Menstrual Products and the Microbiome: What Are the Effects on Vaginal Health?

The vaginal microbiome undergoes cyclical changes throughout the menstrual cycle, yet little is known about how menstrual products - such as tampons, pads and menstrual cups - interact with and influence this delicate ecosystem. Gaining insights into these interactions could lead to innovations that optimise the vaginal microbiome and reduce infection risk.

What We Know:

• The vaginal microbiome fluctuates throughout the menstrual cycle. Research shows that Lactobacillus crispatus increases during non-menstrual phases, while bacterial vaginosis-associated species decrease, reflecting microbial shifts linked to hormonal changes (Krog et al., 2022).

• The reasons behind increased microbiome diversity during menstruation remain unclear, but may involve hormonal shifts, iron availability from menstrual blood or the effects of menstrual products (Krog et al., 2022).

Industry Impact and Potential:

• Research comparing menstrual products suggests nuanced effects on vaginal health. One study found no significant differences in microbiome composition between tampon and menstrual cup users. However, menstrual cup use was linked to increased reports of fungal genital infections, though the small sample size limits the generalisability of these findings (Tessandier et al., 2023).

• Another study examined the impact of tampons and menstruation on vaginal microbiome composition and diversity. It found that Lactobacillus species dominated at mid-cycle, with individualised but significant changes during menstruation. Despite some diversity differences between pad and tampon use, the two tampon types (viscose and cotton) did not significantly alter the microbiome (Hickey et al., 2013).

• A separate study identified tampons as a niche for Staphylococcus aureus, detected in 40% of healthy women and 100% of menstrual toxic shock syndrome cases. However, tampons did not significantly affect microbiome richness or diversity. The virulence of S. aureus seems to stem from complex microbial interactions, rather than tampon use directly affecting the microbiome (Jacquemond et al., 2018).

• These findings underscore the importance of continued research into the interaction between menstrual products and the vaginal microbiome. Understanding these dynamics could lead to menstrual products that better support microbiome resilience, reduce infection risk and promote women's health.

Our Solution:

At Sequential, we are leading the way in microbiome research and development, offering comprehensive services beyond vaginal/vulvar microbiome analysis. We also assess skin, scalp and oral microbiomes, reinforcing our leadership in creating products that maintain microbiome integrity. Our team excels at helping companies develop robust studies to enhance the vaginal microbiome, improving women’s health and well-being.

References:

Hickey, R.J., Abdo, Z., Zhou, X., Nemeth, K., Hansmann, M., Osborn, T.W., Wang, F. & Forney, L.J. (2013) Effects of tampons and menses on the composition and diversity of vaginal microbial communities over time. BJOG: an international journal of obstetrics and gynaecology. 120 (6), 695–704; discussion 704-706. doi:10.1111/1471-0528.12151.

Jacquemond, I., Muggeo, A., Lamblin, G., Tristan, A., Gillet, Y., Bolze, P.A., Bes, M., Gustave, C.A., Rasigade, J.-P., Golfier, F., Ferry, T., Dubost, A., Abrouk, D., Barreto, S., Prigent-Combaret, C., Thioulouse, J., Lina, G. & Muller, D. (2018) Complex ecological interactions of Staphylococcus aureus in tampons during menstruation. Scientific Reports. 8 (1), 9942. doi:10.1038/s41598-018-28116-3.

Krog, M.C., Hugerth, L.W., Fransson, E., Bashir, Z., Nyboe Andersen, A., Edfeldt, G., Engstrand, L., Schuppe-Koistinen, I. & Nielsen, H.S. (2022) The healthy female microbiome across body sites: effect of hormonal contraceptives and the menstrual cycle. Human Reproduction (Oxford, England). 37 (7), 1525–1543. doi:10.1093/humrep/deac094.

Tessandier, N., Uysal, I.B., Elie, B., Selinger, C., Bernat, C., et al. (2023) Does exposure to different menstrual products affect the vaginal environment? Molecular Ecology. 32 (10), 2592–2601. doi:10.1111/mec.16678.