SlideShare a Scribd company logo

Community dynamics of the adolescent vaginal microbiome during puberty (UOregon META Symposium 2014)

•
Roxana Hickey, profile picture
Roxana Hickey

The document discusses the changes in the adolescent vaginal microbiome during puberty, detailing the transition from a sterile environment at birth to a colonized vaginal microbiome influenced by hormonal changes. It highlights a study following girls aged 10-12, revealing that many already possess an 'adult-like' microbiota prior to menarche, characterized by increased Lactobacilli. The research employs advanced sequencing techniques to analyze microbiota composition and the timing of transitions throughout puberty.

Science
1 of 29
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
Community dynamics of the adolescent vaginal microbiome during puberty Roxana Hickey University of Idaho META Symposium on Host-Microbe Systems Biology 9 August 2014 @roxana_hickey
How does the vaginal microbiome change over a lifespan?
Birth Vagina sterile in utero (?), then transiently colonized by mother’s vagina or skin microbiota upon delivery
Childhood Vagina sparsely populated by assortment of anaerobic bacteria, few to no lactobacilli
Adolescence Estrogen levels rise, lactobacilli become more prevalent while anaerobic populations diminish
Reproductive age Estrogen cycling stimulates thickening of vaginal epithelium, abundant lactobacilli help maintain low pH
Menopause Estrogen levels decline, vaginal epithelium thins, lactobacilli diminish, anaerobes prevalent
Community dynamics of the adolescent vaginal microbiome during puberty (UOregon META Symposium 2014)
Vaginal microbiota differ among individuals and are often variable over short time scales Ravel et al. (2011) PNAS Gajer et al. (2012) Sci Transl Med
??? ?
Vaginal microbiota of postmenarcheal adolescents (13-18y) closely resemble those of reproductive age women Yamamoto et al. (2009) J Pediatr Adolesc Gynecol Thoma et al. (2011) J Pediatr Adolesc Gynecol
What is the timing and sequence of events that occur as vaginal microbiota transition to an ‘adult-like’ state?
Study design microbiota composition ๏ 16S rRNA V1-V3 pyrosequencing ๏ mothur + RDP Naïve Bayesian Classifier 24 mothers sampled annually 31 girls enrolled @ age 10-12 & premenarcheal sampled every 3 months for up to 3 years 21 girls became postmenarcheal during study metadata ๏ pubertal development (Tanner stage) ๏ menarcheal status ๏ 21 Black ๏ 8 Caucasian ๏ 2 Native American
Most adolescent microbiota were already ‘adult-like’ prior to menarche
Community dynamics of the adolescent vaginal microbiome during puberty (UOregon META Symposium 2014)
Lactobacillus crispatus L. iners L.gasseri L.jensenii Gardnerellavaginalis ‘Other’
Lactic acid bacteria became prevalent early in puberty
● ● ●● ● ● ● ● ● ● ● −5 0 5 2 3 4 5 Tanner breast Logit−transformedLABproportion a ● ●● −5 0 5 pre post Menarche status b 1 2 3 4 5 Tanner stages Wikimedia Commons 50% ~100% ~0%
Many paths to the same (?) end
0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 103 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit Taxon Lactobacillus_crispatus Lactobacillus_iners Lactobacillus_gasseri Gardnerella_vaginalis Lactobacillus_jensenii Lactobacillus_Other Streptococcus_anginosis Bifidobacterium Gardnerella_Other Prevotella Anaerococcus Other_Bacteria Atopobium Finegoldia Peptoniphilus Ureaplasma Bacteroides Dialister Faecalibacterium Corynebacterium Lachnospiracea_incertae_sedis Alloscardovia Moryella Actinomyces Clostridiales_Incertae_Sedis_XI Porphyromonas Blautia Clostridiales Anaerosphaera Jonquetella Mobiluncus Actinomycetales Staphylococcus Segniliparus Clostridium_XI Lachnospiraceae Coriobacteriaceae Acidovorax Olsenella Peptococcus Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 103 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit Taxon Lactobacillus_crispatus Lactobacillus_iners Lactobacillus_gasseri Gardnerella_vaginalis Lactobacillus_jensenii Lactobacillus_Other Streptococcus_anginosis Bifidobacterium Gardnerella_Other Prevotella Anaerococcus Other_Bacteria Atopobium Finegoldia Peptoniphilus Ureaplasma Bacteroides Dialister Faecalibacterium Corynebacterium Lachnospiracea_incertae_sedis Alloscardovia Moryella Actinomyces Clostridiales_Incertae_Sedis_XI Porphyromonas Blautia Clostridiales Anaerosphaera Jonquetella Mobiluncus Actinomycetales Staphylococcus Segniliparus Clostridium_XI Lachnospiraceae Coriobacteriaceae Acidovorax Olsenella Peptococcus Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
