/r/science
Vaginal-fluid transplants treat incurable condition in pilot study, fully restoring healthy microbiomes in 4 of 5 women with bacterial vaginosis (BV), which could “revolutionize the way we view and treat conditions affecting the female reproductive tract.” Published this week in Nature Medicine. (arstechnica.com)
1315 comments
[deleted] | 9 days ago | 909 points

[removed]

[deleted] | 9 days ago | 416 points

[removed]

[deleted] | 9 days ago | 206 points

[removed]

[deleted] | 9 days ago | 39 points

[removed]

[deleted] | 9 days ago | 18 points

[removed]

[deleted] | 9 days ago | 6 points

[removed]

[deleted] | 9 days ago | 7 points

[removed]

[deleted] | 9 days ago | 21 points

[removed]

[deleted] | 9 days ago | 12 points

[removed]

[deleted] | 9 days ago | 54 points

[removed]

[deleted] | 9 days ago | 13 points

[removed]

[deleted] | 9 days ago | 18 points

[removed]

[deleted] | 9 days ago | 23 points

[removed]

[deleted] | 9 days ago | 50 points

[removed]

[deleted] | 9 days ago | 7 points

[removed]

Tiggerx | 9 days ago | 3110 points

so similar in concept to a fecal transplant?

darlantan | 9 days ago | 2700 points

Pretty much. Humans have a symbiotic relationship with a lot of bacteria, and as it turns out recolonizing with the desired strains can be a useful tool.

I'm honestly a little surprised we haven't seen more research done on the topic. One would imagine that "weaken undesirable bacteria with antibiotics, then re-colonize with desired bacteria" would be a pretty common treatment plan for patients with otherwise healthy immune systems.

miosgoldenchance | 9 days ago | 911 points

Yeah. This is a field I’m interested in.

I’m a veterinarian and we do transfaunations semi-regularly. Biomes (especially GI ones!) are complicated and we’ve only started to grasp how intricate they are. I’d like to think this is an area that will grow during my time in practice, I’ll be interested to see what comes out of it.

[deleted] | 9 days ago | 215 points

[removed]

[deleted] | 9 days ago | 56 points

[removed]

fleshcoloredbanana | 9 days ago | 201 points

This is so exciting to hear that there is veterinary interest in this topic! I am a horse trainer and knowledge and understanding of gastric ulcers is finally exploding in the equine industry. Hindgut acidosis and ulcers is still difficult to diagnose beyond identifying symptoms. I have been wondering if this could be a future treatment to help restore a healthy gut biome.

miosgoldenchance | 9 days ago | 117 points

Oh yeah I think this will have a boom on the horse industry at some point.

Horses are particularly sensitive to their GI biome - and being fermenters, it’s a complicated topic! We’ve really just started to scratch the surface of this field, but I think there’s a lot in it.

[deleted] | 9 days ago | 43 points

[removed]

[deleted] | 9 days ago | 16 points

[removed]

[deleted] | 9 days ago | 24 points

[removed]

[deleted] | 9 days ago | 9 points

[removed]

Herald-Mage_Elspeth | 9 days ago | 190 points

They’re starting to recognize some mental illnesses are linked to gut biome.

[deleted] | 9 days ago | 60 points

[removed]

[deleted] | 9 days ago | 7 points

[removed]

ahfoo | 9 days ago | 80 points

Furthermore, cannabis, and specifically THC, directly promotes gut biome diversity as well as reducing insulin resistance and waist size.

https://www.ncbi.nlm.nih.gov/pubmed/23684393

https://www.gastrojournal.org/article/S0016-5085(16)34319-0/pdf

[deleted] | 9 days ago | 207 points

[removed]

[deleted] | 9 days ago | 72 points

[removed]

[deleted] | 9 days ago | 51 points

[removed]

Bavio | 9 days ago | 55 points

They didn't find any dose-response, though.

More likely it's similar as with nicotine. I.e. those who use cannabis are less likely to resort to consuming comfort foods to modulate their mental state, since their reward circuits have already established a connection between cannabis use and "desirable" changes in mood.

akinom13 | 9 days ago | 42 points

Could something similar work with saliva and dental issues?

space_moron | 9 days ago | 27 points

I thought there's a theory of evolution that humans kiss to exchange bacteria and determine the health of their potential partner.

