Intimate Ecology - Moira Bradfield

Intimate Ecology - Moira Bradfield Influencing global genitourinary health, through practitioner CPD education, mentoring and clinical consultation.

Recurrent infections, vaginal, vulval health, penile and urinary health.

03/06/2026

Q: "I'm negative for Ureaplasma but still have symptoms a year later... biofilms?"

Not necessarily.
A negative test with ongoing symptoms doesn't automatically mean the infection is still there.
Here are some possibilities:

The Ureaplasma wasn't the main cause
Ureaplasma species can be present in healthy people. Sometimes symptoms are actually being driven by another issue that hasn't yet been identified.

Residual inflammation
The immune system doesn't always switch off immediately after an infection or carriage clears. In some people, inflammatory pathways may remain activated long after the microbe is gone.

Histamine and mast cells
Emerging research suggests infections can sometimes leave behind altered immune and nerve signalling, contributing to ongoing burning, urgency, pain or sensitivity.

Microbiome recovery
Antibiotics may remove Ureaplasma, but recovery of a healthy Lactobacillus-dominant vaginal microbiome can take time. Dysbiosis may persist even when the organism is gone.

Hormones matter
Estrogen plays a major role in v.ginal tissue health, immune function and microbiome stability. Hormonal changes can contribute to symptoms that mimic infection.

Partner and s3xual factors
Microbial exchange, s3men exposure, lubricants, friction and other s3xual factors can influence symptoms and microbiome recovery.

What about biofilms?
Biofilms are real, but persistent symptoms alone are not evidence that a biofilm is present. There is currently limited evidence that unexplained symptoms a year after treatment are routinely caused by hidden Ureaplasma biofilms.

Interestingly, research in urinary tract infections shows that symptoms can sometimes persist after bacteria have been eradicated due to ongoing immune, epithelial and nerve-related changes. While we don't yet have equivalent evidence for Ureaplasma, it highlights that recovery isn't always just about eliminating a microbe.

The goal isn't just eradication,
it's recovery of the microbiome, tissues, immune system and pelvic environment.

Need support? Connect today
 

03/06/2026

Stressed or worried about any of our content subject matter?

A quick chat on why we discuss and post the content we do. It is not to target anyone or induce worry that what you are doing is wrong or associated with risk.

Providing information for us is about education and getting all the information so you can make decisions.

But when you are stuck with unexplainable or chronic symptoms it is easy to drum up some health anxiety and take a small snippet of information and spiral with it.

If anything you read is distressing or worries you we encourage you to connect with on of our practitioners who can discuss your individual case presentation and make recommendations that are based on your health history, microbiome composition and symptoms.

Nervous system health and wellbeing is a big part of what we do. Getting informed is a small part of that.

You can book with an Intimate Ecology practitioner via our link in Bio.

This question came through and the answer is nuanced.Cytolytic v.ginosis (CV) is an overgrowth of Lactobacillus bacteria...
02/06/2026

This question came through and the answer is nuanced.

Cytolytic v.ginosis (CV) is an overgrowth of Lactobacillus bacteria in the v.gina, usually dominated by very high levels of Lactobacillus crispatus. It is, however a controversial diagnosis and definately understudied.

Whilst the literature isnt definitive on the drivers of CV we have several hypotheses. Including one explored in my own research on recurrent thrush where we observed increases in L. crispatus after long periods of fluconazole use.
Suggesting that the high levels of Lactobacillus that drive inflammation and cell damage are resultant from overtreatmemt, typically, antibiotics and antifungal drugs.

Some people report they end up with CV symptoms from overuse of v.ginal probiotics, an address that is attempting to resolve imbalance. Which leaves us in unknown territory as all of these interventions are useful in the management of v.ginal microbiome imbalance and infection.

The clinical approach I take when prescribing v.ginal probiotics is metered:

Use is usually ok ongoing if indicated however:

*You need to understand the microbiome to inform best intervention.

*You need to understand symptoms and their cause so you know if they are resolved.

*The v.ginal microbiome is incredibly intelligent and resilient when supported back to balance correctly. If supported correctly there should be no need to continue to use probiotics ongoing.

We also know that probiotics don't permanently colonise so a resultant CV from probiotic use is more about your own tissue state, immunity and disorder and the native microbiome adaptations than the probiotic itself.

Essentially, we dont have any studies that show CV coming from probiotic use so its hard to say what is too much.
It is worth asking yourself the question why are you continuing use and is it because of symptoms or more a "just in case" crutch?