An inconvenient truth: girls have Gardnerella, too
0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 120 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ● 1 2 3 4 5 6 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 121 0.00 0.25 0.50 0.75 1.00 Proportion Subject 135 ● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ● 1 2 3 4 5 6 7 8 Visit ● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ● 1 2 3 4 5 Visit Taxon Gardnerella_vaginalis Lactobacillus_iners Lactobacillus_crispatus Gardnerella_Other Lactobacillus_gasseri Prevotella Atopobium Anaerococcus Lactobacillus_Other Finegoldia Sneathia Peptoniphilus Lactobacillus_jensenii Dialister Other_Bacteria Ureaplasma Mobiluncus Lachnospiraceae Megasphaera Coriobacteriaceae Porphyromonadaceae Veillonella Alloscardovia Clostridiales Anaerosphaera Ruminococcaceae Porphyromonas Clostridiales_Incertae_Sedis_XI Jonquetella Veillonellaceae Gemella Corynebacterium Staphylococcus Lactobacillus_coleohominis Aerococcus Segniliparus Actinomycetales Moryella Escherichia_Shigella Parvimonas Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 120 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ● 1 2 3 4 5 6 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 121 0.00 0.25 0.50 0.75 1.00 Proportion Subject 135 ● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ● 1 2 3 4 5 6 7 8 Visit ● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ● 1 2 3 4 5 Visit Taxon Gardnerella_vaginalis Lactobacillus_iners Lactobacillus_crispatus Gardnerella_Other Lactobacillus_gasseri Prevotella Atopobium Anaerococcus Lactobacillus_Other Finegoldia Sneathia Peptoniphilus Lactobacillus_jensenii Dialister Other_Bacteria Ureaplasma Mobiluncus Lachnospiraceae Megasphaera Coriobacteriaceae Porphyromonadaceae Veillonella Alloscardovia Clostridiales Anaerosphaera Ruminococcaceae Porphyromonas Clostridiales_Incertae_Sedis_XI Jonquetella Veillonellaceae Gemella Corynebacterium Staphylococcus Lactobacillus_coleohominis Aerococcus Segniliparus Actinomycetales Moryella Escherichia_Shigella Parvimonas Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
Same, but different
Same, ● ● ●● ● ● ● ● ● ● ● −5 0 5 2 3 4 5 Tanner breast Logit−transformedLABproportion a ● ●● −5 0 5 pre post Menarche status ● 4 5 6 7 2 3 4 5 Tanner breast VaginalpH b 4 5 6 7 pre post Menarche status ! but different
! but different 0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.50 0.75 1.00 oportion Subject 102 0.50 0.75 1.00 oportion Subject 103 0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 103 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit Taxon Lactobacillus_crispatus Lactobacillus_iners Lactobacillus_gasseri Gardnerella_vaginalis Lactobacillus_jensenii Lactobacillus_Other Streptococcus_anginosis Bifidobacterium Gardnerella_Other Prevotella Anaerococcus Other_Bacteria Atopobium Finegoldia Peptoniphilus Ureaplasma Bacteroides Dialister Faecalibacterium Corynebacterium Lachnospiracea_incertae_sedis Alloscardovia Moryella Actinomyces Clostridiales_Incertae_Sedis_XI Porphyromonas Blautia Clostridiales Anaerosphaera Jonquetella Mobiluncus Actinomycetales Staphylococcus Segniliparus Clostridium_XI Lachnospiraceae Coriobacteriaceae Acidovorax Olsenella Peptococcus Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post Same,
Acknowledgements Procter & Gamble FEMCARE DIVISION Melanie Hansmann Kristin Malone Julie Erb Lisa Bowman Funding Procter & Gamble NIH P30 RR033376 UI BCB Graduate Fellowship Indiana University SCHOOL OF MEDICINE J. Dennis Fortenberry Alexis Roth Cynthia Robbins Marcia Shew SCHOOL OF PUBLIC HEALTH Barbara van der Pol University of Idaho Larry Forney Xia Zhou Matt Settles Dorah Mtui Daniel Beck Matt Pennell Sam Hunter Forney & Top Labs IBEST
@roxana_hickey

