Vaginal microbiome test

Green means your microbes look like those of healthy women. Amber and red show how far they differ. It is not a diagnosis and does not mean you have the condition or that you will get it.

So after menopause your microbes are compared with women at the same stage of life, not with 25-year-olds.

For every trait the handbook says what the colour means, what you can do yourself and when to see a doctor. You can take it to your gynaecologist.

It is the most common shift in balance in women of reproductive age, and about half the time it causes no symptoms. It is compared separately with women before and after menopause.

Sequencing identifies the yeast to species, including the less common ones other than Candida albicans. Many healthy women carry a little Candida, so the result shows carriage, not infection.

It is often confused with bacterial vaginosis, but it is a different shift. The report shows its microbial side; the inflammation is seen under a microscope by a gynaecologist.

The urethral opening is very close, so these bacteria are an early-warning sign, especially if your infections keep coming back. An infection itself is confirmed with a urine test, not with this test.

The symptoms are like thrush, but there is no yeast. Without symptoms, a high result simply means there are plenty of lactobacilli and the environment is well protected.

These conditions begin elsewhere in the body, and the vagina reflects them rather than causes them. They are diagnosed with an examination, hormone tests and imaging, so the result is a reason to talk to a gynaecologist, not a diagnosis.

The result says nothing about ovulation, the tubes or your partner. It shows whether the vaginal environment is one of the factors that can be changed before trying or before an embryo transfer.

Pregnancy itself changes the vaginal microbiome, so outside pregnancy the result shows a tendency only. An accurate assessment is possible only on a sample taken during pregnancy. The result does not tell whether a pregnancy loss will happen and does not explain a past one.

For each one the colour combines two things: whether the organism's DNA was seen in the sample and how strong your lactobacilli's defence is.

If the result is moderate or high, show it to your gynaecologist at your next check-up, and if you are pregnant, tell the doctor who looks after you. The result does not replace group B streptococcus screening late in pregnancy.

Dedicated tests find the organism at very low levels, often from the cervix or urethra. Some of these organisms are rarely detectable in a vaginal swab. If you may have been exposed or have symptoms, take a dedicated test and do not let this result delay it.

After menopause a high level is the expected state and is not a cause for concern on its own. Earlier in life, or with symptoms, it is a reason to talk to a gynaecologist.

How closely your microbes resemble the pattern seen with dryness, burning and frequent urinary infections after menopause. This is the newer name for atrophic vaginitis. The trait changes together with the environment, which makes it useful for comparison on a repeat test.

In the vagina it is the opposite of the gut: the best-protected environment is one in which one or two species of lactobacilli take up almost all the space. High diversity usually means that anaerobes (bacteria that live without oxygen), gut bacteria or Candida have overgrown.

In a healthy woman almost everything is bacterial. A growing fungal share usually means Candida is gaining ground, often before symptoms. Each share sits on a 7-step scale compared with healthy women.

A healthy vaginal pH in the reproductive years is about 3.8–4.5. The report does not measure it with a strip; it gives it in three grades: acidic, slightly elevated and elevated.

Lactic acid keeps the pH low and stops most unwanted microbes. Different lactobacilli produce different amounts of it.

Agmatine often rises early, when the balance starts to shift, sometimes before the other amines and before symptoms.

The odour is more noticeable after sex or during a period, because that is when pH rises and the amines are released.

So raised cadaverine often points to gut bacteria in the vagina, especially if the urinary tract and aerobic vaginitis traits are raised too.

A healthy acidic environment clears gut bacteria within hours. The same bacteria also feed into the urinary tract and aerobic vaginitis traits, so their results often move together. A high result does not mean an infection. Nor does the trait assess your gut: that is what the gut test is for.

The vaginal report gives 24 foods, while the gut report comes with a 12-week nutrition plan based on the microbes in your gut.

Nitroimidazoles, clindamycin, lincosamides, doxycycline, azithromycin, ceftriaxone, penicillin, amoxicillin, amoxicillin with clavulanic acid, ampicillin, erythromycin, cefixime, cefoxitin, cefotaxime, gentamicin, amikacin, piperacillin with tazobactam, meropenem, imipenem, ertapenem, fosfomycin, trimethoprim, sulfamethoxazole, minocycline, vancomycin and linezolid.

It does not say which microbe, whether it causes any problem or whether a treatment will work, so it is not a susceptibility test. “Not detected” means the gene was not seen at this sequencing depth.

For each species the report says what it is linked to. Discuss them with your gynaecologist or pharmacist before you start.

Some bacteria taken by mouth reach the vagina via the gut. That is why the report lists these as well as the ones for vaginal use.

In the sample report they include lentils, salmon, yoghurt, garlic, pomegranate and cranberries. For a detailed nutrition plan the report also recommends a gut test.

These guidelines are the same for everyone.