InstalabVaginal Microbiome
Should you take a Vaginal Microbiome test?
This test is most useful if any of these apply to you.
36 Biomarkers Included
- Vaginal pHA measurement of how acidic or alkaline the fluid in your vagina is, which reflects the balance of helpful bacteria and overall vaginal health.
- Bacterial VaginosisA type of vaginal infection where protective bacteria are replaced by an overgrowth of mixed bacteria, throwing off the natural balance of the vaginal environment.
- Aerobic VaginitisA type of vaginal imbalance where the protective good bacteria are crowded out by inflammatory, oxygen-loving bacteria, leading to irritation and discharge.
- Chlamydia TrachomatisA bacterium that infects the genital tract and is one of the most common sexually transmitted infections, often without causing symptoms.
- Neisseria GonorrhoeaeA sexually transmitted bacterium that infects the moist surfaces of the genital tract and can quietly cause pelvic infection, infertility, and pregnancy complications if left untreated.
- Trichomonas VaginalisA single-celled parasite that lives in the vagina and lower urinary tract, spread through sexual contact, that often causes no symptoms but raises the risk of pregnancy complications and other infections.
- Herpes Simplex Virus 1A common virus that can infect the genital area and cause sores, blisters, or invisible shedding that may pass to others.
- Herpes Simplex Virus 2A virus that causes genital herpes, detected in samples collected from the vaginal area to identify active infection or viral release.
- Enterococcus FaecalisA type of bacteria sometimes found in the vagina that, in some contexts, can signal an imbalance in the vaginal community where protective bacteria are reduced.
- Escherichia ColiA type of bacteria that normally lives in the gut but can colonize the vagina, where its presence often signals a shift away from the protective bacterial balance that keeps the reproductive tract healthy.
- Klebsiella Pneumoniae ComplexA type of bacteria that can live in the gut and sometimes settle in the vagina, where it may signal an unhealthy shift in the vaginal community of microbes.
- Proteus MirabilisA bacterium sometimes detected on a vaginal swab that more commonly causes urinary tract infections and can be present when the protective Lactobacillus layer is reduced.
- Pseudomonas AeruginosaA type of bacteria that can live in moist places on and in the body and, in vulnerable people, can cause serious infections.
- Staphylococcus AureusA common bacterium that can quietly live in the vagina, sometimes harmlessly and sometimes causing inflammation or infection.
- Streptococcus AgalactiaeA common bacterium that can live in the vagina and rectum without symptoms but can pass to a baby during birth and cause serious newborn infections.
- Gardnerella VaginalisA bacterium commonly found in the vagina that, when present at high levels or alongside many strains, signals an imbalance in the vaginal microbial community.
- Atopobium VaginaeA type of bacteria that lives in the vagina and, when it grows in high amounts, signals an unhealthy shift in the vaginal community linked to bacterial vaginosis.
- Prevotella SpeciesA type of anaerobic bacteria commonly found in the vagina whose abundance signals whether your vaginal community is healthy and Lactobacillus-rich or disrupted.
- Megasphaera SpeciesA group of anaerobic bacteria that live in the vaginal environment and, when present at high levels, signal an imbalance in the vaginal microbiome most often tied to bacterial vaginosis.
- Mycoplasma GenitaliumA sexually transmitted bacterium that lives on the lining of the vagina, cervix, and urethra and can cause silent inflammation of the reproductive tract.
- Mycoplasma HominisA bacterium that lives in the genital tract and can be picked up on a vaginal swab, sometimes as a quiet resident and sometimes as part of an unhealthy shift in vaginal bacteria.
- Ureaplasma ParvumA common bacterium that can live on the surface of the vagina and cervix, which in some cases can travel upward and contribute to pregnancy complications.
- Ureaplasma UrealyticumA small bacterium that can live quietly in the genital tract or, in some situations, drive infection, pregnancy complications, or fertility problems.
- Candida AlbicansA common yeast that lives on body surfaces and can overgrow in the vagina to cause itching, burning, and abnormal discharge.
- Candida GlabrataA type of yeast that can live quietly in the vagina and sometimes cause stubborn infections that resist standard treatment.
- Candida kruseiA yeast species, sometimes found in the vagina, that can cause uncomfortable infections and is known for resisting one of the most commonly prescribed antifungal medications.
- Candida ParapsilosisA yeast (fungus) that can live on the vaginal lining either quietly without causing problems or as the cause of a yeast infection.
- Candida TropicalisA yeast species that can live in the vagina and sometimes cause yeast infections, which can be harder to treat than the more familiar Candida albicans in some cases.
- Total LactobacilliA measure of the total amount of helpful bacteria called lactobacilli living in the vagina, which keep the vaginal environment acidic and protect against infection.
- Lactobacillus CrispatusA protective bacterial species that thrives in a healthy vagina, producing acid that keeps harmful microbes in check.
- Lactobacillus GasseriA beneficial bacterium found in the vagina that produces lactic acid to help keep the local environment acidic and unwelcoming to harmful microbes.
- Lactobacillus InersA common type of bacteria found in the vagina that helps shape the local microbial environment, often acting as a transitional resident that can shift between protective and less protective roles.
- Lactobacillus JenseniiA protective bacterium that naturally lives in the vagina and helps keep the environment acidic, healthy, and resistant to infection.
- Lactobacillus RhamnosusA type of friendly bacteria sometimes found in the vagina as part of the normal community of microbes that help keep the area healthy and resistant to infection.
- Lactobacillus SalivariusA type of helpful bacteria that can live in the vagina and helps keep the area healthy by producing lactic acid.
