Vaginal microbiome testing — another tool in the kete

Vaginal discharge and irritation can be really frustrating to manage.

Sometimes the answer is straightforward — thrush, bacterial vaginosis, an STI, hormonal changes or irritation. But sometimes you can still have very real symptoms and the usual swabs either come back normal, inconsistent, or with that slightly unhelpful word: “indeterminate.”

That is where things can get a bit harder.

We still start with the usual tools in the kete — examination, vaginal swabs, STI testing if relevant, vaginal pH, and thinking about things such as vaginal dryness or low oestrogen, skin conditions and irritants.

But if you are continuing to have symptomatic discharge, burning, irritation, odour or recurrent “thrush/BV-type” symptoms and we are not getting a clear answer, another option is vaginal microbiome testing.

Tests such as Juno Bio look more broadly at the community of bacteria and fungi living in the vagina, rather than simply telling us whether one particular infection is present or absent.

Sometimes that extra information can help us understand the overall pattern a little better — for example, whether protective Lactobacillus bacteria are dominant, whether there is a more mixed bacterial picture, or whether there are organisms present that haven't shown up clearly on routine testing.

It is important to say that this is not currently part of standard guideline-based investigation, and I would never use a microbiome result in isolation to diagnose or treat an infection.

But when symptoms are ongoing and the standard tests haven't really given us an answer, I think it can be another useful tool in the kete.

If you do decide to test, it is usually most helpful to take the sample when you are actually having the symptoms you are trying to understand.

More information: www.juno.bio