Your vaginal microbiome is normally dominated by Lactobacillus species, which keep the vaginal environment mildly acidic and help protect against overgrowth of other organisms. When that balance shifts — a state called dysbiosis — species such as Gardnerella vaginalis, Atopobium vaginae or Prevotella can become dominant instead, which is strongly associated with bacterial vaginosis and can make thrush more likely to recur. A standard swab usually only screens for one specific organism at a time; vaginal microbiome testing instead uses molecular analysis to map the full bacterial community present, giving a compositional picture rather than a single positive or negative result.
This matters clinically because two women with identical symptoms can have very different underlying microbiome profiles, and repeated “treat and hope” antibiotic or antifungal courses often fail to address the actual imbalance driving the symptoms. By identifying which organisms are dominant, and how far the balance has shifted from a healthy, Lactobacillus-dominant state, your consultant can target treatment — whether that’s a specific antimicrobial course, probiotic support aimed at restoring Lactobacillus dominance, or addressing contributing factors such as antibiotic use, hormonal changes or sexual health — rather than repeating the same non-specific treatment each time symptoms return.
