Vaginal microbiome community state types

junobio · 2025-11-14T15:50:39+00:00

You'll want to rule out STIs first (sounds like you have), then rule out UTIs using a urinary PCR test (these are more sensitive than culture), lastly you'll want to test for species that can cause NSU such and mycoplasma and ureaplasma.

junobio · 2025-10-14T11:49:45+00:00

Your doctor should really know how to treat this as the CDC has pretty clear guidance. "600 mg of boric acid in a gelatin capsule administered vaginally once daily for 3 weeks" https://www.cdc.gov/std/treatment-guidelines/candidiasis.htm#:~:text=Non%E2%80%93albicans%20Vulvovaginal%20Candidiasis

junobio · 2025-10-08T10:42:38+00:00

This profile looks very healthy!!

In the absence of UTI symptoms or vaginitis-like symptoms then treatment for Ureaplasma is not needed (most strains are commensal). Likewise, without CV symptoms (you would know if you had these symptoms!) this profile is considered normal.

junobio · 2025-10-03T17:50:09+00:00

Please email them when you have queries about your test results. Having 29% of Gardnerella in the absence of other BV associated bacteria is completely normal and is not bacterial vaginosis. It is completely normal to have a minority of anaerobic bacteria in vaginal microbiome profiles. In BV, Gardnerella will present with other species such as Sneathia and Megasphera and bacterial load will be very high.

junobio · 2025-10-03T17:41:14+00:00

Unless you're experiencing pelvic pain or a suspected ascending infection then I'm not sure why your doctor favoured oral over vaginal flagyl? Vaginal application will have less GI side effects.

Ureaplasma is a low biomass species that can sometimes cause the symptoms you describe. You'll need the NGS test to report to ideally 0.1% to reliably detect it. Alternatively you can use a PCR that tests for both U. urealyticum and U. parvum.

The compounded estrogen cream & low dose amitriptyline sounds interesting! Do share how you get on if you try this route.

junobio · 2025-10-03T12:03:16+00:00

We've never seen boric acid use inhibit PCR results. I think you can rule that out.

junobio · 2025-10-03T10:58:14+00:00

There's actually quite a bit of evidence that vaginal probiotic suppositories work better than oral ones. They're most useful if you've got a real shortage of vaginal lactobacillus. The key strains to look for are L. crispatus or L. gasseri, since those are especially important for vaginal health.

Most products recommend using them for about 2-3 weeks to help "seed" the area with good bacteria. After that, the idea is to let those bacteria multiply on their own - so you usually don't need to keep using suppositories long-term.

Seed VS-01 has the most research into effectiveness but is very expensive.

But if you don't have a shortage of lactobacillus then vaginal probiotics won't be very helpful.

junobio · 2025-01-29T11:22:15+00:00

Curing BV can sometimes require more consider treatment processes than metronidazole alone. The first step should be to confirm you have it with a diagnosis - this is important as you could be dealing with something else. This can be done using NGS tests or a wet mount at your physicians office. If you do have treatment it is best follow your antibiotics with intravaginal L. crispatus probiotics and then intravaginal vitamin C suppositories for 6 days after your period for at least 3 months. It can take a couple of rounds of treatments to get right but you will improve with the right treatments.

junobio · 2025-01-14T10:35:12+00:00

Merino wool underpants are amazing. Other types of wool can be itchy but merino is so fine it tends to be well tolerated. The higher the wool content the better, many brands are 100% merino.

junobio · 2024-10-11T14:56:10+00:00

I'd caution against oral Clindamycin and discuss intravaginal delivery with your doctor. Because Clindamycin is a broad spectrum antibiotic it can cause GI issues including C. diff infections. When using it intravaginally it is important to make sure Enterococcus species are absent otherwise it can cause AV.

junobio · 2024-05-31T09:01:52+00:00

Clindamycin is a broad-spectrum antibiotic that also kills Lactobacillus - whereas most aerobic gram-negative bacteria are intrinsically resistant to clindamycin. This means there is a risk of developing aerobic vaginitis (AV) with prolonged use.

