Neovaginal Microbiomes

[Tills]

Good morning.

This is a bit of a niche post but, arguably, should be central to our post-operative care. It's arisen because of a few issues I've had in the first six weeks since surgery and because of trying to understand how my new vagina is building the right kind of microbiome, and what impedes that cultivar e.g. antibiotics, too much alkalinity, too much washing etc.

Cis vaginas are a complex microbiome and, like many parts of our body, have a complex balance of organisms including bacteria. Neovaginas can take time to build similar balanced microbiomes but we can do a LOT to assist the process. The obvious ones include not over-washing (there's a balance here because cleanliness matters), being very careful about what we introduce including during dilation, being very mindful about antibiotics, the kind of soaps we do or don't use, and what we eat and drink. Sex, in all its forms where the neovagina comes into play, is also hugely important in this regard.

There are some articles on the subject so I'll include a few here. I think this is quite a sciency-technical topic so anything that contributes will be greatly valued by everyone now and in the future.

By the way, I am mainly here focussing on penile inversion and peritoneal pull-through. The sigmoid colon technique is a whole different dimension which anyone is very welcome to comment on but, for obvious reasons, is also a separate category in its own right.

xx

https://myvagina.com/the-neovaginal-microbiome/ 🔗

https://www.sciencedirect.com/science/article/abs/pii/S0090429522001765 🔗

https://www.cell.com/cell-reports/fulltext/S2211-1247(25)01317-8 🔗

https://www.nature.com/articles/s41467-024-52102-1 🔗

https://pmc.ncbi.nlm.nih.gov/articles/PMC11500519/ 🔗

https://asm.org/articles/2023/june/genital-microbiome-research-for-transgender-popula 🔗

[Tills]

I found this interesting on oral probiotics:

The only prospective trial in the review demonstrated that oral probiotic supplementation can improve the abundance of Lactobacillus in the neovagina (Kaufmann et al., 2014). This finding is corroborated by similar research in premenopausal and postmenopausal CW demonstrating that oral probiotic supplementation can also improve Lactobacillus presence in cisvaginas (Petricevic et al., 2008; Reid et al., 2003).

https://pmc.ncbi.nlm.nih.gov/articles/PMC11500519/ 🔗

[Tills]

I took my first probiotic with this morning's breakfast with a particular aim of boosting the presence of Lactobacillus, which is the most prominent type of good bacteria in cis vaginas.

After six weeks on antibiotics it's good anyway to help restore healthy gut bacteria. But I have a particular interest at the moment in how to generate the same kind of microbiome in my vagina as in a cis vagina.

Hand on heart, I'm amazed more hasn't been written about this including on this site. It's easy to spend a lot of time focused on depth and appearance rather than the actual biotics. And yet the biological composition of our vaginas is at least as equally important, especially for our long term health.

xx

[Charlotte Kitty ✅]

I'm going to be seriously considering this when I've had GRS. As I'm getting colon vaginoplasty i believe that both microbiome and provision of nutrients inside can be the difference between long term collapse or success of this type.

[Devlyn ✅]

I took my first probiotic with this morning's breakfast with a particular aim of boosting the presence of Lactobacillus, which is the most prominent type of good bacteria in cis vaginas.

After six weeks on antibiotics it's good anyway to help restore healthy gut bacteria. But I have a particular interest at the moment in how to generate the same kind of microbiome in my vagina as in a cis vagina.

Hand on heart, I'm amazed more hasn't been written about this including on this site. It's easy to spend a lot of time focused on depth and appearance rather than the actual biotics. And yet the biological composition of our vaginas is at least as equally important, especially for our long term health.

xx

A very important and interesting thread, Tills. 🙂

I found plenty with the search feature of the site using more general search terms. People frequently use "flora", "bacteria" and "health" in their topics and posts. Limiting the search to the Post-op, GCS, and MTF boards reduces a lot of the clutter. I hope this helps.