The world of ecology has just got a whole lot more interesting. Instead of delving deeper into the uncharted waters of our oceans, or the dark recesses of the world’s rainforests, scientists have turned their focus inwards, to the ecology of microbes lurking in the nooks and crannies of our own bodies.
Incredibly, bacterial cells that live on and in us outnumber our own cells by about 10 to 1. Collectively known as the microbiome, these microscopic passengers are far from simple free-loaders. Our gut is teaming with bacteria that help us to digest everything from our breakfast cereal to our midnight ice-cream indulgence.
They’re a diverse bunch, too, and each particular niche that our body provides harbors a different community. Our skin, for example, is covered with an assortment of critters – there’s one community behind our ears, another living on the tips of our fingers, and still another nestled amongst the hair of our underarms.
Although the communities living in our gut and on our skin have drawn much of the microbiome limelight, a few intrepid teams are braving the wilds of the vagina to find out what exactly is making a home down there.
It’s more than a simple census of what’s there, mind you – there are some important questions being asked as well. For one, how does the curious mix of microbes down there help to keep us healthy? What happens if the community’s unsavory elements start to outnumber the Samaritans? And how can we restore balance once it is lost?
Perhaps not unsurprisingly, what we’re starting to discover is that diseases of the vagina aren’t all down to the odd incursion by the likes of chlamydia and gonorrhea. Although both of these bugs affect millions of women around the globe, a far more common, but less well-known infection is bacterial vaginosis, or BV.
BV is an unpleasant condition that produces an off-white discharge and a foul, fishy odor. At the more sinister end of the spectrum, BV has been implicated in increased risk of miscarriage and preterm births, and a greater susceptibility to HIV and other infections. Up to 30% of American women have BV, and rates in parts of Africa can be as high as 50%.
But unlike chlamydia or gonorrhea, which are caused by single organisms, BV is caused by the community as a whole changing. Working out what changes are occurring in women with BV – and what a healthy community looks like – could be the key to discovering a better cure for the condition.
Currently, women are usually prescribed antibiotics in the hope the nasty elements causing BV will wiped out. For many women, relief is temporary, with BV recurring within a year. As we begin to appreciate the subtleties of the vaginal microbiome, we may be able to move away from antibiotic treatments that indiscriminately wipe out both friend and foe, and turn instead to probiotic treatments that can nudge the community back in the right direction.
I can’t help but spare a thought for the hundreds of women at the coalface of this endeavor – the anonymous human lab rats of the vaginal microbiome project. Dozens of women have signed up to collect vaginal swabs, all in the name of science. It might not be as glamorous as sweeping a butterfly net through a field, but these swabs are as important as any ecological expedition, enabling scientists to catalogue and measure the ecology of the vagina.
Like all great projects of discovery, these swabs and the surge to understand our most intimate of cohabitants are bound to lead to other as-yet undetermined insights into women’s reproductive and sexual health. Women, I salute you!