Scientists in the U.S. hope vaginal fluid transplants could soon be available, offering hope for women who suffer from a common condition that can heighten the risk of premature births and catching sexually transmitted infections (STIs).
The technique would involve taking the vaginal bacteria from a healthy donor and placing it in a recipient. Scientists behind a study looking at how to recruit potential donors believe the approach could help to treat conditions including bacterial vaginosis.
According to the U.S. Centers for Disease Control and Prevention, bacterial vaginosis is the most common vaginal infection in women aged between 15 and 44, affecting an estimated 21.2 million women nationwide.
It is caused by an imbalance in the diversity of bacteria in the vagina, and a depletion of bacteria known as lactobacilli. Despite its prevalence, it is unclear what triggers bacterial vaginosis. The condition most often occurs in women who are sexually active as well as those who douche, but can—in rare cases—also affect those who have never had sex.
Bacterial vaginosis can raise a woman's risk of catching STIs, having a preterm birth, and has been associated with an increased risk of abnormal cells linked to cervical cancer.
Those with the condition can have a white or gray vaginal discharge; itching, pain or burning in the vagina; and give off a fishy smell, particularly after sex. It may also burn when they urinate, and they may find the area around their vagina itches. The condition can be treated with antibiotics, but can keep coming back.
"Vaginal microbiota transplant (VMT) has the potential to revolutionize the way we view and treat conditions affecting the female reproductive tract," the authors wrote in the journal Frontiers in Cellular and Infection Microbiology.
The microbiota is the term used to describe the microorganisms that populate a living thing, like a human. These can include bacteria, fungi and viruses. The word is more commonly associated with the gut microbiota, which in recent years doctors have been able to change using what is known as a fecal transplant.
This approach inspired the authors of the new study.
The researchers designed a universal donor screening program, and tested it in 20 women. They hope the work will speed up clinical studies of vaginal microbiota transplants. Participants, aged between 18 to 45, provided samples of their vaginal fluid, as well as blood and urine. They also completed a questionnaire on variables like their sexual history and whether they used vaginal products, as well as their general medical and travel history.
The team were able to analyze the make-up of bacteria in each woman to work out she if she would be suitable as a donor. They found 35 percent were eligible to be vaginal microbiota transplant donors in a future study.
"We have very few treatment options available for BV [bacterial vaginosis], none of them fully curative or restorative," Ethel Weld, assistant professor of medicine at Johns Hopkins Medicine and co-author of the study, said in a statement.
Weld explained there is "significant" evidence to suggest that the transfer of vaginal microbiota already happens, for instance in women who have sex with women.
"But before clinical trials of VMT [Vaginal microbiota transplant] are conducted, we must first determine how to screen donors to find those with minimal risk of transmissible pathogens, and optimal vaginal microbiota for transplant."
The team envisions a group of "super donors" emerging. Due to the risks associated with sex and bacterial vaginosis, donors will be asked to abstain for 30 days or more before offering a sample, meaning some may be put off.
Study co-author Laura Ensign, assistant professor at Johns Hopkins University, said in a statement: "Once a safe donor has been identified using this protocol, she could donate on multiple appropriately screened occasions. The idea of a 'super-donor' with no identified past or current infections and with favorable Lactobacillus-dominated microbiota is one that should be explored."

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About the writer
Kashmira Gander is Deputy Science Editor at Newsweek. Her interests include health, gender, LGBTQIA+ issues, human rights, subcultures, music, and lifestyle. Her work has also been published in the The Independent, The Independent on Sunday, The i Newspaper, the London Evening Standard and International Business Times UK.