Intimate Ecology - Moira Bradfield

Intimate Ecology - Moira Bradfield Influencing global genitourinary health, through practitioner CPD education, mentoring and clinical consultation.

Recurrent infections, vaginal, vulval health, penile and urinary health.

I read it and at first glance, the takeaway sounds exciting: a L. crispatus “postbiotic” improved outcomes when added to...
01/09/2026

I read it and at first glance, the takeaway sounds exciting: a L. crispatus “postbiotic” improved outcomes when added to standard clobetasol treatment.

We desperately need more research exploring the microbiome, immune environment and v***al health in LS.
But it’s also a great example of why we need to read beyond the headline. The researchers didn’t actually apply L. crispatus to the v***a and the impacts weren’t from a probiotic applied or ingested.

They grew a specific strain of L. crispatus in a lab, then centrifuged and filtered it to remove the bacteria. Participants received 100 μL of the remaining cell-free supernatant alongside clobetasol; the comparison group received clobetasol plus saline.
Essentially, they applied the environment L. crispatus had been growing in, containing products accumulated during fermentation.

So when we read further...
We don’t really know what was in it.
Lactic acid? Other organic acids? Bacteriocins? Peptides? Other metabolites? Altered pH? A combination?
The preparation wasn’t characterised well enough in the methods for us to know :(

So while it’s tempting to conclude:
“L. crispatus is beneficial for lichen sclerosus” that’s not what this research demonstrates.
It tells us that something produced by this particular strain, may have therapeutic potential alongside standard LS treatment.

That isn’t a reason to dismiss the research. Research poses questions, that is the point. And it’s great to see more research into LS, the v***al ecosystem and microbial function. But early research isn’t a clinical conclusion.
Do I use probiotics containing L. crispatus in LS care? Yes, to support specific microbiome changes. This research adds curiosity around potential mechanisms. But for now, we can’t say using L. crispatus improves LS.

Liao H, et al. (2026). Postbiotics originated from Lactobacillus crispatus NCU-31 improves v***ar lichen sclerosus: a randomized, double-blind controlled trial. BMC Microbiology, 26(1), 188.

We talk increasingly about partners sharing bacteria in recurrent bacterial v4ginosis (BV). Most recent attention has fo...
25/08/2026

We talk increasingly about partners sharing bacteria in recurrent bacterial v4ginosis (BV). Most recent attention has focused on p3nis/v4gina partnerships, but there is an important story in AFAB same s3x partnerships too.

Australian data from Melbourne Sexual Health Centre found BV in 14.8% of women who had s3x exclusively with women/AFAB, compared with 7.7% of who had s3x exclusively with men.

Other studies have also found high BV prevalence in women/AFAB who have s3x with women, along with striking similarities between the v4ginal microbiota of partners.
In one study of monogamous couples, v4ginal flora categories were concordant in 95% of couples.

That does not mean we should simply label BV an STI.
It does mean that s3x connects microbial ecosystems.

Potential influences include:
• sharing of v4ginal fluids
• digital pe*******on
• shared s3x toys
• transfer of bacteria between v***al, v4ginal and other body sites
• friction and mechanical disruption
• temporary changes to va**nal pH

BV associated bacteria including Gardnerella, Prevotella and Fannyhessea have been identified across s3xual partners.

New AFAB partners have also been associated with increased v4ginal bacterial diversity and bacterial load.
So when BV keeps returning, it can be useful to ask what keeps shaping this ecosystem?

That may include pH, hormones, menstruation, biofilm, s3xual practices and microbial exchange between partners.

Importantly, we still don't have the same quality of partner treatment evidence for couples where both partners have a v4gina as we now have for p3nis/v4gina couples.
Researchers at Melbourne S3xual Health Centre are studying simultaneous BV treatment in LGBTQIA+ couples through the PACT research program to help answer exactly this question.

So, we wait for the outcomes of their research.

If recurrent BV is part of your story, particularly when symptoms seem closely linked with s3x, this is something we can explore at Intimate Ecology.

