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While age, environment and genetics are known to affect the vaginal microbiome, the impact of hormonal fluctuations during the menstrual cycle and the use of hormonal contraceptives is less clear. Emerging research is now starting to address these influences and explore solutions for imbalances.
What We Know:
The vaginal microbiome is generally dominated by Lactobacillus spp. and this is thought to be regulated by oestradiol and progesterone levels. This dominance is more prevalent during reproductive years when these hormones are high. In contrast, prepubescent girls and postmenopausal women, who have lower hormone levels, typically have a more diverse vaginal microbiome with reduced Lactobacillus abundance (Krog et al., 2022).
Research has yet to explore the long term impact of fluctuating sex hormones during the menstrual cycle and the potential effects of hormonal contraception on microbiome composition (Krog et al., 2022).
Industry Impact and Potential:
Hormonal contraceptives do not significantly alter the composition of the vaginal microbiome. Studies have shown that regardless of the contraceptive method used, the abundances of key species such as Lactobacillus crispatus, Lactobacillus iners, Gardnerella vaginalis and Prevotella spp. remain consistent (Krog et al., 2022).
However, the vaginal microbiome undergoes significant changes throughout the menstrual cycle, particularly in women not using hormonal contraceptives. During the follicular and luteal phases, there is an increase in L. crispatus, alongside a decrease in eight bacterial vaginosis-associated species. This pattern reflects a shift in microbial balance that aligns with hormonal fluctuations throughout the cycle. Notably, Lactobacillus species showed positive correlations with serum oestradiol levels and higher levels of L. iners were associated with increased oestradiol (Krog et al., 2022).
The reasons for increased microbiome diversity during menstruation, whether due to hormonal shifts, iron availability from menstrual blood or the impact of menstrual hygiene products, are still unconfirmed. However, findings suggest that menstrual products and sexual practices have only a minor effect on these microbial changes (Krog et al., 2022).
This study was the first to measure serum oestradiol levels and find a link between high oestradiol and the presence of L. crispatus, indicating that hormones help maintain this beneficial microbe (Krog et al., 2022).
Earlier this year, @Seed Health launched VS-01™, a pioneering vaginal suppository synbiotic featuring three proprietary strains of L. crispatus. Clinically validated to optimise the vaginal microbiome, VS-01™ has been shown to effectively regulate pH levels within one menstrual cycle (Microbiome Post, 2024).
Our Solution:
In addition to vaginal microbiome analysis, we at Sequential provide services for assessing skin, scalp and oral microbiomes, and have established our company as a leader in facilitating the assessment and development of products that maintain microbiome integrity. Our team of experts is well-equipped to support your company in formulating innovative products suitable for maintaining and improving the vaginal microbiome to support women’s health.
References:
Krog, M.C., Hugerth, L.W., Fransson, E., Bashir, Z., Nyboe Andersen, A., Edfeldt, G., Engstrand, L., Schuppe-Koistinen, I. & Nielsen, H.S. (2022) The healthy female microbiome across body sites: effect of hormonal contraceptives and the menstrual cycle. Human Reproduction (Oxford, England). 37 (7), 1525–1543. doi:10.1093/humrep/deac094.
Microbiome Post (2024) Seed Health introduces revolutionary vaginal microbiome product: VS-01.
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