Behind the Benefits of Vaginal Microbiome Transplantation for Bacterial Vaginosis
Bacterial vaginosis (BV) is one of the most common conditions affecting vaginal health among women of childbearing age. In fact, it’s the most common vaginal infection. BV affects roughly one-third of women aged 14-49 in the United States. Currently, the most common treatment is a course of antibiotics. However, it’s well-known that pathogens can quickly become resistant to antibiotics. For BV, antibiotics don’t produce the lowest recurrence rates. Thus, scientists have been looking elsewhere for treatments for BV. They’ve found a candidate (Vaginal Microbiome Transplantation) with a surprising origin.
Vaginal Microbiome Transplantation
A paper published in October in Nature Magazine described the process of researchers testing out Vaginal Microbiome Transplantation (VMT) in women suffering from BV. VMT is an experimental procedure. Five women participated in the study and four of them saw long-term improvement in their recurrent BV after undergoing VMT. The results give researchers high hopes that VMT may be a reliable treatment for BV.
Fecal Microbiota Transplantation: The Idea Behind VMT
The idea behind VMT comes from a procedure for the vagina’s down-the-street neighbor, the gut. Both the gut and the vagina are full of microorganisms that play a huge role in the body’s overall health, and therefore have similarly particular environments in which they thrive. When something throws off those particular environments, the body goes haywire. Gut infections that don’t respond to antibiotics are treated with a procedure called Fecal Microbiota Transplantation (FMT).
When a pathogen, e.g. C. difficile, becomes resistant to antibiotics, it overtakes the rest of the gut’s natural and healthy bacteria. FMT works by transplanting a stool sample from a healthy donor into the colon of the patient. This introduces a new community of healthy bacteria to the gut’s environment. The C. difficile is then replaced by the flourishing new bacteria species. Ultimately, it dies out. This leaves the patient with a healthy level of microbial diversity.
VMT is based on this procedure. When BV occurs, the vagina’s healthy species of microorganisms, primarily Lactobacilli, are out-competed by BV-related pathogens like Gardnerella vaginalis, Peptostreptococcus, and Bacteroides spp. These are primarily anaerobic microorganisms and easily out-compete the vagina’s healthy microbes.
During VMT, healthy microbiota are taken from a carefully screened donor. Then, they are inserted into a patient’s vagina. The new community of healthy microbes from the donor multiplies and out-competes the BV-related pathogens. This restores the vagina’s microbial environment of healthy Lactobacilli in the same way that FMT re-introduces healthy gut microbes in people suffering from gut infections. VMT drastically reduces the chance of recurrence since the BV-related pathogens die out completely after the re-introduction of the new healthy species.
The VMT Experimental Trial
Researchers at Johns Hopkins recently held an experimental trial to test VMT as a treatment for BV. Five women participated in the study, all diagnosed with recurrent BV and all who showed symptoms at the beginning of the trial. Searching for appropriate donors for the study proved to be a difficult task. The ideal donor candidate was someone who was rated unlikely to contract BV, abstain from vaginal intercourse for up to 30 days, and had no history of STIs.
Once donors were selected, they collected vaginal fluid samples. The microorganisms were separated from the fluid using a high-speed centrifuge. Then, they were inserted into a patient’s vagina. The patients started with examinations once a week for the first month, and then at increasingly long intervals for almost an entire year. BV symptoms were noted through pelvic examinations, pH tests, amine tests, and microscopic diagnosis.
Two of the patients received one round of VMT with successful results after one year. Two patients underwent three rounds of VMT and were examined for a longer amount of time. Ultimately, they showed no signs of recurrence and had a completely healthy vaginal environment. One patient underwent two rounds of VMT but went into incomplete remission.
Was This Considered a Success?
With such a small sample size, it’s hard for researchers to have a full idea of how VMT truly works as a treatment for BV, but this trial gave a good insight into how other trials can be adjusted and held successfully in the future. New medical procedures take a long time to get instituted as actual treatments, so it will be some time before VMT could be labeled as an effective treatment for BV. For now, this trial is a strong first step.
VMT Could Be Life-Changing for Many
BV is often a recurring condition. This means that when you affected by it once, it’s likely to come back. While there are no certain causes, BV is more common in women with multiple sex partners, women who douche, women who use IUDs, and women who are pregnant. Anything that disrupts the normal balance of good bacteria in the vagina puts you at risk for BV. Symptoms include unusual vaginal discharge, burning during urination, itching, and irritation. These symptoms impact a woman’s day-to-day life and recurrent BV provides an endless cycle of discomfort.
Antibiotics treat BV currently. Like treatments for gut infections, pathogens can become resistant to antibiotics so other options are needed for treatment. VMT could be a life-changing treatment. Women affected by recurrent BV could finally get the relief they need and go back to their normal lives.
Learn More About Vaginal Microbiome Transplantation
Vaginal health is a delicate balance between good and bad bacteria. The doctor’s office is the last place a woman should have to feel worried about contracting an infection. Clinics should be encouraged to use single-use medical devices whenever possible to ensure the lowest possible risk of cross-contamination between patients. To learn more about the many single-use medical devices obp offers, contact us today. We would love to help you create the safest environment for your patients!