Atopobium vaginae is a type of bacterium that lives in the vaginal microbiome, the complex community of microbes that naturally exists in the vagina. It plays a particularly important role in understanding vaginal health because, although it’s a natural part of the vaginal flora in some women and doesn’t cause any problems, it's also been associated with bacterial vaginosis (BV).

What is Atopobium vaginae?

Atopobium vaginae (A. vaginae) is an anaerobic bacteria that loves to hang out with Gardnerella. While it is seen in asymptomatic individuals, it is much more common in bacterial vaginosis. 

We know it is confusing, but A. vaginae has undergone a name change. In 2018 A. vaginae was renamed to Fannyhessae vaginae.  Most people still know this bug by its original name, Atopobium, but you might see both names in the literature and in your Evvy results. We will use that name here since most people are familiar with Atopobium (instead of Fannyhessea). 

Atopobium vaginae and vaginal health

The vaginal microbiome is crucial to overall vaginal health. Not only does it keep vaginal infections at bay, but it also influences your risk of infertility, pregnancy outcomes, sexually transmitted infections (STIs), and even some gynecological cancers. 

Typically, vaginal Lactobacilli bacteria dominate the microbiome, producing lactic acid that helps keep the vaginal pH at a healthy, slightly acidic level. This acidity is like a natural defense mechanism, preventing overgrowth of potentially harmful bacteria. 

However, when there’s an imbalance (a reduction in Lactobacillus or an increase in other bacteria), it can lead to a state of dysbiosis (imbalance). That’s when conditions like bacterial vaginosis show up, where the vaginal pH rises above its normal range, and certain anaerobic bacteria — like Atopobium vaginae — start to overgrow.

Atopobium vaginae and bacterial vaginosis

Research has shown that Atopobium vaginae is a key player in the development of bacterial vaginosis because of its ability to thrive when the vaginal pH is disrupted. 

Studies find it often coexists with another bacteria called Gardnerella vaginalis, also linked to bacterial vaginosis. Together, these bacteria can create biofilms (a sticky, protective layer of bacteria) that make it harder for the body to restore balance and for treatments, like antibiotics, to work effectively. This biofilm is one reason bacterial vaginosis can be such a pain to get rid of, and why recurrent BV is so common. 

And while it gets along great with Gardnerella, it can cause a lot of problems to the environment as a whole. A. vaginae is known to cause inflammation and it is associated with pregnancy complications, HPV persistence, and cervical neoplasia.

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Risks of bacterial vaginosis

While bacterial vaginosis doesn’t always show symptoms, when it does, they can include:

For the most part, bacterial vaginosis is nothing more than a (smelly) nuisance, but when left untreated it can also increase the risk of other health issues, like:

  • Higher susceptibility to sexually transmitted infections (STIs)
  • Increased risk of pregnancy complications (such as preterm delivery)
  • Higher likelihood of pelvic inflammatory disease (PID).

What if I have Atopobium vaginae?

While the presence of Atopobium vaginae can be a marker for bacterial vaginosis, it’s not necessarily harmful on its own, and researchers are still figuring out its full role in the vaginal microbiome. So don’t panic!

Taking an Evvy Vaginal Health Test will tell you if you have Atopobium vaginae (or other anaerobic bacteria associated with bacterial vaginosis), and in what amounts. Knowing which bacteria are responsible for your symptoms can help healthcare providers tailor treatments more effectively, especially in cases where standard antibiotic treatment has failed. 

FAQ

What does it mean if your Atopobium is high? 

High levels of Atopobium vaginae are typically a sign of bacterial vaginosis. An Evvy Vaginal Health Test can tell you whether you have high levels of Fannyhessea (Atopobium) vaginae in your vaginal microbiome. Eligible users will also have access to personalized prescription treatment via Evvy’s Clinical Care program. 

Is Atopobium a yeast infection? 

No, Atopobium vaginae is a type of bacterium more commonly linked to bacterial vaginosis. Yeast infections are caused by an overgrowth of Candida fungus, usually Candida albicans. It’s important to make this distinction because bacteria and fungi require different types of treatments. While antibiotics are the standard treatment for bacterial vaginosis, yeast infections are treated with antifungal medications.

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How do I get rid of Atopobium?

The first-line treatment for bacterial vaginosis typically includes antibiotics like oral metronidazole, secnidazole, and clindamycin. Antibiotics are generally effective, but some lab studies have suggested that certain strains of Atopobium vaginae might not respond to metronidazole and secnidazole. Because of this, researchers are looking into other treatment options that might work better. One helpful resource is the Evvy Vaginal Health Test, which provides insights into the bacterial composition of your vaginal ecosystem. This test can show whether your vaginal flora is leaning towards bacterial species that cause bacterial vaginosis and can identify the specific types and amounts present. Plus, Evvy’s Extended PCR Panel checks for 11 common antibiotic resistances, including those relevant to bacterial vaginosis treatments. With this information, you and your healthcare provider can work together to find the most effective treatment for you, making sure to choose the right antibiotic based on current research and your health history.