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Meet Your Microbiome

Every day, your vagina performs the equivalent of modern health miracles.

It can fight off infections, defend against cancers, and protect a pregnancy. And the quality of its defense is determined by the composition of your vaginal microbiome — a complex ecosystem of bacteria, fungi, viruses, and more.

How does my microbial defense actually work?
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Given that the vagina is the structural connection between the outside world and some of our most important reproductive organs, the local microbiome has evolved to serve as a critical layer of protection against pathogens entering our bodies.

While there is a variety of bacteria and fungi that can exist in the vagina, Lactobacillus are the local heroes. Lactobacilli ensure that the vaginal environment is inhospitable for potential pathogens in a variety of ways:

1) Producing lactic acid that helps keep the pH low and healthy (ideally between 3.8 and 4.5)
2) Taking up space on the vaginal wall, preventing other pathogens from being able to thrive
3) Producing bacteriocins, which further inhibit pathogens
4) Keeping inflammation down in the genital tract.

When this environment is in an optimal state, it can do amazing things. A balanced vaginal microbiome can lower your risk for:

  • STIs like chlamydia, gonorrhea, trich, herpes, HPV, and HIV
  • Pelvic Inflammatory Disease
  • Fertility complications like infertility and failed IVF
  • Pregnancy complications like miscarriage, preterm birth, neonatal problems, and preeclampsia
  • Gynecological cancers like ovarian cancer and cervical cancer
  • Cervicitis
  • Toxic Shock Syndrome
Are my frequent vaginal infections related to my microbiome?
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Yes! The viruses, fungi, and bacteria that cause vaginal infections are all part of your microbiome. When your microbiome is imbalanced, it creates opportunity for these bad microbes to thrive.

If you’re one of the ~30% of people with vaginas that will get BV this year, that means your vaginal microbiome has a wide variety of bacteria (called dysbiosis) instead of a Lactobacillus bacteria playing the main role in creating that all-important lactic acid environment.

On top of that, 84% of BV cases are asymptomatic, meaning that you might not even know if your vaginal microbiome is imbalanced — but you might still be at risk for infection or other complications.

Dysbiosis of the vaginal microbiome can catalyze other types of infections as well, such as aerobic vaginitis, yeast infections, cytolytic vaginosis (CV), UTIs, all of which can have frustrating (and confusingly similar) side effects, such as itchiness, abnormal discharge, and burning.

One important thing to note: research shows that dysbiosis is more prevalent in Black and Hispanic women, but there is a disappointing lack of research explaining why that is or how we can change it. More broadly, it’s incredibly frustrating that research on this topic has not been more highly prioritized in medicine overall, given the prevalence of vaginal dysbiosis and its impact on our quality of life.

…Go on…  

We know, we know — we could talk about this for hours. But let us point out a few more things —   the current methods for treating vaginal infections are as archaic as diagnosing them.

Antibiotics and antifungals are widely used treatments which have high rates of success in the short term. However, in the long term, they’re not as great of a solution as you might think.  

While antibiotics and antifungals kill off the bad bacteria, they also kill off the good ones, rendering the vagina defenseless and highly susceptible to reinfection. In fact, vaginal infections have some of the highest rates of reinfection, with 80% of BV patients having a reinfection within 3 months and 60-70% of patients taking long term yeast infection treatment having a recurrence within 6 months afterwards.

There have been almost no advancements to improve cure rates for vaginal infections for decades. There is a pressing need for better, more sustainable solutions — and demystifying the microbiome to patients, doctors, and researchers can drastically improve treatment options in this space.

If my vaginal microbiome is so powerful, why haven’t I heard of it?
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Microbiome research is a relatively new field, and lots of resources have been invested in understanding other human microbiomes like the one in your gut or on your skin. But when it comes to your vagina, the microbiome has been overlooked.

We wish the reason why wasn’t yet another gender gap… but that’s why we’re here! Evvy exists to use cutting-edge research techniques to elevate the vaginal microbiome to its rightful place in research and clinical care, all while providing you with critical insights into your health.

How can I check in on my own microbiome?
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Well — that’s the other reason why we exist.

Evvy’s first product willbe the only at-home test that leverages metagenomic sequencing, an advanced form of next-gen sequencing that analyzes the entire genome. This allows us to pick up on all bacteria present at an extremely specific level.

In addition, Evvy won't just return a table of numbers. Evvy results come with actionable recommendations and curated insights on how your vaginal microbiome is related to your holistic health — customized to you based on your specific microbes, symptoms, and experiences.

You’ve convinced me my microbiome is important...how can I take care of it?
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Here’s the thing about vaginas: they’re pretty great at taking care of themselves. They’re self-cleaning and normally self-protecting, as long as the vaginal microbiome is in balance.

However, many of the things we enjoy — sex and sugar, for example — are good at throwing off this balance.

Plus our bodies naturally change over time, and trying new birth control, medications, sexual partners, period products, and more can add chaos to this balancing act.

There are some all-around great things you can do to take care of your vaginal microbiome — and we’re pretty sure you’ve heard them before: Drink water, never douche, wear cotton underwear, pee after sex, cut down on sugar, change out of wet swimsuits as soon as you can, the list goes on.

But surprise! Not all vaginas are the same. What works for you might not work for your sister or your friend. So the best way to care for your unique microbiome is to first understand what your microbiome looks like (what bacteria are present) and whether or not it is optimally balanced (psst...that’s what we made the Evvy vaginal microbiome test for!)

And when you do intervene (try a new probiotic, change your diet, etc.),  Evvy will take the guesswork out of figuring out which solution is working for you. By retesting, you can see how changes you’re making in your diet, life, and supplements are impacting your vaginal microbiome’s defense.

