Researchers have been looking at the ability of Helicobacter pylori (H. pylori) bacteria to be sexually transmitted, primarily via oral sex. Helicobacter pylori colonises the stomach and causes ulcers, gastritis, and sometimes stomach cancers, but we’re not quite sure of its impact on the vagina, or just how spreadable it is. It’s possible that it could be a cause of bacterial vaginosis, but we are not sure yet.

There is some evidence that Helicobacter pylori exist in the mouth as part of the colony, and since oral sex is a common practice, it means it could be spread. Helicobacter pylori has been found in the vagina, nose, coronary (heart artery) plaque, the ears and the breast. It is a known cancer-causing microbe.

Is Helicobacter pylori transmitted via sexual contact?

There is some evidence of a transmission between the mouth and genitals, and theoretical links. Helicobacter pylori colonises yeast in the vagina, and has been associated with biofilm formation. It could be a cause of bacterial vaginosis that resists treatment.

Helicobacter pylori is most commonly found in the stomach and upper gastrointestinal tract, being very apt at colonising this very acidic environment. The vagina is also very acidic, which may allow it to act as a reservoir, allowing sexual transmission to a partner’s mouth.

Helicobacter pylori has been found to have a symbiotic relationship with Candida albicans (which causes yeast infections), as bacteria have been isolated from these yeasts, and genes specific to H. pylori have been found in yeast. This may allow Helicobacter pylori to colonise the vagina.

Studies trying to isolate Helicobacter pylori from the vagina

Early attempts to isolate Helicobacter pylori from the vagina produced nil, but probable low concentrations of the bacteria may produce negative results. The tests are designed for high bacterial counts in the gut, not for low bacteria counts in the vagina. This means testing methods need to be revised to take this into account.

H pylori Helicobacter pylori bacteria

How does transmission of Helicobacter pylori work?

Studies have shown that in sex partners with a man or a woman infected with Helicobacter pylori, the non-infected partner has an increased risk of becoming infected. Spouses have been known to infect or reinfect each other, including with the same strain. Multiple strains may exist in one person.

Transmission could also occur during birth if Helicobacter pylori is in the vagina. Studies show that the incidence of Helicobacter pylori in pregnant women is about 20 per cent.

Why hasn’t an H. pylori species been found in the vagina during vaginal swab cultures?

Taking bacteria from the vagina via a swab and then culturing the bacteria is one of the ways we commonly test for sexually transmitted infections and vaginal infections. The reason we may not have found H. pylori – despite the possibility that it exists in the vagina – is that H. pylori species are hard to grow in culture.

This might be because the colonies are very small in the vagina, and that in the culture, competition from other bacteria may influence outcomes of culture. The number of H.pylori in the stomach are three times more than in the mouth, so using stomach culturing techniques for oral H. pylori isn’t going to be enough. We need to adjust the testing so it is more sensitive to small colonies.

Mouth-to-breast transmission of Helicobacter pylori

A case involving oral contact with the nipple may have resulted in H. pylori entering the breast duct leading to fibrocystic breast changes, and H. pylori was found in the faeces of half of all breast-fed three-day-old babies whose mothers had documented H. pylori antibodies. H. pylori was found in four out of  66 milk samples from mothers.

Mouth-to-mouth and mouth-to-anus transmission of  Helicobacter pylori

Helicobacter pylori can be passed around families via shared objects and food that has come into contact with an infected mouth. It can also be passed on by coming into contact with vomit, faeces, dental plaque, gastric juices or saliva, with waterborne Helicobacter pylori being a factor.

Helicobacter pylori infections tend to appear in clusters like families. There is a link between oral infection and stomach infection, and any infection in the mouth can be easily passed on via wet kisses. Mouth-to-anus transmission of Helicobacter pylori is possible.

Helicobacter pylori and urethritis

A link between urethritis and H. pylori has been suggested. It is possible for H. pylori to be transmitted to the urethra in men or women via oral sex from someone with an infected mouth, so it stands to reason that the bacteria could colonise, causing symptoms and disease. There are a large proportion of men with urethritis not caused by gonorrhoea where no other organisms can be found.

Oral and vaginal yeasts and how they harbour H. pylori

Oral yeasts were found more often in babies born vaginally, with the frequency of H. pylori genes in the vaginal yeasts of the mother significantly higher than in the mother’s oral yeasts. A correlation was found between H. pylori genes in vaginal yeasts and oral H. pylori in babies. It is hypothesised that babies’ mouths could act as a reservoir for H. pylori.

Vaginal yeasts are far more accommodating to H. pylori than oral yeasts, so vaginal yeast is considered to be the primary reservoir of H. pylori, facilitating transmission to babies via vaginal delivery.

Can I treat H. pylori vaginal or urethral infections with herbs and natural medicine?

Treating stubborn bacteria with herbs, particularly in the vaginal or urinary tract, is possible, however you will need to consult with a very experienced herbalist for the best prescription and treatment plan. H. pylori is notoriously hard to get rid of, so a combined approach with conventional treatments with herbal medicine or other support may be recommended.

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
Read more about Jessica and My Vagina's origin story.
Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

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