More Related Content

PDF
Barley environmental association - Plant & Animal Genome 2018
PeterMorrell4
 
PPTX
20131212 - Sydney - Garvan Institute - Human Genetics and Big Data
Allen Day, PhD
 
PDF
Fairisle knitting
zafiro555
 
PDF
正誤表 p39
zafiro555
 
PDF
2018 jsm vancouver
Bin Chen
 
PDF
2018 big data_ignite
Bin Chen
 
PDF
Focusing the diversity of Gardnerella vaginalis through the lens of ecotypes
Roxana Hickey
 
PDF
Microbial interactions between humans and the built environment (Lake Arrowhe...
Roxana Hickey
 
Barley environmental association - Plant & Animal Genome 2018
PeterMorrell4
 
20131212 - Sydney - Garvan Institute - Human Genetics and Big Data
Allen Day, PhD
 
Fairisle knitting
zafiro555
 
正誤表 p39
zafiro555
 
2018 jsm vancouver
Bin Chen
 
2018 big data_ignite
Bin Chen
 
Focusing the diversity of Gardnerella vaginalis through the lens of ecotypes
Roxana Hickey
 
Microbial interactions between humans and the built environment (Lake Arrowhe...
Roxana Hickey
 

Viewers also liked (12)

PDF
Exploring the great indoors: the built environment and human health (LabRoots...
Roxana Hickey
 
PDF
Temporal dynamics of vaginal bacterial communities
Roxana Hickey
 
PDF
Community dynamics of the adolescent vaginal microbiome during puberty and on...
Roxana Hickey
 
PDF
Clouds in a crowd: deciphering individual contributions to the human microbia...
Roxana Hickey
 
PDF
Development and validation of V-chip, a DNA microarray for explorative analys...
Roxana Hickey
 
PDF
Microbiomes in Agriculture, Food, Health and the Environment
Jonathan Eisen
 
PDF
Talk for #FOGM15: Challenges and Opportunities in Microbiome Studies and th...
Jonathan Eisen
 
PDF
The microbiology of the built environment talk for #SequencingCity by @phylog...
Jonathan Eisen
 
PPTX
Ecological Disturbance of the Human Gut Microbiome
Anne M. Estes
 
PPTX
Microbiology: The Human Experience PowerPoint Lecture ch 1
plrsr1
 
PPTX
Nosocomial infections
Priyatham Kasaraneni
 
PDF
Vaginal microbiome of adolescent girls resemble those of reproductive age wom...
Roxana Hickey
 
Exploring the great indoors: the built environment and human health (LabRoots...
Roxana Hickey
 
Temporal dynamics of vaginal bacterial communities
Roxana Hickey
 
Community dynamics of the adolescent vaginal microbiome during puberty and on...
Roxana Hickey
 
Clouds in a crowd: deciphering individual contributions to the human microbia...
Roxana Hickey
 
Development and validation of V-chip, a DNA microarray for explorative analys...
Roxana Hickey
 
Microbiomes in Agriculture, Food, Health and the Environment
Jonathan Eisen
 
Talk for #FOGM15: Challenges and Opportunities in Microbiome Studies and th...
Jonathan Eisen
 
