Exploring the Vaginal Microbiome and Intravaginal Practices in Postmenopausal Women.

Only 21 healthy postmenopausal women were analysed, and the authors state the pilot is underpowered, so it cannot support general conclusions. The vaginal cleansing questionnaire was developed for this study and was not previously validated. Participants were healthy controls; women with cancer, cystic fibrosis, poorly controlled diabetes, autoimmune disease, STIs, or current fungal infection were excluded, so it does not describe those groups. The study was a secondary analysis of baseline data, not a test of whether intravaginal practices cause microbiome change. Microbiome analysis was genus level because species assignment was often missing, so species-specific effects cannot be seen. The study focused on intravaginal practices, not other behaviours that may contribute to microbiome changes, such as smoking, number of sexual partners, and antibiotic use.

The article is supported by NIH and non-U.S. government research funding. REDCap data tools were hosted at Emory University with Library Information Technology Services grant support. No explicit author conflict-of-interest declaration is included.

Do not read the null microbiome association as proof that intravaginal products are safe. The study included only 21 postmenopausal women and was underpowered, so it cannot show whether products help or harm the vaginal microbiome.