Have you tested the microbiome off probiotics?

Need support? Connect with an Intimate Ecology practitioner.

Link in Bio

01/06/2026

An audience question about recurring thrush after a period.

There are a number of considerations and clues that timing points to. These need to be understood to address the pattern. But there is definately hope that you can have a normal v.gina but it may take some good clinical detective work and targeted support to get there.

Need support? Book with an Intimate Ecology practitioner.
Link in Bio

26/05/2026

If you’ve ever been told
“your tests are normal”
or worse
“it’s probably all in your head”
you’re not alone.

We hear it all the time.
Many people living with persistent genitourinary symptoms experience pain, burning, urgency, recurrent infections, vulvovaginal discomfort, pelvic pain, or sexual pain without clear answers. The uncertainty of why can be deeply distressing. And whilst saying it is all in your head is incorrect, the role your nervous system plays is important, that does not mean your symptoms are imagined.

Pain, inflammation, chronic stress, disrupted sleep, fear of relapse, embarrassment, medical dismissal, relationship strain, and hypervigilance can all influence how the nervous system processes symptoms and how symptoms are experienced over time.

Living in a prolonged state of stress or threat can also influence immune signalling, recovery processes, pain sensitivity, and overall wellbeing.

This is why comprehensive care matters.
At Intimate Ecology, we explore the full picture:
• symptoms and testing
• hormonal and metabolic health
• gastrointestinal and microbiome health
• lifestyle and risk factors
• nervous system regulation
• the emotional impact of living with unresolved symptoms

Because acknowledging the nervous system is not the same as dismissing physical symptoms.
Both can be true:
your symptoms are real and your nervous system may need support too.

Compassionate healthcare should make room for both.

If you need support with your genitourinary health, connect with an Intimate Ecology practitioner via the link in bio.

24/05/2026

Proteus mirabilis is a Gram-negative, highly motile bacteria associated with recurrent UTIs, v.ginal dysbiosis, kidney stones, and chronic g3nitourinary irritation.

Did you know its presence may be indicated by a strong ammonia-like odour in urine or v.ginal d1scharge.

This happens because Proteus produces the enzyme urease, which breaks down urea into ammonia, raising pH and disrupting the normal microbial environment.

As pH becomes more alkaline:
• Protective Lactobacillus species may decline
• Biofilms become easier to establish
• Inflammation increases
• Recurrent infections become more likely

Unique Proteus characteristics
•Urease production → ammonia + elevated pH
•Swarming motility → helps spread through the urinary tract
•Biofilm formation → persistence and antibiotic tolerance
•Lipopolysaccharide (LPS/endotoxin) → inflammatory immune activation
•Strong adherence mechanisms → attachment to mucosal tissues and catheters

UTI SYMPTOMS
• Burning urination
• Urinary urgency and frequency
• Cloudy urine
• Pelvic discomfort
• Flank pain
• Recurrent UTIs
• Kidney stones
• Strong ammonia odour

V.GINAL / V.GINITIS-TYPE SYMPTOMS
• V.ginal odour
• Burning or irritation
• Increased discharge
• Elevated vaginal pH
• Vulvov.ginal discomfort
• Symptoms overlapping with BV or aerobic v.ginitis

An ammonia smell may be a biochemical clue pointing toward urease-producing organisms and disruption of the genitourinary microbiome.

Proteus is just one of many urease producers which can be identified with comprehensive testing

Need support? Book with an Intimate Ecology practitioner today.

22/05/2026

Research is showing a huge overlap between chronic pelvic pain and IBS. One population-based study in 2010 found that 40% of women with pelvic pain also met the criteria for IBS, while another more recent study in 2026 found IBS symptoms in 74.2% of women with chronic pelvic pain.

Interestingly, women with deep endometriosis were actually less likely to meet IBS criteria, suggesting symptoms are not always explained purely by structural disease alone.

So what could connect the gut and the pelvis?

The nervous system.

The 2010 study discusses processes like somatisation and central sensitisation where the nervous system becomes more sensitive and reactive to signals coming from the body.
Over time, normal sensations from the gut and pelvic organs can start triggering amplified pain or discomfort responses, even without obvious structural pathology. Essentially, the body’s alarm system can become overprotective.

This doesn’t mean symptoms are imagined or “just stress.” The bloating, cramping, bowel changes, and pelvic pain are still very real. It means the nervous system may be playing a role in how symptoms are processed, interpreted and amplified through the constant communication between the brain, gut and pelvis.