The microbiology of the built environment talk for #SequencingCity by @phylog...
Jonathan Eisen
 
Ecological Disturbance of the Human Gut Microbiome
Anne M. Estes
 
Microbiology: The Human Experience PowerPoint Lecture ch 1
plrsr1
 
Nosocomial infections
Priyatham Kasaraneni
 
Vaginal microbiome of adolescent girls resemble those of reproductive age wom...
Roxana Hickey
 
Ad

Similar to Community dynamics of the adolescent vaginal microbiome during puberty (UOregon META Symposium 2014) (19)

DOCX
Pocket dot grid pages
HIKOO
 
PDF
Deep dive into Nagios analytics
Datadog
 
PPT
アイ・トレーニング１０点）
kenji sakuma
 
PDF
Advanced Procedural Rendering in DirectX11 - CEDEC 2012
smashflt
 
PPTX
Aiello-Lammens: Global Sensitivity Analysis for Impact Assessments.
questRCN
 
PDF
17 polishing
Hadley Wickham
 
PDF
Fruit breedomics workshop wp6 application of high throughput micheletti
fruitbreedomics
 
PPT
Comparing public RNA-seq data
mikaelhuss
 
PDF
Tokyor16
Daisuke Ichikawa
 
PDF
データ社会を生きる技術〜人工知能のHypeとHope〜
Ichigaku Takigawa
 
PDF
17 Sampling Dist
Hadley Wickham
 
PDF
Catalogue hikvision
Nam Nguyen
 
PDF
Optimal Nudging. Presentation UD.
r-uribe
 
PDF
01 intro
Hadley Wickham
 
PDF
20 Polishing
Hadley Wickham
 
PDF
Model Visualisation (with ggplot2)
Hadley Wickham
 
PDF
Adventures in algorithmic cultures
nicolas nova
 
PDF
Demographic Migration Modelling with GIS
SSA KPI
 
PDF
1 basics
Ajay Ohri
 
Pocket dot grid pages
HIKOO
 
Deep dive into Nagios analytics
Datadog
 
アイ・トレーニング１０点）
kenji sakuma
 
Advanced Procedural Rendering in DirectX11 - CEDEC 2012
smashflt
 
Aiello-Lammens: Global Sensitivity Analysis for Impact Assessments.
questRCN
 
17 polishing
Hadley Wickham
 
Fruit breedomics workshop wp6 application of high throughput micheletti
fruitbreedomics
 
Comparing public RNA-seq data
mikaelhuss
 
Tokyor16
Daisuke Ichikawa
 
データ社会を生きる技術〜人工知能のHypeとHope〜
Ichigaku Takigawa
 
17 Sampling Dist
Hadley Wickham
 
Catalogue hikvision
Nam Nguyen
 
Optimal Nudging. Presentation UD.
r-uribe
 
01 intro
Hadley Wickham
 
20 Polishing
Hadley Wickham
 
Model Visualisation (with ggplot2)
Hadley Wickham
 
Adventures in algorithmic cultures
nicolas nova
 
Demographic Migration Modelling with GIS
SSA KPI
 
1 basics
Ajay Ohri
 
Ad

Recently uploaded (20)

PPTX
Feeding stratagey for climate change dairy animals.
Dr.Zulfy haq
 
PPTX
Embark on a journey of cell division and it's stages
sakyierhianmontero
 
PDF
Control and coordination Class 10 Chapter 6
LataHolkar
 
PPTX
The Toxic Effects of Aflatoxin B1 and Aflatoxin M1 on Kidney through Regulati...
OttokomaBonny
 
PPTX
Hericium erinaceus, also known as lion's mane mushroom
TinaDadkhah1
 
PPTX
METABOLIC_SYNDROME Dr Shadab- kgmu lucknow pptx
ShadabAlam169087
 
PPTX
Evolution of diet breadth in herbivorus insects.pptx
Mr. Suresh R. Jambagi
 
PDF
JADESreveals a large population of low mass black holes at high redshift
Sérgio Sacani
 
