Review highlights untapped potential of the vaginal microbiome
The vaginal microbiome is a largely overlooked area of medicine that could dramatically improve outcomes for millions of women, concludes a new review co-authored by the Medicine and Healthcare products Regulatory Agency (MHRA) in partnership with University of Liverpool researchers.
Vaginal microbiome testing has the potential to revolutionise women’s health by enabling earlier, more accurate, and more personalised diagnosis and treatment of a wide range of conditions – such as common infections, infertility and even cancer.
The MHRA worked with researchers at the University of Liverpool, Kings College Hospital London, Ewha Women’s University and Biowave W Seoul to explore the significant potential of vaginal microbiome diagnostics to revolutionise how a wide range of women’s health conditions are detected, treated and managed - including infertility, miscarriage, preterm birth, gynaecological cancers and menopause-related complications.
While the gut microbiome has received widespread attention over the last decade, research into the vaginal microbiome has lagged far behind. Nevertheless, this dynamic ecosystem of bacteria plays a critical role in supporting reproductive health and protecting against infection throughout a woman's life.
Dr Chrysi Sergaki, Head of Microbiome at the MHRA, said: “We are only beginning to understand how powerful the vaginal microbiome could be as a diagnostic tool. This review sets out the case for making this a major focus of women’s health research and development going forward.”
Dr Laura Goodfellow, from the Department of Women’s & Children’s Health at the University of Liverpool, added: “This is an exciting time for women’s health microbiota diagnostics- we’ve spent the past 15 years understanding what is normal, and not. Now vaginal microbiota tests are being developed that can help identify pathology and guide treatment. I look forward to these being brought into routine clinical practice in the next 5-10 years to improve outcomes for women and girls.”
Currently, many diagnostic tools in women’s health are imprecise or subjective, leading to delays in diagnosis, preventative measures and treatment of diseases. The paper highlights how microbiome-based diagnostics could offer faster, more accurate, and personalised options to detect conditions like bacterial vaginosis (a common vaginal condition caused by an imbalance in the types of bacteria present in the vagina), sexually transmitted infections (STIs), endometriosis (a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often in the pelvic area), and even fertility and pregnancy complications, including preterm birth).
The review also highlights the historic underrepresentation of women in clinical research, a gap that has contributed to critical shortcomings in our understanding of female-specific conditions.
To make further progress on making the life-saving diagnostic potential of the vaginal microbiome an everyday reality, the authors call for:
- Increased investment in women’s health research
- Standardised microbiome testing methods
- Wider inclusion of women in clinical trials to achieve a more balanced ratio
- Integration of microbiome diagnostics into frontline healthcare.
The review, ‘The untapped potential of vaginal microbiome diagnostics in improving women's health’ was published in Frontiers in Cellular and Infection Microbiology (DOI: 10.3389/fcimb.2025.1595182).