Link in Bio

This question was a smaller part of my PhD research, but an interesting one. RVVC/recurrent thrush gives us a good reaso...
21/08/2026

This question was a smaller part of my PhD research, but an interesting one. RVVC/recurrent thrush gives us a good reason to start thinking about multiple microbiomes, rather than looking at the v4gina in isolation.

In our small pilot study, we examined both v4ginal and gastrointestinal bacterial and fungal microbiomes in people with RVVC using intermittent or maintenance fluconazole, alongside healthy controls.

A few things stood out:

*Gut microbial diversity wasn't significantly different between groups. We didn't see evidence of a dramatic loss of gut microbial diversity associated with fluconazole use.

*We did see some differences in gut microbial composition, particularly in the maintenance-fluconazole group. Interesting? Yes. Evidence that fluconazole is “damaging the gut”? Not quite. This was a small study and needs further investigation. I do have my suspicions around long term use and constipation (purely clinical observations and it makes sense with the compoaition data).

*Most interestingly for me, matching Candida species between the gut and va**na were uncommon. Our findings didn't support the simple idea that the gut routinely acts as a Candida reservoir continually “reinfecting” the v4gina.

And that is a very useful potentially myth busting clinical practice shaping point.

Looking at multiple microbiomes doesn't mean everyone with RVVC needs gut testing, an intensive “gut protocol” or a highly restrictive anti Candida diet. And it certainly explains why so many people have limited luck with reducing recurrent thrush with gut only approaches.

It points to a need to consider the whole microbial and host environment, gut symptoms where relevant, diet, medications, hormones, immunity and v4ginal ecology, and investigating when there is a reason to.

Our study was small, so these are signals rather than final answers. But they give me some interesting directions for furure research.



Bradfield Strydom et al. (2025). The impact of fluconazole use on the fungal and bacterial microbiomes in recurrent Vulvova**nal Candidiasis.European Journal of Clinical Microbiology & Infectious Diseases.

21/08/2026

HPV persistence isn’t just about the virus.
The environment HPV is living in matters too.

Research is increasingly exploring the relationship between persistent HPV and the cervicov4ginal environment, including v4ginal pH, Lactobacillus dominance, microbial diversity, local inflammation and mucosal immune function.

So when HPV continues to be detected, particularly alongside low grade cervical cell changes, there can be value in looking beyond the HPV result itself.

At Intimate Ecology, Danni takes a broader view of HPV persistence, considering factors such as:

• v4ginal pH and microbiome composition
• cervical and v4ginal inflammation
• local and systemic immune function
• nutritional status
• hormonal influences
• smoking, stress, sleep and other lifestyle factors
• v4ginal symptoms or recurrent infections where relevant

Importantly, this doesn't replace cervical screening. HPV related cell changes need appropriate surveillance, and higher grade changes require closer medical monitoring and collaborative care.
But alongside that care, there may be more to explore about the environment in which HPV is persisting.

Danni works with clients with persistent HPV, using an evidence informed, whole person approach alongside appropriate cervical screening.
Interested in working with Danni?
Head to the links in our bio to learn more about Intimate Ecology, our approach and how to book.



Sun, C., Diao, H., Zhang, X., Han, Z., & Wei, J. (2025). Study on human papillomavirus (HPV) infection, typing, peripheral blood immune factor expression and va**nal microenvironment balance in cervical cancer screening population. Indian Journal of Medical Microbiology, 56, 100883.

People are often surprised to learn that at Intimate Ecology we work across multiple microbiomes and life stages, not ju...
14/08/2026

People are often surprised to learn that at Intimate Ecology we work across multiple microbiomes and life stages, not just the genitourinary tract.

