On this page
The vaginal microbiome is the complex, finely balanced ecosystem of microorganisms living in the vagina – bacteria, fungi and viruses. Few people know this, but this flora is not a static state: its composition changes continuously with age, the hormonal cycle, sexual activity and everyday habits. A healthy microbiome is an invisible but very strong protective shield, which protects the female body from ascending infections and from chronic gynaecological inflammation.
If this delicate balance is upset (this is called dysbiosis), the number of protective bacteria falls sharply, opening the way for pathogens that cause unpleasant symptoms and serious complications. The modern vaginal microbiome PCR test available at Sabjanics Medical Center is the highest level of diagnosis: it doesn't just look for one or two pathogens, it gives a complete, quantified picture of the current state of the vaginal flora.
The pillars of a healthy microbiome: the lactobacilli
In healthy conditions, more than 90% of the vaginal microbiome is made up of beneficial Lactobacillus (lactic acid bacteria) species. The most important of these are:
- Lactobacillus crispatus (the strain that provides the strongest protection)
- Lactobacillus jensenii
- Lactobacillus gasseri
- Lactobacillus iners
These beneficial bacteria produce lactic acid, which keeps the vagina at its healthy, slightly acidic pH (3.8–4.5). This acidic environment, together with the natural antimicrobial substances they produce (such as hydrogen peroxide), makes it practically impossible for harmful bacteria and fungi to settle and multiply.
What happens if the balance is upset? (The consequences of dysbiosis)
When the proportion of lactobacilli falls, the vaginal pH rises (it shifts towards the alkaline), and bacteria that were previously kept in check become dominant. This state lies behind the following stubborn conditions:
- Bacterial vaginosis (BV): When the beneficial flora is replaced by anaerobic bacteria such as Gardnerella vaginalis or Atopobium vaginae. It is characterised by a heavy, thin vaginal discharge with an unpleasant (fishy) smell.
- Aerobic vaginitis (AV): Here, typical gut bacteria such as E. coli, Streptococcus agalactiae (group B Streptococcus) or Staphylococcus aureus overgrow in the vagina. This condition causes marked redness of the mucous membrane, a yellowish, odourless discharge and painful sex.
- Stubborn yeast infections: Loss of the flora opens the way for various Candida species to overgrow.
Why is it dangerous to neglect it?
Long-term vaginal dysbiosis weakens local immune defences, so infections can easily travel up towards the internal reproductive organs. This can lead to chronic pelvic inflammation, scarring of the fallopian tubes and, through this, infertility. It is especially critical during pregnancy: an imbalanced flora has been shown to increase the risk of miscarriage, premature rupture of the membranes and preterm birth.
When is the comprehensive microbiome PCR test recommended?
The specialists at Sabjanics Medical Center recommend molecular mapping of the flora in the following situations:
- For stubborn, recurring vaginal symptoms: If you have been struggling for months with itching, burning or discharge of unclear origin, and standard antifungal or antibacterial treatments have brought only temporary relief.
- After repeated courses of antibiotics or antifungals: To check how much damage the medicines have done to the beneficial flora and whether targeted rebuilding is needed.
- During family planning and fertility investigations: To support successful implantation and a pregnancy free of complications.
- Before planned gynaecological surgery: To minimise the risk of postoperative (after surgery) infections.
Why does PCR offer more than a conventional smear test?
Traditional vaginal cultures and microscopic smear assessments (e.g. the Nugent score) are important basic tests, but they have their limits: delicate bacteria that need an oxygen-free (anaerobic) environment can easily die while the sample is transported, so they remain invisible on culture.
By contrast, the Real-Time multiplex PCR microbiome test we use:
- It identifies the genetic material (DNA) of the bacteria, so it does not require a living or multiplying pathogen.
- It gives a quantitative (numerical) result: It doesn't just tell us whether a bacterium is present; it shows exact percentages and concentrations. We can see the precise amount of beneficial Lactobacilli and the ratio of pathogens to one another.
A short guide to the test
IMPORTANT INFORMATION FOR PATIENTS
- How is the sample taken?
- A completely painless, routine gynaecological sample taken from the vaginal wall with a soft, special sampling brush.
- How should I prepare for the test?
- For 48 hours before the test, you must strictly avoid vaginal douching, pessaries, creams, tablets or lubricants, and you should not have sex. The sample cannot be taken during menstrual bleeding.
- How will I receive my result?
- With your consent, we email your result as an encrypted, password-protected PDF. At the follow-up consultation, our specialist will explain it to you in detail. How results are sent
What should you do after you receive the test result?
The vaginal microbiome PCR test result is an extremely detailed, graphical and quantified diagnostic map.
- The key to personalised treatment: With a positive or imbalanced result in hand, the gynaecology specialists at Sabjanics Medical Center don't just prescribe a general antibiotic – that would also destroy the remaining good bacteria. Using the result, we can put together a precisely targeted treatment: if needed, we eliminate the overgrown pathogens and, at the same time – knowing which Lactobacillus strains are missing – use personalised local flora restoration (targeted probiotic replacement).
Restore the natural balance of your vaginal flora! Don't treat yourself at random with over-the-counter products, and don't let recurring symptoms limit your daily life. Book an appointment for the comprehensive vaginal microbiome PCR test at Sabjanics Medical Center, and let's rebuild your body's confident line of defence!
This guide does not replace a consultation with a doctor.