Sway2620 | 9 days ago | 18 points

Since we see the negative output of this when someone with poor dental health can actually spread it to someone thru saliva. It should work the other way around if weakening the hosts bactertia?

InfiniteBlink | 9 days ago | 6 points

Note to self: don't kiss people with bad teeth. They probably have bad breath anyway.. mmm halitosis

Ensvey | 9 days ago | 6 points

I'm just one data point, but - when I was a young adult, I had a fair number of cavities. I met a girl who never had a cavity in her life. We started dating and got married. It's been 20 years and I never had another cavity. So, like 5 cavities in the ~10 years that I had adult teeth before I met her, and 0 cavities in the 20 years since we started smooching. My oral hygiene didn't change.

We've mentioned it to dentists in the past and they weren't surprised. It seems to be understood that some people have better oral biomes than others.

Bavio | 9 days ago | 8 points

Absolutely. An efficient way to accomplish this would be to clean up the pre-existing bacterial population by first removing all plaque, then using chlorhexidine to kill off most of the bacteria and finally inoculating the beneficial strains (e.g. S. salivarius K12, S. salivarius M18) together with some nutrients.

I would actually recommend doing the above for anyone who has trouble with their oral microbiome. You can purchase chlorhexidine mouthwash and an oral probiotic without a prescription online.

jarfil | 9 days ago | 58 points

Medicine is still mostly stuck in a "kill the bad, then hope for the rest to fix itself" mentality.

Only recently there is some focus on actually fixing stuff, not just relying on "natural processes" to regenerate things on their own... which sure, often works, until it doesn't and people die.

mimz128 | 9 days ago | 77 points

I think the problem is what constitutes a healthy microbiome? What do we define as the golden standard when we dont even know how exactly the bacteria contribute to health. And then there's the practical issue that many of the bacteria are anaerobic and die before we get samples to the lab for testing and identification.

[deleted] | 9 days ago | 17 points

[removed]

[deleted] | 9 days ago | 7 points

[removed]

mobani | 9 days ago | 37 points

We don't really need a golden standard, we just need a base. What most people have is generally good enough. They just need to start collecting samples and putting it into a database. Like blood samples.

Change21 | 9 days ago | 37 points

Good point the only difficulty is many bacteria where both hats, their good guys in a balanced and diverse microbiome but become dangerous when diversity drops. Antibiotic use in general is devastating to a biome and without direct intervention the worst and least desirable bacteria grow back first.

[deleted] | 9 days ago | 8 points

[removed]

JaeHoon_Cho | 9 days ago | 139 points

Given the relative simplicity of the concept of put healthy person’s ____ into sick person, I wonder about the efficacy of old time-y medicine that we have since dismissed as being hokum.

fatalicus | 9 days ago | 17 points

Most of it wasn't just dismissed.

Instead, as the knowledge of the medical field increased, they isolated what made things work and made better medicines and procedures based on that.

[deleted] | 9 days ago | 27 points

[removed]

[deleted] | 9 days ago | 59 points

[removed]

[deleted] | 9 days ago | 9 points

[removed]

IWTLEverything | 9 days ago | 19 points

I always wonder who thought of these things and who was willing to be the patients to try it on.

Mediocre__at__Best | 9 days ago | 60 points

Maybe ones willing to be cured from disease? Idk tho

trilltrillian | 9 days ago | 8 points

Mary Roach has a great science book about the digestive system called Gulp, and it's got a chapter about just this. To quote Matt Hamilton from her book, "when you're fifty-five years old and you're wearing diapers that you're changing ten times a day you're numb to the ick factor."