PPTX
The Obesity Paradox. Friend or Foe ?pptx
drdgd1972
 
PPTX
Home Garden as a Component of Agroforestry system : A survey-based Study
AkhangshaRoy
 
PDF
High-definition imaging of a filamentary connection between a close quasar pa...
Sérgio Sacani
 
PDF
Identification of unnecessary object allocations using static escape analysis
ESUG
 
PPTX
ANTIANGINAL DRUGS.pptx m pharm pharmacology
46JaybhayAshwiniHari
 
PPTX
mirna_2025_clase_genética_cinvestav_Dralvarez
Cinvestav
 
PPT
Grade_9_Science_Atomic_S_t_r_u_cture.ppt
QuintReynoldDoble
 
PPTX
Q1_Science 8_Week4-Day 5.pptx science re
AizaRazonado
 
PPTX
Role of GIS in precision farming.pptx
BikramjitDeuri
 
PPTX
Hepatopulmonary syndrome power point presentation
raknasivar1997
 
PPTX
Brain_stem_Medulla oblongata_functions of pons_mid brain
muralinath2
 
PPTX
Pengenalan Sel dan organisasi kehidupanpptx
SuntiEkaprawesti1
 
Feeding stratagey for climate change dairy animals.
Dr.Zulfy haq
 
Embark on a journey of cell division and it's stages
sakyierhianmontero
 
Control and coordination Class 10 Chapter 6
LataHolkar
 
The Toxic Effects of Aflatoxin B1 and Aflatoxin M1 on Kidney through Regulati...
OttokomaBonny
 
Hericium erinaceus, also known as lion's mane mushroom
TinaDadkhah1
 
METABOLIC_SYNDROME Dr Shadab- kgmu lucknow pptx
ShadabAlam169087
 
Evolution of diet breadth in herbivorus insects.pptx
Mr. Suresh R. Jambagi
 
JADESreveals a large population of low mass black holes at high redshift
Sérgio Sacani
 
The Obesity Paradox. Friend or Foe ?pptx
drdgd1972
 
Home Garden as a Component of Agroforestry system : A survey-based Study
AkhangshaRoy
 
High-definition imaging of a filamentary connection between a close quasar pa...
Sérgio Sacani
 
Identification of unnecessary object allocations using static escape analysis
ESUG
 
ANTIANGINAL DRUGS.pptx m pharm pharmacology
46JaybhayAshwiniHari
 
mirna_2025_clase_genética_cinvestav_Dralvarez
Cinvestav
 
Grade_9_Science_Atomic_S_t_r_u_cture.ppt
QuintReynoldDoble
 
Q1_Science 8_Week4-Day 5.pptx science re
AizaRazonado
 
Role of GIS in precision farming.pptx
BikramjitDeuri
 
Hepatopulmonary syndrome power point presentation
raknasivar1997
 
Brain_stem_Medulla oblongata_functions of pons_mid brain
muralinath2
 
Pengenalan Sel dan organisasi kehidupanpptx
SuntiEkaprawesti1
 

Community dynamics of the adolescent vaginal microbiome during puberty (UOregon META Symposium 2014)

