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What we know:
Bacterial Vaginosis (BV) affects 23-29% of women worldwide, and it costs $4.8 billion to treat symptomatic BV annually (Peebles et al., 2019)
Treatment often only presents temporary relief, with recurrence in around 80% of patients three months of successful treatment (Coudray et al., 2020)
BV is characterised by discomfort of the vagina, it is generally caused by a decrease in amount of Lactobacillus (which we know is dominant in the vaginal microbiomes of healthy women) and an increase in facultative or obligate anaerobic microbes (Chen et al., 2021) (Onderdonk et al., 2016).
Studies have shown that Bacterial Vaginosis prevalence varies between ethnic groups in nearly all of the populations studied
In the US bacterial vaginosis has been black race, in the UK Afro-Caribbeans, in Canada aboriginal populations, in Spain Gypsy populations, and in China Tibetan ethnicity all had a higher prevalence - interestingly, all of these groups constitute a minority population in the country researched (Lewis et al., 2017)
We know that certain types of hormonal contraceptives can alter the vaginal microbiome, and the use of an oral contraceptive has been found to be consistent with a decrease in BV prevalence (Lewis et al., 2017)
An increased risk of BV is thought to be caused by more frequent vaginal intercourse as well as intercourse with new, multiple, or an increased number of male sexual partners (Lewis et al., 2017)
BV has been associated with a variety of health issues within women, including preterm birth, pelvic inflammatory disease, an increased susceptibility to infection of HIV (Onderdonk et al., 2016)
Industry impact & potential:
It is clear that a more effective and complex strategy to the treatment and prevention of BV is needed
(According to The National Institute for Health and Care Excellence) Around 50% of BV cases among women are asymptomatic, therefore it is important that reliable technology is developed to better identify BV in an effort to limit misdiagnosis
A pilot study in 2019 highlighted the possibility of using vaginal microbiome transplantation from healthy donors as a treatment for BV, and this presents an interesting potential for the future of treatment. Yet, it has to be noted that the risks and potential long-term consequences need to be studied a great deal more in order to determine whether this has the potential to become a feasible option in the future (Vieira-Baptista et al., 2022)
Sequential’s approach:
Our Scientific Advisor Professor Phillip Bennett is a key pioneer in vaginal microbiome research. By conducting microbiome testing on intimate care formulations, manufacturers can address common concerns like bacterial vaginosis. Microbiome testing in vaginal care products ensures that they are not only effective in addressing individual concerns, but also gentle and supportive of the natural microbial community.
References:
Chen X, Lu Y, Chen T, Li R. The Female Vaginal Microbiome in Health and Bacterial Vaginosis. Front Cell Infect Microbiol. 2021 Apr 7;11:631972. doi: 10.3389/fcimb.2021.631972. PMID: 33898328; PMCID: PMC8058480.
Coudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol. 2020 Feb;245:143-148. doi: 10.1016/j.ejogrb.2019.12.035. Epub 2019 Dec 24. PMID: 31901667; PMCID: PMC6989391.
Lewis FMT, Bernstein KT, Aral SO. Vaginal Microbiome and Its Relationship to Behavior, Sexual Health, and Sexually Transmitted Diseases. Obstet Gynecol. 2017 Apr;129(4):643-654. doi: 10.1097/AOG.0000000000001932. PMID: 28277350; PMCID: PMC6743080.
Onderdonk AB, Delaney ML, Fichorova RN. The Human Microbiome during Bacterial Vaginosis. Clin Microbiol Rev. 2016 Apr;29(2):223-38. doi: 10.1128/CMR.00075-15. PMID: 26864580; PMCID: PMC4786887.
Peebles K, Velloza J, Balkus JE, McClelland RS, Barnabas RV. High Global Burden and Costs of Bacterial Vaginosis: A Systematic Review and Meta-Analysis. Sex Transm Dis. 2019 May;46(5):304-311. doi: 10.1097/OLQ.0000000000000972. PMID: 30624309.
Vieira-Baptista P, De Seta F, Verstraelen H, Ventolini G, Lonnee-Hoffmann R, Lev-Sagie A. The Vaginal Microbiome: V. Therapeutic Modalities of Vaginal Microbiome Engineering and Research Challenges. J Low Genit Tract Dis. 2022 Jan 1;26(1):99-104. doi: 10.1097/LGT.0000000000000647. PMID: 34928260; PMCID: PMC8719494.
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