While much of our clinical and research focus includes the v4ginal and urinary ecosystems, Intimate Ecology is really about the broader landscape of human microbial life: different niches, transitions and stages of development.
So when I came across this recent Nature study following more than 700 mother infant pairs across gut, v4ginal and breast milk microbiomes, I knew I had to read it.
The maternal gut emerged as the dominant reservoir for infant gut colonisation, with strain-level sharing highest in the first month of life and decreasing as the infant microbiome diversified.
It reinforces something increasingly important in microbiome research: transmission isn't simply about which species are present, but which strains successfully establish and persist.
The v4ginal microbiome is where things got interesting.
Clinically, we often see communities dominated by Lactobacillus species, yet these organisms are rarely abundant in the infant gut (or any gut). That has always made the simple va**na to infant gut transmission, feel incomplete.
There are exceptions that matter.
In this study, Bifidobacterium breve found in the maternal v4ginal microbiome was also detected in infants and, in most cases, represented an exact strain match.
So while v4ginal → infant gut transmission is less common overall, if it occurs it is remarkably specific.
Rather than a single site as "the source", we're looking at a layered system: the maternal gut as a major reservoir, v4ginal and breast milk microbiomes as potential contributors, and the infant gut as a rapidly evolving ecosystem shaped by these inputs alongside feeding, environment and delivery mode.
The perfect example of moving away from reductionist thinking and back towards ecology.
NB: limited direct v4ginal to infant gut, doesn't make the v4ginal microbiome unimportant. Its important before birth, across conception, fertility, pregnancy.
Microbiomes don't exist in isolation. Neither should the way we think about them.

11/08/2026

Always great to see research looking at biomarkers that may aid in clinical diagnosis and decision making.

A new study explored PRA1, a zinc binding protein produced by Candida albicans, as a potential biomarker for clinically relevant vulvova**nal candidiasis (VVC).

PRA1 levels were markedly higher in AFAB/women with Candida positive samples and were highest when Candida was associated with symptomatic vaginitis. PRA1 also correlated with symptom severity, suggesting it may help distinguish Candida colonisation from active, inflammatory disease.

This connects directly with research we’ve discussed previously: zinc availability regulates PRA1 expression, and experimental work has shown that suppressing PRA1 with zinc can reduce Candida associated inflammation and symptoms. This was the rationale behind the zinc containing Juvia gel study we covered previously (i'll link to stories).

The potential withthis type of research is exciting: PRA1 could become both a biomarker of disease activity and an important target in understanding VVC.

This like the Juvia gel study was a very small exploratory study (just 9 women), so the diagnostic findings need validation in much larger, independent studies. I look forward to learning more about PRA1 and hopefully seeing it as a functional marker on reports if it is all they hope it is.

Need support? LINK IN BIO

Health professional? Vagiversity starts August 18th enrolment still open. Link in bio.

**nalmicrobiome

If you have been on our website lately you may have noticed a few new changes and upgrades. New information pages, a pra...
10/08/2026

If you have been on our website lately you may have noticed a few new changes and upgrades. New information pages, a practitioner finder quiz, the beginnings of a conditions library, blog, updated FAQ and more.

This week we updated our FREE e-book download. If you are a member of the public struggling with recurrent infections this e- book is a great place to start.

"Why won't it go away?" Explores a different approach to genitourinary health by moving past micribes and thinking about ecology shaping factors.

You can get your copy by popping your email on the list. The link is in the bio, on the main page of the website as a pop up and in our stories. If you are a practitioner there is a seperate email list for you but the new download is not quite ready yet.

These lists also serve as a safety net should anything ever happen to my social media accounts (ahhh).

If you're not sure if you are on the email list already, it has been largely inactive while I got everything sorted, so I can't blame you for not knowing. You can join again and the list will merge any duplicate emails (we'll that is what they tell me).

I hope you enjoy the gift whixh should be emailed after you have signed up and I look forward to talking to you via newsletters and emails in the future.

X
Dr Moira Bradfield Strydom
PhD, M.Acu, B.Nat

**nalhealth

We often look at a microbiome report as though each bacterium is acting independently.However, research over time tells ...
06/08/2026

We often look at a microbiome report as though each bacterium is acting independently.

