Speed Round: Jessica Younes on the Vaginal Microbiome

Welcome to The Microbiome Coalition's Speed Round series in which we ask key opinion leaders a single question about the latest happenings in the microbiome sphere. We hope you enjoy!

In this Speed Round, we feature Jessica Younes, Science Liaison of Winclove Probiotics and Chairwomen of Women & their Microbes. 

TMBC: Although much of the recent media coverage and research centers on the gut microbiome, why is it important to study the vaginal microbiome? How will this change women’s health in the future?

Younes: That’s an important question that microbiome scientists in women’s health are often faced with and the answer is actually quite simple: the effect on health of the vaginal microbiome (VMB) spans generations. Let’s back up for a moment. It is well-acknowledged that a healthy adult vagina is dominated by Lactobacillus species and it should be noted that this recognition of a core bacterial community among the human microbiomes is unique to the vagina. These beneficial microbes have 3 main functions: to provide microbial defenses against pathogen overgrowth, to provide synergistic metabolism in the vagina, and to support the local immune function of the host. This allied protection prevents against a number of urogenital diseases, secondary infections including HIV, low grade inflammation, and from a number of painful, distracting, and quite embarrassing symptoms such as itching burning, dryness and odor. Many are ignorant of the embarrassing, stigmatizing, and life-altering effects that suboptimal vaginal health presents for a woman.

In addition to the overall quality of life and sexual health of women, the VMB seems to play an important role in reproductive and pregnancy outcomes. The vagina has been described as a microbial gateway for reproductive health to protect from the world while simultaneously preparing them for life in the world, all in utero. A number of scientific groups, including David MacIntyre in the UK, has hypothesized that the VMB shifts that they have identified during pregnancy are part of a deliberate and coordinated effort to ensure the maternal transmission of pioneer bacteria for the neonatal, oral, gut, and skin microbiomes. After all, the female body is designed to give birth vaginally, so perhaps it is not a such surprising scientific discovery that vaginal bacteria are important for all kinds of normal infant development. This transgenerational impact is often ignored or poorly understood, which leads to either a lack of prioritization or poor execution due to shame or lack of support.

We already have an indication of what to expect without the protection of a healthy VMB, but Caesarian sections have provided a chilling view of future generations without the initial maternal microbial inheritance: higher risk of obesity, asthma, allergies, and other chronic diseases related to the metabolic development of the infant. If even a small number of these diseases can be prevented by ensuring vaginal health prior to and during pregnancy, then we have a public health responsibility to embrace this preventative approach. Another large gap in VMB research is understanding the resilience and development of the VMB across the life span, as the microbial fingerprint of each VMB is unique. This will not only have an impact the way we approach adult vaginal health, but also on how we support our young and elderly women. With the exception of those front line healthcare professionals that care for women, to speak about vaginal health is shameful and frowned upon even in medical circles. This must stop if progress is to be made and this is what the annual scientific conference, Women & their Microbes hopes to accomplish: bringing together all of the best minds in this field to enact change and progress. The VMB is worth studying because it is a fundamental contributor to “a healthy woman, a healthy baby, a healthy generation."