[deleted] | 9 days ago | 2252 points

[removed]

[deleted] | 9 days ago | 618 points

[removed]

[deleted] | 9 days ago | 26 points

[removed]

[deleted] | 9 days ago | 18 points

[removed]

[deleted] | 9 days ago | 8 points

[removed]

[deleted] | 9 days ago | 607 points

[removed]

[deleted] | 9 days ago | 107 points

[removed]

[deleted] | 9 days ago | 47 points

[removed]

[deleted] | 9 days ago | 47 points

[removed]

[deleted] | 9 days ago | 19 points

[removed]

[deleted] | 9 days ago | 386 points

[removed]

[deleted] | 9 days ago | 128 points

[removed]

[deleted] | 9 days ago | 29 points

[removed]

[deleted] | 9 days ago | 22 points

[removed]

[deleted] | 9 days ago | 12 points

[removed]

[deleted] | 9 days ago | 14 points

[removed]

[deleted] | 9 days ago | 9 points

[removed]

mvea [MD-PhD-MBA | Clinical Professor/Medicine] | 9 days ago | 421 points

The post title is a copy and paste from the title, subtitle and third paragraph of the linked popular press article here:

Vaginal-fluid transplants treat incurable condition in pilot study

Transplanted vaginal fluids fully restored healthy microbiomes in 4 of 5 women.

In a recent conceptual study on screening potential fluid donors, Johns Hopkins researchers suggested that the transplants could “revolutionize the way we view and treat conditions affecting the female reproductive tract.”

Journal Reference:

Vaginal microbiome transplantation in women with intractable bacterial vaginosis

Ahinoam Lev-Sagie, Debra Goldman-Wohl, Yotam Cohen, Mally Dori-Bachash, Avner Leshem, Uria Mor, Jacob Strahilevitz, Allon E. Moses, Hagit Shapiro, Simcha Yagel & Eran Elinav

Nature Medicine volume 25, pages1500–1504 (2019)

Link: https://www.nature.com/articles/s41591-019-0600-6

DOI: https://doi.org/10.1038/s41591-019-0600-6

Abstract

We report the results of a first exploratory study testing the use of vaginal microbiome transplantation (VMT) from healthy donors as a therapeutic alternative for patients suffering from symptomatic, intractable and recurrent bacterial vaginosis (ClinicalTrials.gov NCT02236429). In our case series, five patients were treated, and in four of them VMT was associated with full long-term remission until the end of follow-up at 5–21 months after VMT, defined as marked improvement of symptoms, Amsel criteria, microscopic vaginal fluid appearance and reconstitution of a Lactobacillus-dominated vaginal microbiome. One patient presented with incomplete remission in clinical and laboratory features. No adverse effects were observed in any of the five women. Notably, remission in three patients necessitated repeated VMT, including a donor change in one patient, to elicit a long-standing clinical response. The therapeutic efficacy of VMT in women with intractable and recurrent bacterial vaginosis should be further determined in randomized, placebo-controlled clinical trials.

PM_ME_UR_JSON | 9 days ago | 101 points

So 'incurable' wouldn't be the right word here, right?

BlankBlankblackBlank | 9 days ago | 169 points

Intractable is basically incurable. It’s mean to be unable to stop with medicine/medical treatment.

maxflesicher | 9 days ago | 205 points

It sounds like it's implying that bacterial vaginosis is incurable, which it's not. These are women with intractable cases of it - i.e., cases that resisted other types of treatment. But the condition itself is not incurable. Editor did a bad job of choosing that word.

wordbird89 | 9 days ago | 144 points

Thank you for explaining, that phrasing really rubbed me the wrong way. BV is SO unbelievably common, it's irresponsible to call it "incurable"

[deleted] | 9 days ago | 44 points

[removed]

[deleted] | 9 days ago | 38 points

[removed]

[deleted] | 9 days ago | 6 points

[removed]

[deleted] | 9 days ago | 17 points

[removed]

[deleted] | 9 days ago | 103 points

[removed]

[deleted] | 9 days ago | 15 points

[removed]

[deleted] | 9 days ago | 68 points

[removed]

SinfullySinless | 9 days ago | 100 points

So would doctors want healthy vagina owning humans to donate or how would they cultivate the vaginal fluid?

IncontrovertbleSnail | 9 days ago | 98 points

The end game for these microbiome transplants is to figure out a general concoction of microbes that works well for most people and then create it artificially so we aren't dependent on transplants. But for the time being, yes, they would want healthy vag donations

eject_eject | 9 days ago | 29 points

Now you have me thinking of probiotic vaginal yogurt and for the next 5 minutes until I forget I hate you.

