Forget the gut microbiome—another community of microbes is getting attention online: the vaginal microbiome. Longevity influencers have recently been sharing their experiences with at-home tests that analyze the bacteria, fungi, and other tiny living things residing in the vagina.

Earlier this year, wealthy biohacker Bryan Johnson posted on X that his girlfriend, Kate Tolo, took a vaginal microbiome test and received a score that ranked her in the “top 1% of all vaginas.” Johnson asserted that the score is a reflection of overall health, describing it as being “downstream” of factors like sleep and diet.

Another influencer, Kayla Barnes-Lentz, wrote about boosting her score from 97 to 100, saying she has an “A+ vaginal microbiome.”

Tolo and Barnes-Lentz haven’t explained why they initially took the tests. But their posts generated a slew of comments from people wanting to try them, sparking a question: What, if anything, can these scores—and the tests behind them—actually reveal about health, especially if you don’t have vaginal symptoms?

I decided to talk to experts about it—and take a test myself—to find out.

How Vaginal Microbiome Tests Work

While several brands offer vaginal microbiome tests, which typically cost anywhere from $150 to several hundred dollars, I went with Evvy’s test.

Influencers might be holding the tests up as a marker of overall health, but Priyanka Jain, Evvy co-founder and CEO, said the vast majority of test users are looking for information that can help them understand why they aren’t conceiving or why they’re experiencing vaginal symptoms.

I wasn’t testing for either reason. I’m not trying to conceive, and I wasn’t experiencing bothersome symptoms like itching, irritation, and pain. But when I filled out the required health questionnaire, I did check one symptom-related box: milky white discharge that I’ve always assumed was related to my menstrual cycle.

The test itself was simple and quick: I used a cotton swab designed to collect cells and fluids from the vaginal wall, then placed it in a pre-prepared package and mailed it to a lab.

Unlike testing traditionally done at a doctor’s office—which may involve growing a sample in a culture or using a PCR test to look for specific pathogens—these tests use metagenomic sequencing, a highly precise testing method that can result in a profile of detected bacteria and fungi.1

The results are comprehensive. Test users receive a list of detected microbes, from protective bacteria such as strains of Lactobacilli to members of the Gardnerella genus, which is a biomarker for bacterial vaginosis (BV), an infection that can cause symptoms like itchiness and discolored discharge.2 The results also assign a “Community State Type,” a classification system that describes the overall composition of the microflora community, ranging from the most to the least protective.

What Do the Results Actually Mean—Especially If You Feel Fine?

The experts I spoke to seemed certain that the vaginal microbiome matters. And its influence may extend beyond the vagina to nearby organs like the bladder, said Shaya Taghechian, MD, a urologist with Georgia Urology.

But the experts also believe there isn’t enough information to understand what test results mean for your health if you don’t have symptoms or a specific condition that requires treatment. There’s also no surefire way to meaningfully raise your levels of “good” bacteria.

There are no current “interventions that can reliably and predictably change the vaginal microbiome in a way that we’re sure is helpful,” said Caroline Mitchell, MD, MPH, director of the vulvovaginal disorders program at Massachusetts General Hospital, whose lab is working to develop a therapy that would add beneficial Lactobacillus crispatus bacteria to the microbiome.

“I think what’s challenging is that there’s a lot of information that we can get from the vaginal microbiome,” added Indriati Hood-Pishchany, MD, PhD, an assistant professor of pediatric infectious diseases at the University of North Carolina at Chapel Hill. “I think how we act on it is not always 100% clear.”

That was certainly the case for me. My test showed that about 60% of the bacteria in my vaginal ecosystem (classified as a more protective type two and dominated by Lactobacillus gasseri) was made up of “good” bacteria. But Gardnerella leopoldii accounted for 11% of my microbiome. Based on that finding, along with my answer about discharge on the questionnaire, Evvy’s clinicians diagnosed me with BV.

According to one estimate, 84% of women who have BV are asymptomatic.3 The Centers for Disease Control and Prevention recommends treatment only for people with symptoms.4

But despite the fact that I didn’t have bothersome symptoms, Evvy offered me a very specific treatment plan: boric acid suppositories, an antibiotic, an antifungal, probiotics in the form of oral pills and suppositories, antibiotics for a male partner, and an additional test to check whether the treatment was working.

If I went all-in on everything they recommended, I was looking at $459 to fix a problem I wasn’t totally convinced was a problem. And while I’m not opposed to treatment for a condition that is detrimental to my health or interrupting my daily life, antibiotic resistance is a real concern, and I’d be wary of taking antibiotics if I don’t truly need them.

So, Are These Tests Worth It?

That really depends on whom you ask. According to Jain, having some information, regardless of how it’s used, is better than having none at all. “I think so often the system gatekeeps information from women and says, ‘Until we have perfect information, you get no information,’” she said. “And I think that we don’t need to live in that world anymore.”

However, the experts I spoke to said the test is likely not worth it if you’re not trying to conceive or having vaginal symptoms.

Based on my experience, I’d agree. My BV diagnosis left me wondering whether I had the condition during my pregnancy—and, if I did, whether it led to my daughter’s otherwise unexplained premature birth, given the association between BV and preterm birth. Still, there’s nothing I can do about that now.

If I were to have another child, whether a test like this would be useful remains to be seen.