A recent Trends in Microbiology paper advocates for a more inclusive approach to vaginal microbiome research. Drawing on studies from the past five years and insights from citizen-science initiatives like the Isala Project the paper emphasizes the importance of considering social cultural and environmental factors that influence vaginal health and calls for expanded global research efforts.

Swiss TPH contributed expertise on social health determinants examining how historical research biases have shaped global disparities in women's health. Incorporating global perspectives allows us to develop microbiome based health interventions that are relevant for all women not just those in high-income regions said Monica Ticlla Postdoctoral Scientific Collaborator at Swiss TPH.

Understanding the Vaginal Microbiome
The vaginal microbiome plays a crucial role in reproductive and overall health influencing conditions such as bacterial vaginosis preterm birth urinary tract infections and sexually transmitted infections. However research has largely focused on high-income regions limiting the global understanding of vaginal health. 

Limited Global Representation: Many regions particularly Africa and South America are underrepresented in microbiome research. The authors call for greater collaboration with researchers from low- and middle-income countries to address this gap.

Inadequacies in Current Classification Systems: The vaginal microbiome is typically classified into five community state types (CSTs) based on dominant bacterial species. However this model oversimplifies the complexity of microbiome diversity.

Impact of Social and Cultural Factors: Vaginal microbiome composition is influenced by more than genetics with hygiene practices dietary habits and healthcare access playing significant roles.

Rethinking Treatment Strategies: Bacterial vaginosis and related conditions are often treated with antibiotics but recurrence rates can reach 60%. Alternative treatments such as vaginal microbiota transplants and live biotherapeutic products may offer more sustainable long-term solutions.

These challenges highlight the need for a transformative approach to vaginal microbiome research ensuring studies better represent the diverse health experiences of women globally. Ticlla stressed the importance of broadening research beyond high-income regions stating The vaginal microbiome impacts health outcomes in ways we're just beginning to uncover. Expanding research to include diverse populations is crucial for creating effective health strategies.

Source: https://www.cell.com/trends/microbiology/fulltext/S0966-842X(24)00328-7