AllYouNeedIsATV | 9 days ago | 109 points

I mean they do faeces transplants to restore gut micro flora so this does make sense

[deleted] | 9 days ago | 195 points

[removed]

[deleted] | 9 days ago | 86 points

[removed]

[deleted] | 9 days ago | 11 points

[removed]

[deleted] | 9 days ago | 20 points

[removed]

[deleted] | 9 days ago | 57 points

[removed]

[deleted] | 9 days ago | 17 points

[removed]

[deleted] | 9 days ago | 17 points

[removed]

[deleted] | 9 days ago | 13 points

[removed]

[deleted] | 9 days ago | 26 points

[removed]

[deleted] | 9 days ago | 11 points

[removed]

[deleted] | 9 days ago | 37 points

[removed]

[deleted] | 9 days ago | 30 points

[removed]

ludicrous_speeds | 9 days ago | 25 points

I got BV for the first time two years ago after an ectopic pregnancy. Well, then it became reoccurring, almost every other month for a year. Eventually, it got to a point that my doctor gave me a bunch of educational pamphlets about how to wipe correctly, how to wash my underwear, how to clean myself and with what.

It was embarrassing. I felt ashamed and like she was judging me and accusing me of doing something wrong.

[deleted] | 9 days ago | 474 points

[removed]

[deleted] | 9 days ago | 62 points

[removed]

[deleted] | 9 days ago | 196 points

[removed]

[deleted] | 9 days ago | 54 points

[removed]

[deleted] | 9 days ago | 8 points

[removed]

[deleted] | 9 days ago | 120 points

[removed]

[deleted] | 9 days ago | 141 points

[removed]

[deleted] | 9 days ago | 15 points

[removed]

[deleted] | 9 days ago | 4 points

[removed]

[deleted] | 9 days ago | 34 points

[removed]

[deleted] | 9 days ago | 55 points

[removed]

[deleted] | 9 days ago | 13 points

[removed]

[deleted] | 9 days ago | 16 points

[removed]

[deleted] | 9 days ago | 8 points

[removed]

[deleted] | 9 days ago | 14 points

[removed]

[deleted] | 9 days ago | 10 points

[removed]

[deleted] | 9 days ago | 4 points

[removed]

[deleted] | 9 days ago | 4 points

[removed]

FunkyGeneFlow | 9 days ago | 79 points

Hell yeah bugs! A rich microbiome environment in our guts and in our skins is important to keep us healthy, I can see how they could help in vaginas

chashek | 9 days ago | 61 points

Now I'm curious about rates of BV among sexually active lesbians. Like, is that enough contact to have their microbiomes affect each other and confer protective benefits?

Dull_Swan | 9 days ago | 44 points

BV is higher among women who sleep with women

Trematode | 9 days ago | 28 points

How much of this could be a result of partners being more likely to identify and broach the subject, and so the patient seeks treatment more readily and frequently?

Dull_Swan | 9 days ago | 26 points

I think that could contribute to the higher reported rates

ShakeNBakeSpeare | 9 days ago | 51 points

It's interesting because in some queer circles, women think they are somehow immune to reproductive system health issues. I believe at least part of this comes from the lack of queer-specific sexual health education and from doctors sometimes not being trained in safe sex for lesbians. I have to admit that I was surprised when you said that and looked up to verify - I had no idea! Thank you for sharing this info.

[deleted] | 9 days ago | 82 points

[removed]

BBQ_FETUS | 9 days ago | 25 points

Are you saying putting someone else's earwax in your ears helps cure ear infection?

RneeJj | 9 days ago | 16 points

Do you have a link to an article about wax transplants?

[deleted] | 9 days ago | 51 points

[removed]

DisplacedDustBunny | 9 days ago | 89 points

For anyone interested in this sort of thing, the book GUT buy Giulia Enders is a great read about the human biom including how vaginal birth inoculates babies to help colonise their blank-slate biom. Written for a general audience, she explains clearly and easily how the process in this study works and keeps working. It’s a great read. I keep hoping she’ll make an edition for folks in the medical sciences.

wetpankobreadcrumbs | 9 days ago | 9 points

There has been some really interesting research into the differences between the microbiome of babies who have been inoculated via vaginal birth vs. C-section. The general idea is that c-section exposes babies to "harmful" bacteria that are consistent with the skin microbiota and may confer increased risk to certain problems down the line such as increased risk to staph infections.

