Researchers at Johns Hopkins University have taken the first steps towards permanently restoring healthy vaginal bacteria. Inspired by the success of faecal transplantation, the researchers hope to stop recurring bacterial vaginosis.
WTF is bacterial vaginosis?
Bacterial vaginosis (BV) is the most common vaginal infection – and while it is curable, the infection often comes back. Unfortunately it can be pretty nasty, as it’s generally accompanied by an unusual discharge that has a strong fishy smell.
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BV is not a life-threatening infection but it can make you more susceptible to catching sexually transmitted infections and puts you at increased risk of urinary tract infections. It also increases the risk of premature birth in pregnant women.
Why a vaginal fluid transplant might help
Your vagina is similar to your gut in the way that it needs bacteria to function. The finely balanced ecosystem in your gut and vagina are easily affected by your diet, lifestyle choices and medication. While there have been numerous studies done on the microorganisms in the gut, less is known about the vagina.
What researches do know is that microorganisms in the vagina prefer an acidic environment, and when the pH becomes too alkaline, other bacteria – including those that cause BV – can thrive.
There are many things that can affect the pH levels in the vagina, including semen and salvia, which are both alkaline. And let’s not forget common culprits like using scented soaps, douching and hormone changes during your cycle.
The study
In gut dysbiosis – out of balance gut bacteria – faecal transplants from healthy donors have shown tremendous success in restoring bacterial diversity, with positive health benefits. Could vaginal fluid transplants restore protective Lactobacillus monoculture in BV sufferers?
“There is significant epidemiological evidence that vaginal microbiota transfer already occurs, for example between women who have sex with women,” explains study co-author Dr Ethel Weld, who sees great potential in the vaginal microbiota transplant (VMT). “But before clinical trials of VMT are conducted, we must first determine how to screen donors to find those with minimal risk of transmissible pathogens and optimal vaginal microbiota for transplant,” says Weld.
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Weld and colleagues designed a universal screening approach for VMT donors, which they piloted in a small sample of 20 healthy women aged 23 to 35. The screening consists of a medical questionnaire with blood, urine and vaginal swab and fluid testing. As well as checking for exposure to STIs and other infections, analysis of the samples allowed the team to correlate vaginal bacterial community structure with function.
The researches are now in search for their “super donors”, which appears to be rare. “Based on our exclusion criteria, 7/20 (35%) of these participants might be eligible VMT donors,” says co-author Dr Laura Ensign. “But the actual success rate for participation as a VMT donor in a clinical trial will likely be much lower still.”
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But once they find their ideal donors, the researchers anticipate that the trajectory of VMT will likely follow that of faecal transplantation. It would probably take years before this treatment reaches South Africa, but it does show promising results and could permanently cure BV.