  • 1. Community dynamics of the adolescent vaginal microbiome during puberty Roxana Hickey University of Idaho META Symposium on Host-Microbe Systems Biology 9 August 2014 @roxana_hickey
  • 2. How does the vaginal microbiome change over a lifespan?
  • 3. Birth Vagina sterile in utero (?), then transiently colonized by mother’s vagina or skin microbiota upon delivery
  • 4. Childhood Vagina sparsely populated by assortment of anaerobic bacteria, few to no lactobacilli
  • 5. Adolescence Estrogen levels rise, lactobacilli become more prevalent while anaerobic populations diminish
  • 6. Reproductive age Estrogen cycling stimulates thickening of vaginal epithelium, abundant lactobacilli help maintain low pH
  • 7. Menopause Estrogen levels decline, vaginal epithelium thins, lactobacilli diminish, anaerobes prevalent
  • 9. Vaginal microbiota differ among individuals and are often variable over short time scales Ravel et al. (2011) PNAS Gajer et al. (2012) Sci Transl Med
  • 10. ??? ?
  • 11. Vaginal microbiota of postmenarcheal adolescents (13-18y) closely resemble those of reproductive age women Yamamoto et al. (2009) J Pediatr Adolesc Gynecol Thoma et al. (2011) J Pediatr Adolesc Gynecol
  • 12. What is the timing and sequence of events that occur as vaginal microbiota transition to an ‘adult-like’ state?
  • 13. Study design microbiota composition ๏ 16S rRNA V1-V3 pyrosequencing ๏ mothur + RDP Naïve Bayesian Classifier 24 mothers sampled annually 31 girls enrolled @ age 10-12 & premenarcheal sampled every 3 months for up to 3 years 21 girls became postmenarcheal during study metadata ๏ pubertal development (Tanner stage) ๏ menarcheal status ๏ 21 Black ๏ 8 Caucasian ๏ 2 Native American
  • 14. Most adolescent microbiota were already ‘adult-like’ prior to menarche
  • 16. Lactobacillus crispatus L. iners L.gasseri L.jensenii Gardnerellavaginalis ‘Other’
  • 17. Lactic acid bacteria became prevalent early in puberty
  • 18. ● ● ●● ● ● ● ● ● ● ● −5 0 5 2 3 4 5 Tanner breast Logit−transformedLABproportion a ● ●● −5 0 5 pre post Menarche status b 1 2 3 4 5 Tanner stages Wikimedia Commons 50% ~100% ~0%
  • 19. Many paths to the same (?) end
  • 20. 0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 103 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit Taxon Lactobacillus_crispatus Lactobacillus_iners Lactobacillus_gasseri Gardnerella_vaginalis Lactobacillus_jensenii Lactobacillus_Other Streptococcus_anginosis Bifidobacterium Gardnerella_Other Prevotella Anaerococcus Other_Bacteria Atopobium Finegoldia Peptoniphilus Ureaplasma Bacteroides Dialister Faecalibacterium Corynebacterium Lachnospiracea_incertae_sedis Alloscardovia Moryella Actinomyces Clostridiales_Incertae_Sedis_XI Porphyromonas Blautia Clostridiales Anaerosphaera Jonquetella Mobiluncus Actinomycetales Staphylococcus Segniliparus Clostridium_XI Lachnospiraceae Coriobacteriaceae Acidovorax Olsenella Peptococcus Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
  • 21. 0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 103 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit Taxon Lactobacillus_crispatus Lactobacillus_iners Lactobacillus_gasseri Gardnerella_vaginalis Lactobacillus_jensenii Lactobacillus_Other Streptococcus_anginosis Bifidobacterium Gardnerella_Other Prevotella Anaerococcus Other_Bacteria Atopobium Finegoldia Peptoniphilus Ureaplasma Bacteroides Dialister Faecalibacterium Corynebacterium Lachnospiracea_incertae_sedis Alloscardovia Moryella Actinomyces Clostridiales_Incertae_Sedis_XI Porphyromonas Blautia Clostridiales Anaerosphaera Jonquetella Mobiluncus Actinomycetales Staphylococcus Segniliparus Clostridium_XI Lachnospiraceae Coriobacteriaceae Acidovorax Olsenella Peptococcus Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
  • 22. An inconvenient truth: girls have Gardnerella, too