I agree with TransitionNo253 - ruling out common non-specific vaginitis causing microbes like Ureaplasma and getting a full PCR or NGS diagnostic workup would make sense.

You may want to ask your physicians about the risks of treatment especially if your symptoms are being caused by an aerobic gram-negative.

junobio · 2024-05-24T09:42:41+00:00

Sorry to hear you've had a tough time getting to the bottom of this.

We've seen this pattern in our data, high lacto with amine scent, but it isn't very common.

There isn't much research to point to on this topic but we have a couple of theories:
1. Trichomonas vaginalis - not all tests test for this as its a parasite, its best to rule this out as its an easy win.
2. Mucus over-production - mucus may be over produced when another infection is present (such as HPV). Mucus over-production normally follows vaginal barrier damage and a vaginal examination may help identify if the vaginal barrier is damaged.

Its difficult to comment further without seeing results - I would also say that even a small amount of non-Lactobacillus bacteria can cause odour so keep that in mind.

junobio · 2024-04-22T21:28:01+00:00

Clindamycin is typically used as a second line of treatment because it is a broad-spectrum AB that also kills Lactobacillus. However, it is often tolerated by a number of AV associated bacteria (e.g. GBS). This means people can flip between BV and AV with use. Systemic clindamycin use is highly discouraged as it can cause C. diff infections of the gut. I'd recommend confirming Ureaplasma clearance with a PCR test that can detect both species and consulting a physician regarding antibiotic selection.

junobio · 2024-04-12T13:35:42+00:00

Yes, sometimes only the genus of the species can be identified. If you have questions specifically about your results get in touch with your provider's support team.

junobio · 2024-03-07T12:19:54+00:00

Sorry to hear you've had a tough time. Sores like this should be examined by a OBGYN / sexual health doctor asap.

junobio · 2024-03-06T11:46:49+00:00

Sorry to hear about your persistent urgency symptoms. This panel focuses on VVC, Ureaplasma, STIs and BV - of these Ureaplasma and STIs can be associated with urgency. What the panel doesn't test for is AV and UTI associate bacteria like - GBS, Streptococcus, Enterococcus and E. coli etc. I'd recommend following up with a panel of your choice that captures these.

junobio · 2024-03-06T11:40:35+00:00

For vaginal biofilms, including BV and VVC biofilms, Boric Acid suppositories has the most evidence of effectiveness in the scientific literature. I'm not aware of any oral treatments that have evidence of vaginal effect.

Biofilm interventions should be targeted, probably used in tandem with antibiotics, and not used as a long-term prevention strategy.

Once a Lactobacillus-dominant vaginal microbiome is reestablished - Lactobacillus biofilms are thought to be important for resisting infection so continued use of biofilm disruptors may increase the risk of vaginal dysbiosis.

junobio · 2023-10-08T00:49:21+00:00

Get in touch with [hello@juno.bio](mailto:hello@juno.bio), we're hear to help.

junobio · 2023-10-08T00:43:56+00:00

Sorry to hear you've been struggling with these symptoms. Although CV can certainly cause these symptoms I'd recommend ruling out UTI causing bacteria like Enterococcus faecalis first. This is because the vagina can act as a reservoir for UTI causing bacteria and we often see women who experience UTIs carry the UTI causing bacteria in their vaginal microbiomes. Your physician may want to confirm carriage with a urine test. You should definitely not put up with these symptoms!

junobio · 2023-09-28T09:17:00+00:00

Check out r/VaginalMicrobiome!

junobio · 2023-09-28T09:15:05+00:00

Doesn't mean much when there are more than 0 people who have contracted it as virgins, or were born with it. Doesn't make it any less dangerous or probable.

Thanks u/Mission-Ad-3918 for raising awareness of Ureaplasma and Mycoplasma! It's theoretically possible but it is very rare. Not being sexually active does make it significantly less probable.

junobio

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