such as in manure transported with surface runoff after heavy rain.

    One study which modelled Cryptosporidium concentrations in rivers around the world estimated there are anywhere from 100 to one million oocysts in a litre of river water.

    In Australia, cryptosporidiosis outbreaks tend to occur during the late spring and early summer periods when there’s an increase in recreational water activities such as swimming in natural water holes, water catchments and public pools. We don’t know exactly why cases have seen such a surge this summer compared to other years, but we know Cryptosporidium is very infectious.

    Oocysts have been found in foods such as fresh vegetables and seafood but these are not common sources of infection in Australia.

    What about chlorine?

    Contrary to popular belief, chlorine doesn’t kill off all infectious microbes in a swimming pool. Cryptosporidium oocysts are hardy, thick-walled and resistant to chlorine and acid. They are not destroyed by chlorine at the normal concentrations found in swimming pools.

    We also know oocysts can be significantly protected from the effects of chlorine in swimming pools by faecal material, so the presence of even small amounts of faecal matter contaminated with Cryptosporidium in a swimming pool would necessitate closure and a thorough decontamination.

    Young children and in particular children in nappies are known to increase the potential for disease transmission in recreational water. Proper nappy changing, frequent bathroom breaks and showering before swimming to remove faecal residue are helpful ways to reduce the risk.

    Two children playing in a body of water.
    Cryptosporidium can spread in other bodies of water, not just swimming pools.
    Yulia Simonova/Shutterstock

    Some sensible precautions

    Other measures you can take to reduce yours and others’ risk of cryptosporidiosis include:

    • avoid swimming in natural waters such as rivers and creeks during and for at least three days after heavy rain
    • avoid swimming in beaches for at least one day after heavy rain
    • avoid drinking untreated water such as water from rivers or springs. If you need to drink untreated water, boiling it first will kill the Cryptosporidium
    • avoid swallowing water when swimming if you can
    • if you’ve had diarrhoea, avoid swimming for at least two weeks after it has resolved
    • avoid sharing towels or linen for at least two weeks after diarrhoea has resolved
    • avoid sharing, touching or preparing food that other people may eat for at least 48 hours after diarrhoea has resolved
    • wash your hands with soap and water after going to the bathroom or before preparing food (Cryptosporidium is not killed by alcohol gels and sanitisers).

    Not all cases of diarrhoea are due to cryptosporidiosis. There are many other causes of infectious gastroenteritis and because the vast majority of the time recovery is uneventful you don’t need to see a doctor unless very unwell. If you do suspect you may have cryptosporidiosis you can ask your doctor to refer you for a stool test.The Conversation

    Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Vaginal Probiotics: What Does The Science Say?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝Is there any merit to vaginal probiotics?❞

    What a fun question! First let’s break it down, as this could mean two different things:

    1. Probiotics, which you consume, using your mouth, which are marketed as benefiting vaginal health
    2. Probiotics taken as a vaginal pessary/suppository, to act directly there

    The former has limited evidence for it, but generally speaking, improving one’s gut health improves all other areas of health, so it’s not surprising if it helps this too.

    See for example:

    Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis

    Some notes:

    • candidal vaginitis means a yeast infection causing vaginal inflammation
    • bacterial vaginosis means a vaginal bacterial imbalance (generally also featuring vaginal inflammation, though it can be asymptomatic)

    In the latter case, the “imbalance” in question is usually a shortage of Lactobacillus sp. (that is to say, the diverse species of the Lactobacillus genus) resulting in an overgrowth of other kinds of bacteria, which in turn results in changing the vaginal microbiome to make it warmer and more acidic than it should be.

    While a healthy vagina shouldn’t smell of roses, it shouldn’t smell fishy either; if it does, that’s a sign of bacterial vaginosis.

    What it’s supposed to be like: slightly bitter, slightly salty, distinctly umami, along with a cocktail of personal pheromones (and if menstruating or otherwise* vaginally bleeding, then of course add: iron/”metallic”). The pheromones will also reflect any hormonal changes, but should never make anything smell bad, just different.

    *e.g. due to PCOS, fibroids, etc. Note that in the case of PCOS, it may also smell a little different (if it does, then usually: a little more musky), due to often different hormone levels. Again: it still shouldn’t smell bad, though, just different.

    In the above-linked study, taking more live Lactobacillus acidophilus (in yogurt, eating it, with their mouths) improved levels of L. acidophilus in the vagina. While the study authors concluded “this ingestion of yogurt may have reduced episodes of bacterial vaginosis”, which is rather a weak claim, it can be argued that it merely improving the levels of L. acidophilus in the vagina was already a win.

    That was a small (n=42, and only 7 followed through to completion) and old (1996) study, and it bears mentioning that most of the studies into this seem to be small and old, but conclude similarly with weakly positive statements.

    However, it does make a difference what kind of Lactobacillus is used, for example in this next study…

    • L. fermentum RC-14 worked well (90% success rate)
    • L. rhamnosus GR-1 worked somewhat (40% success rate)
    • L. rhamnosus GG did not work (0% success rate)

    So, diversity is key, and getting a wide range of Lactobacillus sp. seems to be a safe bet.

    Short version: enjoying probiotics as part of your diet probably improves vaginal health, just like it improves pretty much everything else.

    See also: Make Friends With Your Gut (You Can Thank Us Later)

    You would think that this would mean that taking probiotics as a vaginal pessary/suppository would be even better, but the results are weaker, as in this study, which produced temporary improvements in about half the study group, with only 3 out of 28 being free of bacterial vaginosis the next month:

    Treatment of bacterial vaginosis with lactobacilli

    This study got better results, with a 61% success rate:

    Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis

    Important note

    Do note that this last category, involving topical treatments (i.e., manually introducing Lactobacillus sp. to the vagina) were all in cases of pre-existing bacterial vaginosis, not as a prophylactic and/or general health-improving thing.

    If your vagina seems happy right now, then do not mess with its happy bacterial balance!

    And at all times (regardless of whether it seems happy right now or not): do not douche (it does not need it and will not benefit from it; the vagina is self-cleaning*) as this will wash out many of your Lactobacilli and will do absolutely nothing against any Candida there (C. albicans being a rooted fungus, whereas Lactobacillus is a sausage-shaped bacterium with many tiny appendages but no actual ability to stay put), so Candida will flourish in the Lactobacillus’s absence.

    *by the vagina, we are referring to the vaginal canal. The vulva—the outside part consisting of the two pairs of labia, the glans clitoris, and clitoral hood—are not self-cleaning, and should just be washed gently per your normal bath/shower routine; that’s perfectly fine and good.

    And definitely don’t put any “cleansing” toiletries inside the vagina (or any toiletries at all, for that matter), even if they are sold and marketed for that purpose; they will not help and they will harm.

    Also, due to their neighborliness, messing up the microbiome inside the vagina is a common way to also get Candida inside the urethra:

    How To Avoid Urinary Tract Infections (UTIs)

    One other option

    Finally, unless you have a “very good friend” you have a pressing urge to swap germs with, you might want to leave this one to the scientists, but we share this paper just for interest:

    The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review

    Lastly…

    Going back to oral supplementation, if you’d like to try that then check out this for further notes on what, why, how, etc:

    How Much Difference Do Probiotic Supplements Make To Health?

    Take care!

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