The microbiome has been a beauty buzzword for the past year, from skincare launches like Cultured to testing services such as Kind to Biome and Skin Trust Club, as well as microbiome-friendly fragrances by Givaudan. When it comes to wider health implications, the core focus of microbiome health has been on the gut, with the wellness market awash with prebiotic, probiotic, and postbiotic supplements. But for female-bodied people, an entire avenue had been overlooked, until now.

Priyanka Jain and Laine Bruzek founded the at-home vaginal microbiome testing kit Evvy in hopes of not only destigmatizing vaginal health, but giving consumers personal agency and straightforward tools for managing it. Both Jain and Bruzek are Stanford University alumni, but Jain’s background was in algorithm building as Head of Product at soft-skills platform pymetrics, while Bruzek worked as Team Lead at Google Creative Labs. Together they fused Jain’s passion for harnessing data science to drive equality, and Bruzek’s brand-building skills to fund the company with a $5 million seeding round in July 2021. Investors included General Catalyst, Box Group, Virtue, Human Ventures, G9 Ventures, and BBG Ventures, among others.

“While we had to explain why vaginal health is important to a few more people than we had hoped, we were excited to see the interest in investing in women’s health. As we always say, women’s health is not a niche market,” they tell BeautyMatter. With the femtech sector looking to reach a value of $60 billion worldwide by 2027, the numbers speak for themselves. But for the everyday person, accessible solutions are still needed, especially since, in the US at least, only 4% of healthcare R&D spending benefits women’s health.

The Evvy test uses metagenomics (an advanced form of sequencing) to test across all bacteria and fungi, of which there are thousands. “Even though the vaginal microbiome is an important marker of health, women (and their providers) have never had affordable access to it—until Evvy,” Jain and Bruzek state. After performing and mailing an at-home swab test, users will receive actionable results within two weeks via a private online dashboard, along with further health insights and holistic recommendations. “Evvy’s unique approach is grounded in our belief that we lack effective care options because we lack proper research. That’s why we’re building a platform for personalized, precision female healthcare, powered by holistic definitions of disease and health that are grounded in data—not guesswork,” Bruzek adds.

The medical system, after all, has a recorded gender bias. Inclusion of female bodies in clinical trials wasn’t mandatory until 1993. Public health researcher Dr. Kate Young argues that the exclusion of women throughout medical history has resulted in the misdiagnosis of women’s diseases, with a healthcare system made “by men for men.” “The consequences of this research gap are serious—even deadly. To this day, women are still diagnosed on average 4 years later than men across 770+ diseases. We’re more likely to die from heart attacks, react poorly to prescription drugs, have our pain and symptoms dismissed by doctors, and more,” Jain says. For some, there are feelings of shame or embarrassment attached to speaking candidly about vaginal health issues. 66% of 18- to 24-year-olds in a study were too shy to even say the word “vagina” to their practicing physician.

While initiatives such as Society for Women’s Health Research are campaigning for equal rights, and medical bias is being acknowledged more, the playing field is far from fair. “This historical exclusion has caused a massive gender health gap that has further fed the overall stigmatization of women’s bodies with a specific taboo being created around reproductive health organs like the vagina,” Bruzek explains. “If you look at the majority of research and data that exists in healthcare, it's mainly average-sized middle-aged men that have been the basis of understanding what health and disease look like.”

Where does the vaginal microbiome factor into all of this? Simply put, it can be a useful marker of diagnosing conditions beyond yeast infections, including specific types of cancers. Medical studies show that changes in the vaginal microbiome can affect the risk of gynecological cancers  Overall, 30% suffer from vaginal microbiome imbalances annually, and studies are uncovering links between this imbalance and further issues such as infertility, preterm birth, and STIs (sexually transmitted infections). With 1 in 3 people with vaginas experiencing BV (bacterial vaginosis), and 1 in 2 a UTI (urinary tract infection) over their lifetime, it’s important to be able to properly diagnose these in order to receive appropriate treatment. But self-diagnoses are only correct roughly half of the time and misdiagnosis of BV is at 66%, meaning you’re more likely to get it wrong than right. Furthermore, the recurrence of BV, UTIs, and yeast infections after treatment sit at 80%, 30%, and 28%.

Jain and Bruzek see the lack of data and cultural taboos around vaginal health as a huge hurdle in accessing its full medical potential. “Because it's a taboo topic, one of the biggest obstacles to women getting the vaginal healthcare they need is misinformation. The internet has tons of medically misguided advice on it, in addition to the constant beauty industry narrative that vaginas should look pristine and smell like flowers,” Jain adds. The latter point not only fuels the shame narrative and silence around speaking about these issues, but often consumers will combat the area with highly perfumed products that only lead to more issues such as rashes or pH imbalances. Furthermore, there was a 73% increase in labiaplasty procedures since 2015, but since the labia protects the vaginal opening, removing too much skin can actually result in more vaginal infections (alongside other side effects such as decreased sensitivity and chronic dryness).

In order to equip consumers with the information to make the best decisions for their health, Evvy’s online platform encourages visitors to submit questions, learn about the vaginal microbiome, and read medically backed posts that debunk the biggest myths. “Now more than ever, women are empowered to take their health into their own hands and break age-old taboos in the process. They want to be active decision makers in their healthcare journeys, and Evvy’s scientific education and precision at-home testing can help them achieve that,” Bruzek states.

With tens of thousands of consumers already a part of their online community, the two are proud to see their innovation resonating with others. “From our results experience to our education platform #AskEvvy, Evvy’s ethos is grounded in science, but refreshingly human,” Jain proclaims. “This approach brings much-needed nuance and thoughtfulness to a space where women have often been told their symptoms are all in their heads.” Now those same heads are breaking down barriers through science, with a little bit of help from our mutual microbiomes.