Vaginal Microbiome

The article states that the vaginal microbiome should remain low-diversity across life. Restoring the microbiome directly addresses candida overgrowth, which is a common co-occurring condition with birth control pill use. The primary outcome measures the log-ratio of Dialister to Lactobacillus crispatus relative abundances after each menstrual product period. A healthy vaginal microbiome is typically dominated by Lactobacillus species. Lactobacillus species help maintain low vaginal pH and produce antimicrobial compounds. A dysbiotic vaginal microbiome is characterized by Lactobacillus depletion and overgrowth of facultative anaerobes. Lactobacillus bacteria maintain vaginal acidity by producing lactic acid. Vaginal microbial composition naturally changes across the menstrual cycle, during pregnancy, and with disease. Estrogen supports Lactobacillus dominance and an acidic protective vaginal environment. The log-ratio outcome is intended to capture shifts between protective and dysbiotic microbiome states. Estrogen decline after menopause reduces glycogen production, which can lower Lactobacillus populations and raise vaginal pH. Copper disrupts the vaginal microbiome, which is re…