Yes, the gut microbiome, inflammation, hormones and immune function absolutely play an important role in this connection. But the nervous system is such a key part of the puzzle.

This is where something like PRT (Pain Reprocessing Therapy) can be so useful. It helps to calm a sensitised nervous system, reduce fear around symptoms and retrain the brain’s response to pain and internal sensations.

Practitioner Danni works with pelvic pain, gut and genitourinary health as part of her naturopathic practice or with standalone PRT sessions. Link in Bio



Herrick, L. M., et al. (2010). Irritable bowel syndrome and chronic pelvic pain: a population-based study. Journal of clinical gastroenterology

Powell, S. G., et al, (2025). High prevalence of irritable bowel syndrome in women with chronic pelvic pain and discerning features relevant to deep endometriosis. Journal of Endo

17/05/2026

Gram stains in v.ginal microbiology are often interpreted as a high level snapshot of the environment, not just a list of what happened to grow in culture. I use this high level overview to understand symptoms and what the client is reporting. 

When we see the comment “gram-positive bacilli,” it is not incorrect to assume Lactobacillus dominance.

But not always...

Gram-positive bacilli on microscopy can also include other vaginal organisms such as:

• Corynebacterium

• Clostridium

• Bifidobacterium

• Actinomyces

• Fannyhessia

• Mobiluncus

And some v.ginal organisms like Gardnerella behave gram-variable, meaning their staining characteristics can shift depending on growth phase, cell wall integrity, biofilm state, or sampling conditions.

Microscopy is incredibly useful, however morphology is not definitive for taxonomy.

This is one reason molecular v.ginal microbiome research changed the field so dramatically, we can now understand exactly what a culturable microbe sits amongst.  The v.ginal microbiome is far more diverse, dynamic, and context-dependent than testing techniques like culture and microscopy suggest. 

If you are a practitioner and interested in understanding how comprehensive testing can be used to inform case support and intervention then check out the June 2 part Clinical Mentoring Intensive. We will be working through real life cases and experiences. 

Link in Bio

 

16/05/2026

Sometimes the thing you apply to soothe the tissue is feeding the inflammation.

Meet Malassezia:

A lipid-loving fungal species increasingly found on v.ginal microbiome testing.
Unlike Candida, Malassezia can’t efficiently make its own fatty acids. So it scavenges them from its environment including:

*oleic acid
*palmitic acid
*stearic acid
*skin lipids
*oil-based products

This creates a major clinical challenge.
In highly inflamed vulval and v.ginal presentations, oil-based products are often used because they can:

*reduce friction
*calm irritated tissue
*support barrier function

If Malassezia is contributing to the inflammatory picture, especially in:

*vulval burning
*reactive erythema
*cyclic vulval and v.ginal irritation
*“everything burns” presentations

some oils may worsen symptoms.

Malassezia produces lipases that break down oils and sebum into inflammatory fatty acid byproducts, especially oleic acid derivatives, which may:

*disrupt epithelial barrier integrity
*increase transepidermal water loss
*activate inflammatory cytokines
*trigger burning and stinging sensations

This mechanism is well described in seborrhoeic dermatitis and atopic dermatitis where Malasezzia features. It appears to have relevance in vulvov.ginal tissue too.

This is why microbiome testing that identifies all fungi is needed.

And then we ask the clinical questions:

*Which species?
*What symptoms are present?
*Is burning dominant?
*Is tissue highly reactive?
*Do oils flare symptoms?

Not every inflamed presentation needs oil.

Need support? Book with an Intimate Ecology practitioner today.

15/05/2026

Some weeks in clinic really highlight how connected the vaginal microbiome, gut health, immune function, and fertility truly are.

Jessie-Anne is an experienced and empathetic practitioner who supports patients navigating both fertility journeys and complex chronic health concerns with a thoughtful, personalised approach. This week in clinic included support for:

✨ Multiple patients experiencing improvements in BV symptoms
✨ Recurrent UTIs and thrush
✨ Digestive and microbiome imbalances
✨ Clearance and improvement of Saccharomyces cerevisiae overgrowth
✨ Post-antibiotic vaginal microbiome restoration support
✨ Preconception and fertility-focused microbiome care

So many people are told recurrent symptoms are “normal” or simply something they’ll need to keep managing indefinitely. Often, there’s far more going on beneath the surface and targeted support can make a real difference.

If you’re looking for a practitioner who combines clinical experience with genuine compassion and a microbiome-focused lens, Jessie-Anne is available for consultations at Intimate Ecology. Link in Bio





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