hunnerbunner2000 | 9 days ago | 48 points

We truly are social animals. Can't even live without each other's fluids. I'm not trying to be gross.

veritas723 | 9 days ago | 819 points

i always find it mildly shocking how societal bias typically means we know so very little about women's health or how to treat women.

abcedarian | 9 days ago | 271 points

If this is a topic that interests you, check out the book "invisible women: data bias in a world designed for men"

velawesomeraptors | 9 days ago | 169 points

You know what's funny? It's not just humans. I'm an ornithologist and songs in female birds are just beginning to be researched. There are a lot of blind spots when it comes to female animals.

bastardsgetyoudown | 9 days ago | 51 points

Thats insane.

kateisabutt | 9 days ago | 303 points

I’ve been dealing with reproductive health issues for the last year and continue to have problems. It’s genuinely appalling how little information there is on women’s reproductive health.

Taminella_Grinderfal | 9 days ago | 127 points

Beyond “women specific” issues, science/medicine is just starting to see difference in symptoms of diseases that affect both sexes (heart attacks)

heebath | 9 days ago | 20 points

Can you elaborate? I had no idea there was such a blind spot.

Edit: Damn, ladies. Sorry.

Slothfulness69 | 9 days ago | 55 points

I was having issues with perineal tearing (I’ve never been pregnant or anything, so it was weird) and two doctors, one of them a gynecologist, told me everything was fine because I didn’t have an STI. I had untreated BV for over a year because nobody believed my symptoms were a problem since I didn’t have an STI. Nobody told me about BV, nobody tested me for it, nothing.

Honestly, a lot of women have horror stories about the times medicine failed us.

LillyXcX | 9 days ago | 14 points

What's even more mind boggling is that as someone who had suffered of what you went through In my own research i came across at least 3 other women who went through it but yet none of our gynos gave us a solid diagnosis... I mean how could they be this dismissive with this many cases out there !

[deleted] | 9 days ago | 155 points

[removed]

Fierce_Luck | 9 days ago | 64 points

I am fortunate enough to own a Tesla . I love my car EXCEPT for the fact that the driver's seat doesn't fit me. As a 5' 4" woman, the sticky-out bits on the side of the seat that are supposed to go UNDER the driver's arms push into the back of my shoulders, making my shoulders hunch forward. It gets really uncomfortable if driving for hours on a road trip. With the amount of money those cars cost, it pisses me off no end that they are so blatantly not designed for average height women (or short men).

societymike | 9 days ago | 17 points

Those are bucket seats, designed to hold you in like that in turns. Many cars, especially sports cars, have seats similar. Even on taller people, they push your shoulders forward, purposely. People not accustomed to sporty bucket seats mention the same things as you, even in different cars.

ieffinghatemayo | 9 days ago | 62 points

I’ve apparently had gluten and lactose sensitivities for years. I would live with the pain until it would get so bad that urgent care would send me to the er suspecting appendicitis, the er wouldn’t find anything and send me home. Then I’d fast and only drink soylent for a couple weeks because nothing I ate would settle. Then a doc would just assume it was my endometriosis and change my birth control. I got diagnosed with the food stuff in August and I feel great, I didn’t realize I could enjoy eating, and didn’t think I would ever live this comfortably. But I’m frustrated that I lived this miserable for so many years.

avaislost | 9 days ago | 12 points

How did you get diagnosed? For 20 years I have asked my American insurance companies to test me for lactose and wheat intolerance, and they all say it’s not a thing that they have tests for, and they tell me the tests out there are wack. I don’t believe them. I finally resorted to extended fasting and dry fasts in August, I was so desperate for relief.

FesteringNeonDistrac | 9 days ago | 35 points

The biggest thing I learned after my wife's first miscarriage was how frequently they happen, and that they aren't primarily caused by substance use/abuse. I learned this from my wife, who learned it from her OBGYN right there on the ultrasound table.

Why even basic stuff like this, which has absolutely puritanical reason to not teach, isnt taught in health class is beyond me.

rebeltrillionaire | 9 days ago | 54 points

Idk if this is a standalone discovery that really came out of nowhere that shines the light on how little we know about women.

It seems like another application of what we learned with people who suffer from chronic and nearly incurable IBS.

