After Sequencing 100,000+ Real-World Patient Samples, Evvy Shares Novel Understanding of the Microbial Patterns Behind the Most Common Vaginal Condition in Reproductive Age Women

Evvy, the precision women’s health company, today announced new data showing that bacterial vaginosis (BV) encompasses multiple distinct microbial subtypes, rather than a single uniform biological state.

While Evvy-affiliated clinicians continue to diagnose BV using established clinical criteria, these findings provide a comprehensive, microbiome-level context for patients and their clinicians, shining a light on the underlying biology behind a patient’s diagnosis.

BV is the most common vaginal condition in the United States, affecting more than 30 percent of reproductive-aged women annually and accounting for a leading reason people with vaginas visit the gynecologist. Still, BV is broadly defined as an “overgrowth of bacteria," lacking a nuanced understanding of the microbiome behind the condition.

“BV has historically been defined in very broad terms, despite advances in sequencing technology,” says Dr. Kate McLean, OBGYN and Chief Medical Advisor at Evvy. “By applying high-resolution microbiome analysis across a large and diverse population, Evvy can identify reproducible microbial patterns that add important biological context to a BV diagnosis. This is how precision medicine begins to take shape in women’s health.”

Over the past four years, Evvy has conducted shotgun metagenomic sequencing on more than 100,000 vaginal microbiome samples from real patients across the United States, building the world’s largest and most comprehensive dataset of its kind.

By clustering microbiome profiles from individuals who were diagnosed with BV by a clinician, Evvy identified six distinct microbial patterns — highlighting that patients with the same clinical symptoms can have fundamentally different underlying vaginal microbiomes:

• Typical BV: The classic BV presentation, characterized by bacteria commonly associated with BV, including certain Gardnerella and Prevotella species, alongside low levels of protective Lactobacillus.
• Transitional BV: Characterized by a community in flux — progressing toward more typical BV or recovering from it. This subtype is dominated by Lactobacillus iners with BV microbes present. Dominance by L. iners is often associated with lower stability compared to other Lactobacillus-dominant states.
• Lacto-dominant BV: A microbiome dominated by protective lactobacilli species (e.g., L. crispatus) with BV-associated bacteria present at lower levels.
• Biofilm BV: Characterized by the presence of specific bacterial species known to form biofilms — protective structures that can shield bacteria and make them more difficult to treat.
• Mixed BV: Characterized by the co-occurrence of BV-associated anaerobic bacteria and bacteria commonly associated with aerobic vaginitis (AV), resulting in mixed microbial community patterns.
• Atypical BV: Characterized by the presence of less common gram-positive anaerobic bacteria that may be underrepresented in traditional diagnostic approaches.

These BV subtypes are now integrated into the Evvy experience. Patients who take Evvy’s at-home vaginal microbiome test and are diagnosed with BV will receive results that reflect their specific microbial subtype, along with clear education and access to clinician-designed care pathways when eligible. These subtypes represent an important step forward in providing additional microbial insights alongside known diagnostic criteria. They are designed to complement existing diagnostic criteria, providing additional biological insight alongside established clinical standards.

Evvy has shared the methodology and initial findings behind these BV subtypes, with the goal of publishing larger papers that contribute to the ongoing clinical and research conversations around BV heterogeneity, recurrence, and precision care.

Building on this momentum, recent advances in gene-based microbiome research have shown that vaginal communities vary at the subspecies and functional level. Evvy is uniquely positioned to integrate these insights at scale, helping translate microbiome complexity into increasingly personalized and clinically actionable care over time.

"For too long, patients with BV have been treated as if a simple diagnosis tells the whole story,” said Priyanka Jain, co-founder and CEO of Evvy. “By investing in uncovering deeper biological context, we’re helping clinicians and patients better understand what’s actually happening beneath the surface—and laying the groundwork for more precise, evidence-driven care.”

To take an Evvy test and learn more about your vaginal microbiome, visit www.evvy.com.

About Evvy:

Evvy is closing the gender health gap through novel biomarker discovery in the vaginal microbiome. Evvy’s groundbreaking Vaginal Health Test is the world’s only certified, peer-reviewed test to uncover 700+ microbes with a single, at-home swab. Combined with precision treatment pathways and 1-1 coaching, Evvy provides over 90,000 women with data-driven, personalized healthcare for vaginal infections, fertility, menopause, and more. Evvy has built the world’s largest dataset on the vaginal microbiome, and they are pioneering research to improve outcomes across the female lifespan.

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