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Vaginal Microbiome


What is the vaginal microbiome’s contribution to our health?

The vaginal microbiome changes in composition throughout a woman’s lifetime. In reproductive years, the vaginal microbiome is dominated by one species of bacteria called Lactobacillus [1], with the vagina being the only site that is described to be healthy/normal with low diversity. Human vaginal microbiota is described to be causative of bacterial vaginosis, yeast infections, and urogenital diseases. Dysbiosis of the vaginal microbiome could potentially increase a person’s risk of contracting sexually transmitted infections (STIs) and urinary tract infections (UTIs). Misdiagnosis for various vaginal conditions and recurrence of conditions like bacterial vaginosis (BV) is a huge problem for women who suffer this discomfort. Bacterial vaginosis, the most common vaginal dysbiotic condition, is thought to affect 1 in 3 women of reproductive-age [2]. BV is also considered to be a risk factor for subfertility and infertility in women. Therefore, vaginal microbiome testing might be useful in the following conditions: recurrent bacterial vaginosis, aerobic vaginitis, yeast infection, Trichomonas, STIs (sexually transmitted diseases), menopause and vaginal dryness.

How does the vaginal microbiome effect fertility?

A specific class of microbiome, called Mollicutes are implicated in causing fertility issues. Increased presence of specific bacterial taxa along with higher abundance of Candida (yeast) and reduced Lactobacillus in the vaginal microbiome, is often present in women with fertility problems. Research also confirms the vaginal microbiome as being a component that influences outcomes with IVF and assisted reproductive technology (ART).

How does the vaginal microbiome effect pregnancy?

In a healthy pregnancy, the mucous plug at the cervix blocks bacteria from ascending into the uterus. However, a subset of vaginal microbiome organisms are able to ascend to the upper genital tract and gain access to the uterus and amniotic sac during pregnancy. The subset of bacteria that do this are able to degrade hyaluronan and other amino sugars that form the matrix of cervical mucous plug. By degrading the mucous plug of the cervix, and thereby gaining access to uterus, the microbiome can act on the amniotic sac and cause preterm birth and other prenatal and postpartum complications. Microbiome testing can be useful in cases with history of preterm birth, spontaneous abortions, preterm labor, chorioamnionitis, amnionitis, and PPROM (Preterm premature rupture of membrane during pregnancy) [3].


  • Chaban, B., Links, M. G., Jayaprakash, T. P., Wagner, E. C., Bourque, D. K., Lohn, Z., … & Money, D. M. (2014). Characterization of the vaginal microbiota of healthy Canadian women through the menstrual cycle. Microbiome, 2(1), 1-12.
  • Schellenberg, J. J., Paramel Jayaprakash, T., Withana Gamage, N., Patterson, M. H., Vaneechoutte, M., & Hill, J. E. (2016). Gardnerella vaginalis subgroups defined by cpn 60 sequencing and sialidase activity in isolates from Canada, Belgium and Kenya. PloS one, 11(1), e0146510.
  • Paramel Jayaprakash, T., Wagner, E. C., van Schalkwyk, J., Albert, A. Y., Hill, J. E., Money, D. M., & PPROM Study Group. (2016). High diversity and variability in the vaginal microbiome in women following preterm premature rupture of membranes (PPROM): a prospective cohort study. PloS one, 11(11), e0166794.