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Examining the microbiome of the vagina.

On March 1, 2023, the University of Maine Ishaq Lab hosted Professor Sarah Lebeer for a talk on her research of vaginal microbiome. Lebeer shared her findings from her discreet and considerate scientific investigation on the microbes that live within the female reproductive organ. The study was done in Belgium and introduced her to a wider field of research involving the relationship between a mother’s microbiome and her babies, as well as comparing the microbiome of the gut to the vaginal microbiome. Her team was looking at the lactobacilli population in the vagina, a bacteria crucial to the stability of the vagina.

“[She] is a research professor at the Department of Bioscience Engineering of the University of Antwerp, Belgium. She has studied bioscience engineering, with a specialization in cell and gene biotechnology and food and health,” said Sue Ishaq, assistant professor of animal and veterinary sciences and host of the lecture.

Lebeer and the other researchers named the study Isala after the first female doctor in Belgium. After the study was released, other countries such Switzerland and Peru began their own research, Laura and Maria respectively. This is just the start of the process.

Lebeer began the process by looking at the microbiome of babies. The microbiome of babies begins at birth, and at three years of age it is an adult microbiome. The microbiome changes over time with age. They focused on the vagina as as the source for the microbiome community with a research group of 18 years and older.

Proper vaginal health is crucial for reproduction and the health of women. A low vaginal pH is important. So why is there not more research on the role of lactobacilli in women outside hospitals in a clinical setting? Humans are unique, being the only animals with lactobacilli in the vagina. There is no animal model suitable for study. They needed to look at the bacteria population in its “wild” environment. Their scientific goals were to map the female microbiome and presence of lactobacilli in healthy women as well as the impact of lifestyle and environment on the female microbiome. Their societal goals were to break taboos surrounding vaginal health, empower women to take samples, bring women into science and make way for diversity. About 5.4% of the participants were below the poverty line.

“In 2020, Lebeer obtained an ERC StG Grant (Lacto-Be) that enables her to gain in-depth knowledge of the evolutionary history and ecology of lactobacilli. Within this ERC project, Lebeer has launched the Isala citizen-science project to gain new insights in the ecology and role of vaginal lactobacilli for women’s health, but also to actively involve women to contribute with ideas on how to improve vaginal health and break some taboos together,” Ishaq said. 

Worried about the stigma surrounding the vagina, Lebeer and her team figured there were not going to be many women who would want to participate in such a vulnerable project. Afterall, these women had to provide a sample swab of their vagina and send it to a lab to be processed, all to be received with news they might not want to have heard. Much to their surprise, a significant number of women in Belgium sought to participate in the study. 

“Citizens drive science,” Lebeer said. “[We] ask women for a sample in return for something back.”

Over 6,000 women in less than 10 days wanted to participate in the study, 4,600 women completed an hour-long survey and 3,345 people contributed a vaginal swab. They made the process as welcoming as possible. After the research study, 94.6% of women said that they would participate again. To help decrease the taboo that follows the vagina, Lebeer and her team made the swab box look like something you would receive in the mail from a monthly subscription box. It also came with a tote bag and conversation cards about the vagina. They compiled facts from the survey and found that nearly 83% of women have problems with their period and 13% have experienced problems with their pregnancy. 

Lebeer and her team found a variety of factors that can lead to a high or low population of lactobacilli or a high population of a different bacteria. Some bacteria-increasing factors include diet, pregnancy and personal hygiene practices such as the use of cotton underwear or pads. 

“We looked at what we could ask related to the microbiome,” Lebeer said.

Their next research study will be on the microbiome and inheritance in offspring.

Ishaq Lab’s next presentation will be on March 8 from 11a.m. to noon. It is about the gut microbiome, nutrition and food security and will be presented by Merilee Brockway.


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