A review in Frontiers in Cellular and Infection Microbiologyexplores how analyzing the vaginal microbiome could improve diagnostic testing for a range of women’s health conditions.
The vaginal microbiome is typically dominated by Lactobacillus species, which help maintain an acidic pH and protect against pathogens. Disruption to this balance – known as dysbiosis – has been linked to bacterial vaginosis (BV), sexually transmitted infections (STIs), certain cancers, and complications in pregnancy and fertility.
Current tests for BV, such as Amsel’s criteria and Nugent scoring, can be subjective and may miss important microbial changes. In STIs, conventional methods focus on specific pathogens, whereas microbiome profiling could detect broader shifts that signal risk before symptoms appear.
For cervical cancer, persistent infection with high-risk human papillomavirus (HPV) is a major cause. Research suggests that microbiome composition may influence susceptibility, offering a potential addition to existing screening methods.
The review points to possible diagnostic applications for:
Gynecological cancers: Certain microbial profiles may be linked to cervical, endometrial, and ovarian cancers.
Fertility and pregnancy: Microbiome changes could help predict reduced fertility or higher risk of preterm birth.
Postmenopausal conditions: Species linked to genitourinary syndrome of menopause could serve as markers for diagnosis and monitoring.
The authors highlight that variability in study design and laboratory methods has hindered the comparability of microbiome research. They recommend developing vaginal microbiome-specific reference reagents, standardizing protocols, and ensuring robust clinical trial design to support regulatory compliance and integration into clinical workflows.
The review concludes that incorporating microbiome profiling into diagnostic strategies could enhance precision in women’s health testing. Such tools, if standardized and clinically validated, could complement existing methods, support earlier detection, and inform targeted treatment approaches.
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