32 INTIMATE CARE
Figure 1: The vaginal microbiome alters throughout a female’s lifespan, particularly during the menstruating period and after menopause
Lactobacillus is characterised as a Gram- positive bacteria with a rod shape. These bacteria are known to produce lactic acid and make the vagina’s pH more acidic (<4). According to current research, an acidic
environment can restrict the growth of non-indigenous bacteria, which can foster a healthier environment. As a general rule, the Lactobacillus species converts sugar into pyruvate which in turn converts it to lactic acid. They can make two types of lactic acid known as D-Lactic acid and L-Lactic acid.4
Characterising the vaginal microbiome In 2011 the concept of Community State Types (CSTs) was introduced with the aim of categorising the vaginal microbiome communities.6
This categorization was
introduced after sampling women of asymptomatic ages through to reproductive women with 16S rRNA Sequencing. As a result, five CSTs were found, namely: ■ (L. crispatus): Type 1 is understood to be the healthiest, with research showing that this type can even prevent infections such as STIs, BV, and UTIs. ■ (L. gasseri): Type 2 is also linked to a healthy vaginal microbiome, with Lactobacillus gasseri dominating the population of bacteria. ■ (L. iners): Type 3 is neutral meaning it could be disruptive or protective to the vaginal community and is dominated by a species of Lactobacillus known as Lactobacillus iners. ■ (Diversity group): Type 4 is understood to be an unhealthy vaginal environment with a high diversity of bacteria and low population of lactobacilli. ■ (L. jensenii): Type 5 is another state type acknowledged as healthy with a dominance of Lactobacillus jensenii. It is interesting to note that within
this research females of different ethnic backgrounds fell under different community types. It is crucial to acknowledge that ethnicity plays a key role in the vaginal microbiome and further research is necessitated to understand how it varies from female to female.6 In a paper published in 2020, it is disputed that CSTs need to go a step further to help
PERSONAL CARE January 2024
classify the vaginal microbiome. That is where Valencia comes in (or VAginaL community state typE Nearest CentroId clAssifier). It is a centroid-based tool for measuring vaginal microbial communities based on composition.7 The aim is to classify samples based purely on similarities against a reference that has been defined from 13,160 taxonomic profiles from 1,975 women within the United States. This large dataset allows for a more comprehensive process of identifying, characterising and defining CSTs.
Vaginal microbiota through the female lifespan Just as with any element of the human body, the vaginal microbiome alters throughout a female’s lifespan, particularly during the menstruating period and after menopause (Figure 1). This is due to the structural and hormonal features of the vaginal tissue (epithelium), which results in a changing environment. It is still not entirely clear what specific changes we can expect to see in each of these stages, as there are many factors at play, including lifestyle, environment and yes, even ethnicity. In order to uncover more about the
vaginal and vulvar microbiome, it is crucial to conduct further studies and test products made for feminine intimate care with the correct methodologies and quantitative analysis to understand their true effect on the microbiome. Given the sensitivity of the region, applying strict regulations is necessary to avoid harm to women using products that are meant to help them.
Intimate care products: a regulatory vacuum The personal care industry is ever flourishing, with influences from celebrities driving hype towards products, and scientists debunking what we thought we knew about trends such as clean beauty and organic while shedding light on truly beneficial ingredients. The entire industry is wrought with overly stimulating brands that are exciting and fun to use, as compared to their counterparts that put strict emphasis on the science-backed formulations over their branding. When the correct balance is struck between
these two components, we can see the overall benefit of a product coupled with our own enjoyment of using it. However, because these two camps of brands stand so separately, there is an increasing need to regulate formulations, to separate brands hoping to hop on a bandwagon and those brands that are truly wanting to make a change in their consumers’ lives. At present, the entire personal care industry is seeing a definitive lack of regulation when it comes to products. Unlike the FDA in the United States, which emphasises food and drug safety, the beauty industry does not have a set guideline to follow. It operates in grey areas, where it is very easy for brands to make certain claims about their formulations and consumers are likely to believe them. While the abundance of choices might
suggest a wealth of options, it often brushes over the fact that many products, particularly those targeting intimate care for women, lack adequate testing and data. However, we are beginning to see a shift in this trend.
TABLE 1: IN VIVO VERSUS IN VITRO TESTING FOR UNDERSTANDING PRODUCT EFFECTS ON THE VAGINAL MICROBIOME
in vitro Study Design
Narrow view of microbiome: Isolated from other bacteria
Cannot extract meaningful conclusions on how the product will interact with its place of application
Limited analysis: brief snapshot of how the product interacts with an isolated bacteria
in vivo Study Design Analyze a number of selected bacteria within a lab setting Analyze all bacteria within their natural context
Broad view of microbiome: you can see interactions between bacteria
Can extract meaningful conclusions on how the product will interact with its place of application
Longitudinal analysis: evaluate the product over time and its impact on the microbiome
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