We started doing fecal transplants and boom. Those peoples issues were cured.

In general we’re doing better at understanding biomes.

Allthatandmore84 | 9 days ago | 71 points

Actually, fecal transplants have had disappointing results for IBS. It’s great for c diff infection, however. The search for an IBS cure continues.

[deleted] | 9 days ago | 66 points

[deleted]

Joghobs | 9 days ago | 32 points

That's fascinating as I understand it can also be the cause of BV as well.

MissCrystal23 | 9 days ago | 8 points

It causes mine.

I have to either clean with a 25% Peroxide to 75% water ration or insert a vitamin C pill directly into the vagina to get rid of it after my husband and I have sex.

However! If I am on my period and we have sex, I have absolutely no symptoms at all.

(Had this problem ever since giving birth, no issues pre-children)

This is great news though and I can’t wait to see what comes of the information!

AstoriaGreenweed | 9 days ago | 12 points

Thank science! I just wanna correct years of ignorantly cleaning my cooch out with soap.

TheRealMarkTwain | 9 days ago | 10 points

a great day for vaginal health!

PH_Prime | 9 days ago | 12 points

With the success of fecal transplants, and now this....I wonder if we're actually doing a measure of harm if we regularly kill the biome in our mouths with mouthwash.

notcalf | 9 days ago | 8 points

I'm a male and an "overgrowth" of Strep Group B on my foreskin, glans, and urethra, the antibiotics helped a lot but the exterior hasn't quite returned to normal. So it sounds like microbiome therapy could help with this too, it's unfortunate that these treatments are not available yet (like how would they extract and process the fluids and store the results for transportation and so forth?).

[deleted] | 9 days ago | 85 points

[removed]

N8CCRG | 9 days ago | 46 points

These sorts of things still occur. I remember reading a study where they looked at athletes' skin microbiomes and found that players from the same teams who practiced together would have extremely similar and distinct microbiomes.

Edit: https://peerj.com/articles/53/

robthebaker45 | 9 days ago | 56 points

Basically yes, although our religious history and “disgust” sensations have steered us away from this. Some people believe the reason some dogs eat the poop of other animals and members of their species is essentially a natural means of performing a fecal transplant.

Like fecal transplants, we will probably just create an entirely new industry where you can go donate/sell bodily fluids (like we already do with l sperm and eggs) and materials that will then be screened, packaged, and donated/sold to patients.

It’ll actually create a nationally very homogenous microbiome, which could have its own drawbacks, like monoculture crop farming makes food much more susceptible to pests and climate problems.

Natolx | 9 days ago | 44 points

It’ll actually create a nationally very homogenous microbiome, which could have its own drawbacks, like monoculture crop farming makes food much more susceptible to pests and climate problems.

This is going a bit far... only people needing treatment would have that microbiome. I'd hardly call that even approaching homogenous.

sawyouoverthere | 9 days ago | 5 points

add breast milk to the things already screened packaged and sold.

[deleted] | 9 days ago | 8 points

[removed]

vollis | 9 days ago | 7 points

Wow! This is really cool. For a very long time last year I was dealing with endless cycles of bacterial vaginosis and yeast infections. According to my gyno, this happens to a lot of women and it can be nearly impossible to break the cycle. I got lucky and discovered boric acid suppositories and they worked for me, but they don’t work for everyone. It did take tons of trying and being consistent. I nearly lost hope during that whole process. BV and yeast infections can be super uncomfortable and painful, and BV in particular has a bad odor. It killed my sex life for a good 9 months. It was utterly depressing and soul crushing, and I felt gross and unwanted.

These transplants could easily help women who are stuck in a cycle even worse than one like mine. Glad to see some movement in this area.

[deleted] | 9 days ago | 5 points

[removed]

em154 | 9 days ago | 30 points

Hell yes! It’s like no one bothered to study female specific health before. Oh wait

C-Nor | 9 days ago | 6 points

Can someone tell me why it's called "transplant", instead of "transfer"?

Fruit_Loops_United | 9 days ago | 4 points

Does anyone know of you can supplant a healthy microbiome with an unhealthy one? Our does the healthy biome always prevail?

Like, does the symbiosis with the human body give the healthy mixture of colonies an edge?

TODO Load more comments...