We envision a world where everyone with a vagina is in control of their own health through personal data, accessible research, and empathetic care.
Scientific accuracy is important to us.
See what we're reading and citing here.

Vaginal Discharge: What's "normal"?

When you’re worried about whether or not your discharge is normal, trying to understand the different types of smells, colors, and textures can be overwhelming and confusing. But take a deep breath — if yours seems a little off, you’ve come to the right place.

Highlights from this article: 

  • Vaginal discharge is common and healthy. 
  • Vaginal discharge changes with your menstrual cycle.
  • Keep an eye on differences in color, consistency, odor, and amount of your discharge, compared to what’s normal for you. 
  • Atypical vaginal discharge may be a symptom of a microbial imbalance, an infection or an STI. In rare cases, it may indicate something more serious.
  • One way to prevent unusual discharge is to better understand and care for your vaginal microbiome

Your vagina is amazing.

(Okay, we’re biased — but you should be too!)

Among many other things, your vagina has the unique ability to self-clean — but not quite without leaving a trace. That’s where vaginal discharge comes in.

Vaginal discharge is fluid from the cervix and vagina that helps clear out old cells and keep your reproductive tract clean. Aside from menstrual blood, practically any fluid leaving the vagina (including cervical mucus and natural lubrication) can be characterized as vaginal discharge. 

Not only is vaginal discharge common and healthy, but it can also be a very important indicator of your overall vaginal health

What is “normal” vaginal discharge? 

When it comes to the human body, the word “normal” is tricky — what’s normal for you might be atypical for your sister or a friend. But many factors can influence the quantity, consistency, and color of your vaginal discharge, and there are a few things you can keep in mind as you figure out your “normal.”

In a healthy vagina, vaginal discharge will consist primarily of the mucus produced by the cells of the cervix (also known as cervical mucus, or CM for short) and will naturally change over the course of your hormonal cycle. It’s common for vaginal fluid to increase in volume the closer you are to ovulation, which makes monitoring the consistency and quantity of your discharge on an ongoing basis a good way to keep track of general fertility. Note that if you take hormonal birth control, you might not be able to see these changes. 

Typically speaking, normal vaginal discharge will follow a monthly pattern of:
  • Dry — following menstruation, there may be little to no cervical mucus or discharge present
  • Sticky and White — as estrogen levels rise, CM becomes sticky and pasty (often crumbly and white when dried)
  • Thin and Creamy/Milky— as the water content increases throughout your cycle, CM can more closely be compared to the texture of lotion
  • Slippery/Stretchy and Clear — just prior to ovulation, when the female body is at peak fertility, CM becomes clear and resembles the consistency of egg whites. After ovulation, CM returns to dry and sticky until your next period and the cycle continues. 

What about smell?

When it comes to smell, normal vaginal discharge should be unique but not strong. Any sudden or significant changes in odor potentially indicates an imbalanced microbiome —  and may indicate an untreated infection.

Abnormal types of vaginal discharge, based on color:

In addition to smell, it’s important to look out for any big changes in the color of your vaginal discharge.

Grey

Grey-ish yellow/white discharge accompanied by a fishy or foul smell, and with or without the presence of genital pain, itching, and burning, can be a sign that something down there is “off.” Most commonly these symptoms are caused by a condition called bacterial vaginosis — aka BV. 

BV  is the most common cause of infective vaginal discharge, and one in three people with vaginas in the U.S. will experience BV this year.

White and Thick/Chunky

Also referred to as “cottage cheese” discharge, it tends to resemble, well…cottage cheese (this categorization ruined the dairy aisle for us, too.) 

This kind of discharge, along with itching, swelling, and redness (particularly around the opening of the vagina), may indicate a yeast infection. One of the main symptomatic differences between yeast infections and BV is the kind of smell: BV is often fishy, while yeast infections are usually odorless or have a slightly soured smell like beer or bread.

Caused by an overgrowth of the Candida albicans fungus, yeast infections affect up to 75% of healthy women at one point or another during their lifetime, so rest assured that you’re not alone. 

Yellow/Greenish

Frothy yellow discharge, genital itching, burning, and soreness, and a foul smell are all symptoms of a treatable STI called trichomoniasis. However, many individuals with trichomoniasis are completely asymptomatic. 

Pink or Brown

Brown discharge is usually nothing more than the result of old blood becoming oxidized, most commonly at the beginning or end of the menstrual cycle. This is perfectly normal and also can differ between cycles. 

That said, experiencing any pink or brown discharge that is abnormal for you and your body can be indicative of irregular menstruation, or a sign of something more serious — in any case, talking to a doctor can help. 

How to prevent unusual vaginal discharge 

Your discharge is often related to how well-balanced your vaginal microbiome is, so one way to normalize your discharge is to take better care of your microbiome. 

A general guide to best practices includes:

  • drinking enough water
  • wearing cotton underwear (or going without!)
  • peeing after sex
  • avoiding the use of bath bombs or fragranced soaps
  • cutting down on sugar and alcoholic drinks
  • changing quickly out of wet or sweaty clothes

We know you’ve probably heard these strategies before, and that they don’t always help — it can be frustrating to get the same advice without different results. 

A little plug for our test here: this is why we invented the Evvy at-home vaginal microbiome test. By testing and retesting your microbiome over time, you can see how the changes you make in your diet, lifestyle, and self-care routine are impacting your vaginal microbiome’s defense against infection and abnormal vaginal discharge. 

Looking for something we didn’t cover here? Let us know at ask@evvy.com or with #AskEvvy on social.

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