  • 23. 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 120 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ● 1 2 3 4 5 6 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 121 0.00 0.25 0.50 0.75 1.00 Proportion Subject 135 ● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ● 1 2 3 4 5 6 7 8 Visit ● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ● 1 2 3 4 5 Visit Taxon Gardnerella_vaginalis Lactobacillus_iners Lactobacillus_crispatus Gardnerella_Other Lactobacillus_gasseri Prevotella Atopobium Anaerococcus Lactobacillus_Other Finegoldia Sneathia Peptoniphilus Lactobacillus_jensenii Dialister Other_Bacteria Ureaplasma Mobiluncus Lachnospiraceae Megasphaera Coriobacteriaceae Porphyromonadaceae Veillonella Alloscardovia Clostridiales Anaerosphaera Ruminococcaceae Porphyromonas Clostridiales_Incertae_Sedis_XI Jonquetella Veillonellaceae Gemella Corynebacterium Staphylococcus Lactobacillus_coleohominis Aerococcus Segniliparus Actinomycetales Moryella Escherichia_Shigella Parvimonas Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
  • 24. 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 120 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ●● ● ● ● ● 1 2 3 4 5 6 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 121 0.00 0.25 0.50 0.75 1.00 Proportion Subject 135 ● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ●● ● ● ● ● ● 1 2 3 4 5 6 7 8 Visit ● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ●● ● ● ● 1 2 3 4 5 Visit Taxon Gardnerella_vaginalis Lactobacillus_iners Lactobacillus_crispatus Gardnerella_Other Lactobacillus_gasseri Prevotella Atopobium Anaerococcus Lactobacillus_Other Finegoldia Sneathia Peptoniphilus Lactobacillus_jensenii Dialister Other_Bacteria Ureaplasma Mobiluncus Lachnospiraceae Megasphaera Coriobacteriaceae Porphyromonadaceae Veillonella Alloscardovia Clostridiales Anaerosphaera Ruminococcaceae Porphyromonas Clostridiales_Incertae_Sedis_XI Jonquetella Veillonellaceae Gemella Corynebacterium Staphylococcus Lactobacillus_coleohominis Aerococcus Segniliparus Actinomycetales Moryella Escherichia_Shigella Parvimonas Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post
  • 26. Same, ● ● ●● ● ● ● ● ● ● ● −5 0 5 2 3 4 5 Tanner breast Logit−transformedLABproportion a ● ●● −5 0 5 pre post Menarche status ● 4 5 6 7 2 3 4 5 Tanner breast VaginalpH b 4 5 6 7 pre post Menarche status ! but different
  • 27. ! but different 0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.50 0.75 1.00 oportion Subject 102 0.50 0.75 1.00 oportion Subject 103 0.00 0.25 0.50 0.75 1.00 Proportion Subject 107 0.00 0.25 0.50 0.75 1.00 Proportion Subject 109 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 Visit 0.00 0.25 0.50 0.75 1.00 Proportion Subject 102 0.00 0.25 0.50 0.75 1.00 Proportion Subject 103 ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● 1 2 3 4 5 6 7 8 9 10 11 12 Visit Taxon Lactobacillus_crispatus Lactobacillus_iners Lactobacillus_gasseri Gardnerella_vaginalis Lactobacillus_jensenii Lactobacillus_Other Streptococcus_anginosis Bifidobacterium Gardnerella_Other Prevotella Anaerococcus Other_Bacteria Atopobium Finegoldia Peptoniphilus Ureaplasma Bacteroides Dialister Faecalibacterium Corynebacterium Lachnospiracea_incertae_sedis Alloscardovia Moryella Actinomyces Clostridiales_Incertae_Sedis_XI Porphyromonas Blautia Clostridiales Anaerosphaera Jonquetella Mobiluncus Actinomycetales Staphylococcus Segniliparus Clostridium_XI Lachnospiraceae Coriobacteriaceae Acidovorax Olsenella Peptococcus Tanner breast ● ● ● ● ●1 2 3 4 5 Menarche status ● ●Pre Post Same,
  • 28. Acknowledgements Procter & Gamble FEMCARE DIVISION Melanie Hansmann Kristin Malone Julie Erb Lisa Bowman Funding Procter & Gamble NIH P30 RR033376 UI BCB Graduate Fellowship Indiana University SCHOOL OF MEDICINE J. Dennis Fortenberry Alexis Roth Cynthia Robbins Marcia Shew SCHOOL OF PUBLIC HEALTH Barbara van der Pol University of Idaho Larry Forney Xia Zhou Matt Settles Dorah Mtui Daniel Beck Matt Pennell Sam Hunter Forney & Top Labs IBEST