- Lactobacillus VaginalisA type of friendly bacteria that lives in the vagina and helps keep the local environment acidic enough to hold off harmful microbes.
About Vaginal Microbiome
Most vaginal symptoms are diagnosed by guesswork. A doctor sees discharge, makes a clinical call, and prescribes something. About half the time the call is wrong, which is one reason recurrent infections are so common. This panel replaces that guesswork with a molecular read of what is actually living in your vagina.
The picture matters beyond infection treatment. The mix of bacteria in your vagina shapes your risk of contracting a sexually transmitted infection, your chance of carrying a pregnancy to term, your odds of conceiving through assisted reproduction, and your susceptibility to urinary tract infections. A single swab captures all of it.
What This Panel Reveals
The panel covers six overlapping clinical questions in one collection. First, the protective bacteria. The Lactobacillus species and the overall lactobacilli load tell you whether your vagina is anchored by the bacteria that produce lactic acid and keep the pH acidic. A vagina dominated by Lactobacillus crispatus is the most stable and protective configuration. A vagina dominated by Lactobacillus iners is more fragile and shifts toward dysbiosis more easily.
Second, bacterial vaginosis. The panel quantifies Gardnerella vaginalis, Atopobium vaginae (also called Fannyhessea vaginae), Prevotella, and Megasphaera, the anaerobic group that crowds out lactobacilli and shifts pH upward. Molecular detection of this group identifies bacterial vaginosis more accurately than the older microscopy-based scoring systems.
Third, sexually transmitted infections. Chlamydia, gonorrhea, trichomoniasis, herpes simplex, and Mycoplasma genitalium are detected directly from the same swab. Fourth, aerobic vaginitis. Group B Streptococcus, E. coli, Staphylococcus aureus, Klebsiella, Proteus, Pseudomonas, and Enterococcus faecalis represent a different pattern of dysbiosis, characterized by inflammation and overgrowth of aerobic bacteria more typical of the gut and skin.
Fifth, yeast. Beyond Candida albicans, the panel detects the non-albicans species (glabrata, krusei, parapsilosis, tropicalis) that respond differently to standard treatment. Sixth, the genital mycoplasmas. Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum are common commensals but can drive inflammation and have been linked to urethritis and pregnancy complications.
How to Read Your Results Together
No single number in this panel tells the whole story. The combinations are what matters.
| Pattern | What It Suggests |
|---|---|
| High L. crispatus, low Gardnerella, pH under 4.5, no pathogens | Optimal protective state. Stable against infection and supportive of pregnancy. |
| High L. iners, low other lactobacilli, pH near 4.5 | Fragile baseline. Higher risk of shifting into bacterial vaginosis or yeast under stress, antibiotics, or hormonal change. |
| High Gardnerella, Atopobium, Prevotella, or Megasphaera, low total lactobacilli, pH above 4.5 | Bacterial vaginosis pattern. Linked to increased risk of sexually transmitted infections, preterm birth, and pelvic inflammatory disease. |
| High aerobic bacteria (E. coli, GBS, S. aureus), low lactobacilli, pH above 5 | Aerobic vaginitis pattern. Different from bacterial vaginosis and treated differently. |
Detection of Candida is interpreted in the context of symptoms. Candida albicans without symptoms is often normal carriage. Candida glabrata or krusei is clinically meaningful even at lower levels because both species resist standard fluconazole treatment and need a different drug. A positive result for chlamydia, gonorrhea, trichomoniasis, or Mycoplasma genitalium is treated as an infection regardless of symptoms or other findings.
Group B Streptococcus detection has age-specific weight. Outside pregnancy, it is a common colonizer of no immediate clinical consequence. In the third trimester it triggers a recommendation for antibiotics during labor to prevent neonatal sepsis.
What to Do with Your Results
A clean result with strong Lactobacillus dominance and no pathogens is the cleanest outcome. Reorder in twelve months unless symptoms emerge, you change sexual partners, you become pregnant, or you take a course of antibiotics. A bacterial vaginosis pattern, even without symptoms, warrants treatment if you are pregnant, trying to conceive, or about to undergo an intrauterine procedure. Untreated bacterial vaginosis raises the risk of HIV acquisition by approximately 60 percent and is associated with elevated risk of gonorrhea, chlamydia, and trichomonas acquisition.
A positive sexually transmitted infection requires treatment plus partner notification and retesting at three months. Aerobic vaginitis is treated with antibiotics chosen for the dominant aerobic organism, not the standard metronidazole used for bacterial vaginosis. Non-albicans Candida requires non-fluconazole treatment, typically boric acid or a newer antifungal.
Recurrent dysbiosis, defined as more than three bacterial vaginosis episodes a year or chronic non-albicans yeast, benefits from serial retesting at six-week intervals during treatment, then at three to six months once stable. Tracking whether Lactobacillus crispatus regrows after treatment predicts whether the next episode is around the corner. If lactobacilli stay low, suppressive therapy or a vaginal Lactobacillus crispatus probiotic becomes a reasonable next step.
When Results Can Be Misleading
Several factors affect the entire panel at once. Recent vaginal intercourse, douching, lubricants, spermicides, or vaginal medications within 48 hours of the swab can shift the bacterial readout. Menstrual blood interferes with detection, so swab at least three days after the end of your period. Recent oral or vaginal antibiotics suppress detection of the organisms they target and temporarily disrupt the lactobacilli population. Estrogen status matters: low estrogen states (postpartum, breastfeeding, menopause) reduce lactobacilli regardless of vaginal health, so the threshold for what counts as normal shifts.