Vaginal Microbiome Analysis
A vaginal microbiome test is a specialised diagnostic tool used to identify and quantify the types and relative proportions of microorganisms (bacteria, fungi and other microbes) present in the vaginal environment. Unlike traditional vaginal swabs that might only culture for specific common pathogens, this test uses advanced DNA sequencing techniques which allow for a much more comprehensive and precise assessment of the entire microbial community. This test can help to understand the overall ecosystem and identify subtle imbalances (dysbiosis) that might contribute to health issues, including understanding factors that may influence recurrent vaginal infections or thrush, HPV persistence and cervical changes, chronic HSV recurrent UTI's and there is even emerging evidence linking changes in the vaginal microbiome to Endometriosis and Adenomyosis.
Different microbial compositions within the vaginal and cervical microbiome can significantly contribute to various gynaecological and reproductive health problems:
Vaginal and Cervical Inflammation/Infections:
A healthy vaginal microbiome is typically dominated by beneficial Lactobacillus species which produce lactic acid which maintains a low, acidic pH and inhibits the growth of harmful bacteria. They also produce antimicrobial compounds like hydrogen peroxide.
Bacterial Vaginosis (BV) occurs when there is a significant decrease in Lactobacillus species and an overgrowth of various anaerobic bacteria which leads to a higher pH, inflammation, discharge, and often a characteristic "fishy" odour.
Aerobic Vaginitis (AV) involves an overgrowth of aerobic bacteria resulting in intense inflammation, yellow discharge, and significant discomfort.
Cervical inflammation (Cervicitis) can arise from the ascent of bacteria associated with BV or specific sexually transmitted infections (STIs) like Chlamydia and Gonorrhoea, altering the delicate cervical microbial balance.
Recurrent Thrush (Vulvovaginal Candidiasis):
Thrush is caused by an overgrowth of Candida yeast, which can be a normal resident in small amounts. An imbalance in Lactobacillus species can allow Candida to proliferate unchecked and lead to recurrent thrush. Factors like antibiotic use and hormonal changes can disrupt the protective Lactobacillus shield, making the vagina more susceptible to Candida overgrowth.
Urinary Tract Infections (UTIs):
Most UTIs are caused by bacteria originating from the gut and ascending into the urinary tract. The vaginal microbiome acts as a critical barrier against these uropathogens. If the vaginal microbiome is imbalanced (e.g., low Lactobacillus numbers and a higher pH), it can make it easier for pathogens to colonize the periurethral area and enter the urethra, leading to recurrent UTIs.
Endometriosis and Adenomyosis:
Dysbiosis in the vaginal microbiome with low protective Lactobacillus and high levels of pathogenic bacteria can allow inflammatory toxins to travel up the reproductive tract. When combined with factors like retrograde menstruation, these toxins trigger a chronic immune response in the pelvis and uterus, creating an environment conducive to the implantation and growth of endometriotic lesions and the invasion of endometrial tissue into the uterine muscle, which defines adenomyosis. Testing the microbiome provides allows us to identify and correct this dysbiosis, potentially reducing the inflammatory load that drives these chronic pelvic conditions.
Infertility & Preconception Care:
An imbalanced vaginal or uterine microbiome can significantly impact fertility. Chronic inflammation caused by BV or other dysbiotic states can create an unfavourable environment for sperm survival and motility, hinder embryo implantation in the uterine lining, and increase the risk of early pregnancy loss. Specific bacteria found in the vaginal microbiome, if present in the uterus (known as the endometrial microbiome), have been linked to recurrent implantation failure and unexplained infertility.
HPV Persistence and Cervical Changes:
Research increasingly shows a strong link between vaginal dysbiosis (especially BV-like profiles) and the persistence of Human Papillomavirus (HPV) infections, as well as the progression of HPV-related cervical changes (dysplasia). A reduced dominance of protective Lactobacillus species and an abundance of anaerobic bacteria create an inflammatory environment. This inflammation may impair the body's ability to clear HPV infections naturally and can contribute to changes in cervical cells, increasing the risk of abnormal Pap test results and potential progression to more severe cervical lesions.
HSV Persistence:
A lack of Lactobacillus species removes the natural lactic acid and hydrogen peroxide that normally neutralise the Herpes Simplex Virus on contact. An imbalanced microbiome produces enzymes that disarm local antibodies, making it harder for your immune system to suppress viral replication. This creates a chronic inflammatory state that can actually trigger the virus to wake from its dormant state in the nerves, leading to more frequent shedding and outbreaks.
Pelvic Inflammatory Disease (PID):
PID is a serious infection of the upper reproductive organs (uterus, fallopian tubes, ovaries) that typically occurs when bacteria from the vagina and cervix ascend. While often associated with untreated STIs (Chlamydia trachomatis, Neisseria gonorrhoeae), other non-STI bacteria commonly found in BV (Mycoplasma genitalium, Gardnerella vaginalis, etc.) can also contribute to PID development when the vaginal microbiome is disrupted. PID can lead to severe pain, scarring of the fallopian tubes, chronic pelvic pain, ectopic pregnancies, and irreversible infertility.
A vaginal microbiome PCR test is recommended with any recurrent vaginal discomfort, abnormal odour or discharge, recurrent UTI's, unexplained infertility or as preparation for conception, and for women experiencing persistent HPV infections or cervical changes.
If you would like to discuss if a Vaginal Microbiome test is suitable for you then book a time for your free Discovery Call
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