Intimate health is something many women only start thinking about when something feels off. But behind the scenes, there’s a complex ecosystem quietly working to protect you every day: your vaginal microbiome.
Our founder & CEO, Dr Chiara Board, spoke with Dr Rob Bradley, microbiome expert and Scientific Lead at Salient Bio, an award- winning UK-based microbiome analysis service provider, to better understand how this ecosystem works, how it changes during menopause, and what new research is beginning to reveal.
What exactly is the vaginal microbiome and why does it matter?
Rob: Firstly, more generally, microbiome is the collection of microorganisms that live in a specific part of the body. That includes bacteria, but also fungi and other microbes.
The vaginal microbiome is particularly important because it plays a protective role throughout a woman’s life. When it’s balanced, it works with your body to help keep unwanted bacteria out and maintain a healthy environment.
What makes a “healthy” vaginal microbiome?
Rob: If you take one thing away, it’s this: a healthy vaginal microbiome is strongly associated with Lactobacillus species.
These bacteria are key because they help maintain an acidic environment, which makes it much harder for harmful bacteria to grow. When Lactobacillus levels are stable, the environment tends to stay balanced. When they drop, that’s when problems can begin.
What happens when that balance is disrupted?
Rob: When Lactobacillus levels go down, we often see other bacteria move in. And importantly, it’s usually not just one — they tend to appear in groups. That’s why imbalances in the vaginal microbiome can be difficult to shift once they’re established. It becomes a multi-species environment that reinforces itself.
Chiara: And that’s something we hear a lot, women feeling like they’re stuck in a cycle!
Rob: Exactly. Which is why protecting the microbiome in the first place, and supporting it early, is so important.
How can you actually measure your microbiome?
Rob: Microbiome testing has come a long way. The process is relatively simple, it usually involves a swab that’s sent to a lab. From there, we analyse the DNA to understand which microbes are present and how balanced the ecosystem is.
The results are typically interpreted by a clinician or practitioner, who can then help guide next steps.
We explored this in our recent study*. What did we find?
Chiara: For context, to better understand how the intimate microbiome can be supported, we conducted a 24-week longitudinal study, working closely with the microbiome testing experts at Salient Bio. We wanted to better understand how supporting the microbiome might impact women’s day-to-day experience — especially during times when it’s more vulnerable, like menopause. One of the key priorities for us was making sure we didn’t disrupt the beneficial bacteria.
Using Salient’s vaginal microbiome testing, participants provided swab samples throughout the study. This allowed us to track changes in the microbial environment over time, alongside reported symptoms and day-to-day experiences.
Rob: One of the most important findings was that Lactobacillus populations remained stable throughout the study period. What this means: The protective bacteria that help maintain a healthy vaginal environment were not disrupted which is an important indicator of microbiome-friendly support.
Chiara: Yes, unfortunately there are a lot of products that just claim to be microbiome-friendly or probiotic-friendly, but for us it was really important to validate that properly with actual swabs we have taken from women, so real samples not just in the lab. Seeing that there was no negative impact on beneficial bacteria was to be expected but still great to see from a scientific perspective. It shows that you can support and support the microbiome without disturbing the balance that’s already there.
Beyond bacteria: what else was observed?
Rob: Alongside microbiome stability, the study also explored how women’s experiences changed over time. Participants reported improvements across a range of intimate health symptoms, including comfort, dryness, and overall wellbeing. Many also described a noticeable difference in how quickly things began to feel more balanced once they introduced microbiome support into their routine.
Figure 1: Microbiome difference between Perimenopausal and Post-menopausal status. A significant difference in 16S rRNA gene abundance (bacterial load) was observed between perimenopausal and postmenopausal individuals (p = 0.004781).
How does menopause affect the vaginal microbiome?
Rob: One of the biggest drivers of change is oestrogen. It plays a key role in maintaining a healthy, well-populated microbiome.
In perimenopause, you typically still see relatively high levels of bacteria, including beneficial species. But in postmenopause, there’s often a significant drop. What we can see from the study results (Figure 1) is that more postmenopausal women have lower levels of bacteria overall (orange graph thins out, is less concentrated at the top than the blue one). The environment changes, and it’s no longer as supportive for those protective microbes.
Chiara: So in simple terms: before menopause, the microbiome is more abundant and stable, lots of bacteria. After menopause, it can become much more sparser and variable.
Rob: Exactly! And that shift is often linked to symptoms like dryness, irritation, and increased vulnerability to imbalance, persistent discomfort and recurring infections.
Why is protecting the microbiome so important?
Rob: Because once the balance is disrupted, it can be difficult to restore. The vaginal microbiome isn’t just about one type of bacteria — it’s an ecosystem. Supporting that ecosystem early, and maintaining it over time, can make a big difference.
What’s the bigger takeaway for women?
Rob: Intimate health isn’t just about reacting to symptoms, it’s about understanding and supporting the underlying system.
From hormones to lifestyle to the microbiome itself, everything is connected. And as research in this space grows, we’re starting to see more ways to support that balance in a targeted, thoughtful way.
Where does P.Happi® fit into this?
Chiara: P.Happi® is designed to support the natural balance of the intimate microbiome, without disrupting beneficial bacteria. It’s a non-hormonal, non-antibiotic approach that works alongside your body, helping to maintain an environment where protective bacteria can thrive.
There is still so much to learn about the microbiome, but it is becoming increasingly clear: it plays a vital role in our health. From the gut to the intimate microbiome, these communities of microbes help maintain balance and protect the body. As the science evolves, so does our ability to better understand and support them.
If you want to learn more about Salient Bio and their microbiome testing, visit:
Website: www.salient.bio
Email: contact@salient.bio
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This content is for informational purposes only and is not intended as medical advice. Individual experiences may vary. If you have ongoing or concerning symptoms, please consult a qualified healthcare professional.
*The study mentioned is currently pending publication.