However, research over time tells us that singling out ine bacteria is flawed :

For example, Gardnerella and Prevotella actually help each other survive.

Gardnerella releases amino acids that Prevotella uses for growth. In return,Prevotella produces ammonia, which Gardnerella can use as a nitrogen source.

Together they create a larger, more resilient biofilm and environmental shift than either species can produce alone.

For practitioners interpreting microbiome reports, relative abundance still matters but so does big picture thinking.

For example:

•Prevotella begins to catch my attention from around >2%, particularly when accompanied by symptoms or other BV associated anaerobes.

•Gardnerella is more nuanced. Even 20–30% can be compatible with health when Lactobacillus remains dominant, whereas much lower levels may become clinically significant in the context of low Lactobacillus, biofilm formation or a cluster of anaerobes.

The va**nal microbiome isn't just a list of bacteria.
It's an ecosystem, where microbes communicate, exchange nutrients, compete and cooperate and are fuelled and supported by you the host (and your health).

Understanding those relationships helps explain why two people with similar microbiome reports can have completely different symptoms and why recurrent infections are rarely about a single "bad bug."

The microbiome holds clues, do you know how to interpret them?

Vagiversity starts in 11 days. Practitioners there are still spots left.

Need support? Naturopathic consultations available

Links in Bio

Standing at the top of a mountain today, I found myself completely absorbed in the view.And it made me think about somet...
05/08/2026

Standing at the top of a mountain today, I found myself completely absorbed in the view.

And it made me think about something clients often tell me after they've recovered.

"I realised I hadn't thought about my symptoms for days."

That sentence always sticks with me.

Because when you've lived with chronic v.ginal or urinary symptoms, your brain becomes trained to constantly scan for danger.

You become incredibly aware of your body.

That is so common because it's what chronic symptoms teach us to do.

The goal of support with Intimate Ecology is restoring health and often that means you wake up one day and realise you haven't thought about the utch or irritation, you haven't checked your underwear, smelt yourself, or had to decide if having s3x is worth all the hassle..

Essentially restoring your attention to everything else life has to offer.

Need support? Book with an Intimate Ecology naturopath for support today.

I talk about this often. Ultimately, the person sitting in front of you matters. There are many reasons why similar micr...
31/07/2026

I talk about this often. Ultimately, the person sitting in front of you matters. There are many reasons why similar microbiome patterns can result in very different clinical presentations. One area we're beginning to understand in more detail is bacterial strain and functional diversity. This is likely to explain at least some of what we observe clinically, including asymptomatic CST IV communities and cytolytic v.ginosis.

New research: A new paper showed that not all Gardnerella dominated microbiomes are the same. The researchers identified multiple Gardnerella community types with different genes, functions, activity and interactions with the host immune system.
It reinforces something I've taught for a long time: understanding a clinical picture has to extend beyond the microbe name.

The ecological context, functional potential, surrounding microbial community, symptoms, hormones, immune function, life stage, s3xual ecology and overall host health all contribute to clinical decision-making.

The microbiome is the footprint of an ecosystem, not the ecosystem itself. A clue for us to follow and piece together. Part of what I love about my job.

Are you thinking about your clients this way when interpreting genitourinary microbiome results?
These are the concepts we explore in Vagiversity, my six month education and mentoring program for practitioners. The next cohort begins 18 August.

If you're ready to move beyond pattern recognition and into ecological clinical reasoning, I'd love to have you join me. Link in bio.

Ref: Williams, A., Maros, A., France, M. T., Ravel, J., & Holm, J. B. (2026). Not all va**nal microbiomes are equal: functional context shapes immune landscapes. mBio, e03645-25.

ClinicalReasoning

Address

Gold Coast, QLD
4213

Opening Hours

Thursday 12pm - 5pm
Friday 9am - 5pm

Website

Alerts

Be the first to know and let us send you an email when Intimate Ecology - Moira Bradfield posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Shortcuts

Share

Category