Vaginal Multiomics: Understanding the System, Not the Signal

The vaginal ecosystem is not just a microbial community. It is a host-microbe system shaped by hormones, immunity, metabolites, and local chemistry. Multiomics, a combination of microbiome, metabolome, immune signals, and genomics, moves the field beyond "which bacteria are present?" to what they are doing, how the host responds, and what that means for health.

What we know

• This approach has transformed understanding of the vaginal ecosystem, revealing complex host–microbe interactions, functional diversity, and links to BV, reproductive outcomes, and gynaecological cancers 1.

• The mix of small molecules in the vagina (metabolites) is one of the best ways to understand its state. Certain fats (lipids) help show levels of inflammation, while amino-acid by-products reflect which bacteria are present and the pH 2.

• The vaginal environment is different for everyone and changes over time. Simple “normal” vs “abnormal” labels miss important differences between people 3.

• Recent advances include AI-powered diagnostic models that integrate microbiome and metabolome data for improved BV detection 4.

Impact and potential

Vaginal multiomics opens real innovation pathways.

• Microbiome-compatible formulation: Designing intimate care that avoids disrupting the vaginal microbiome

• Prebiotic and postbiotic development: Targeting favourable metabolic environments, not simply eliminating bacteria.

• Longitudinal testing and claims: Shift from single timepoint testing to tracking changes over time (e.g. across cycles, treatment use), enabling more meaningful and defensible claims.

• Subtype-driven product design: Move beyond one-size-fits-all “intimate care” by developing products tailored to different dysbiosis or symptom subtypes identified through multiomics.

Our position

At Sequential, we approach the skin as an ecosystem, not a single pathway. Our focus is on generating measurable, real-world evidence of how formulations interact with both the barrier and the microbiome simultaneously. Using integrated multi-omics approaches, we can quantify changes in lipid composition, protein expression, microbial activity, and overall skin resilience over time. By testing formulations on diverse skin types and environments, using our global sample database, we generate insights that reflect real-world use rather than idealised conditions.

References

1. Ottinger, S., et al. (2024). The human vaginal microbiota. Curr Opin Microbiol, 77, 102422.

2. Bokulich, N., et al. (2022). Multi-omics integration in the cervicovaginal microenvironment. PLoS Comput Biol, 18, e1009876.

3. Challa, A., et al. (2024). Multi-omics biomarkers of bacterial vaginosis. J Eur Acad Dermatol Venereol, 38, 1152–1165.

4. Saluzzo, S., et al. (2024). AI-powered multiomics in bacterial vaginosis. J Eur Acad Dermatol Venereol, 38,999 -1000.