Interview with Priyanka Jain, CEO of Evvy and Advocate for Better Vaginal Health Data

There is still an incredible amount of confusion, stigma, and frankly bad information around vaginal health. So we wanted to have a direct, practical conversation about what the vaginal microbiome actually is, why so many people get stuck in cycles of itching, odor, discharge, antibiotics, and repeat infections, and how better data could change everything.

That brings Dr. Thais Aliabadi and Mary Alice Haney to Priyanka Jain, co-founder and CEO of Evvy, a precision women’s health company focused on overlooked biomarkers, starting with the vaginal microbiome. What makes this conversation so valuable is that it lives at the intersection of science, real symptoms, and a problem many women deal with constantly but rarely get properly educated about.

Table of Contents

• Getting to the root of vaginal health
• What the vaginal microbiome actually does
• Why so many people get misdiagnosed
• How Evvy’s test works
• What recurrent BV and yeast infections really look like
• What Evvy’s data is beginning to reveal
• Birth control, sex, menopause, and other major influences
• When it is not a vaginal infection at all
• PCOS, insulin resistance, and the vaginal microbiome
• Five practical takeaways for a healthier vaginal microbiome
• FAQ

Getting to the root of vaginal health

What led us into this conversation about vaginal health in the first place?

We started from a very simple truth. People are finally beginning to talk more openly about topics that used to stay hidden. Menopause, PCOS, fertility struggles, painful periods, vaginal discomfort, all of it is becoming part of public health conversation in a way it should have been years ago.

Priyanka’s work fits directly into that shift. Her mission is not only to make vaginal health easier to understand, but to make better science available in a way people can actually use. That matters because access to good information is often the difference between getting help early and spending years feeling dismissed.

How did Priyanka Jain end up building a company focused on the vaginal microbiome?

Her path was not the obvious one. She began by working in nonprofits focused on girls and women around the world. A lot of that work centered on opportunity, education, and the basic fact that women often cannot reach their potential when access to healthcare and information is limited.

At Stanford, she became interested in how science and technology could scale impact. She studied across engineering, computing, design, and business, all with the idea of understanding how problems are solved in the real world. After that, she joined a startup working on fairer hiring systems using data science and machine learning.

That experience may sound far from gynecology, but there was a throughline. In both hiring and healthcare, the quality of the system depends on the quality of the data. If the data is biased, incomplete, or built around the wrong assumptions, the outcome will be flawed too.

Eventually, Priyanka began dealing with her own unexplained health issues and ran into a problem familiar to many women. She was told vague things. Rest more. Drink more water. Stress less. But there were not enough concrete tools to explain what was happening.

That frustration led her deeper into women’s health research, where she found a staggering gap. Women were historically underrepresented in clinical research, and that legacy still shows up today in delayed diagnosis, poor diagnostics, and treatments that are often blunt rather than precise.

That gap is what Evvy is trying to address.

Why is there such a big data gap in women’s health?

Because for a long time, medicine studied male bodies as the default. That affected everything from how diseases were defined to how drugs were tested to which symptoms were taken seriously.

When research is built around one type of body, everyone else ends up trying to fit into a model that was never designed for them. Priyanka pointed out that even today, women are diagnosed later than men across a huge number of conditions. That is not a minor oversight. It changes outcomes.

It also explains why so many women feel like they have to become mini experts in their own conditions just to get basic care.

This is especially relevant in vaginal health, where symptoms are common, testing can be limited, and many people are treated based on assumptions instead of detailed evidence.

What the vaginal microbiome actually does

What is the vaginal microbiome?

At the simplest level, it is the community of bacteria and fungi that live in the vagina. We hear a lot about the gut microbiome, but the vagina has its own microbial ecosystem too, and it plays a major role in day to day health.

Most people only think about it when something goes wrong. There is itching, unusual discharge, odor, burning, or repeated infections. But the microbiome is active all the time, not just when symptoms show up.

A healthy vaginal microbiome is often dominated by protective bacteria, especially certain lactobacilli. These bacteria help maintain an acidic environment, make it harder for harmful microbes to grow, and physically occupy space so pathogens have less opportunity to take hold.

Why does acidity matter so much?

The vagina is exposed to the outside world, so it needs defenses. The helpful bacteria produce substances that keep the environment acidic. That acidity acts like a natural protective barrier.

When the system is balanced, potentially harmful microbes are much less likely to thrive. When that balance gets disrupted and pH rises, those microbes have more room to multiply.

That shift can happen for all kinds of reasons. Sex. Menstrual blood. Antibiotics. Hormonal changes. Long periods in wet clothes. Menopause. Certain devices. A lot of common experiences can temporarily alter the environment.

And once that environment changes, some people end up in a loop of symptoms, treatment, partial relief, and recurrence.

Why is this important beyond discomfort?

Because the vaginal microbiome may affect much more than whether someone gets BV or a yeast infection. Emerging research suggests that when the protective barrier breaks down, the risk may rise for problems involving the broader reproductive tract.

That includes associations with fertility outcomes, pregnancy complications, progression of certain cervical disease processes, and increased vulnerability to sexually transmitted infections. The science is still evolving, and Priyanka was careful to emphasize that we need larger and better studies, but the direction is important.

This is not just a comfort issue. It is a whole-body women’s health issue.

Why so many people get misdiagnosed

Do bacteria and yeast always mean something is wrong?

No. That is one of the most important points in this whole conversation.

The vagina is not supposed to be sterile. Bacteria and yeast can be present without causing disease. What matters is balance, proportions, symptoms, and context.

That is why overreacting to every trace finding can create more harm than good. Dr. Aliabadi made this point very clearly. Some people see a result for a microbe like ureaplasma or mycoplasma and panic. Then they start taking antibiotics repeatedly, which can disrupt the protective environment even more.

The vagina is an ecosystem. If we wipe out one group aggressively, another may overgrow. That is why a lot of people feel like they treat one issue and immediately trigger another.

How can we tell the difference between normal discharge and a true infection?

Part of the problem is that most of us were never taught what is normal. Discharge changes through the cycle. Texture changes. Volume changes. Mild odor can vary. Not everything is a crisis.

At the same time, some symptoms should not be ignored. What matters is pattern, severity, and whether the symptoms line up with a real imbalance.

Dr. Aliabadi gave a very practical breakdown:

• Bacterial vaginosis often brings a thinner or creamy discharge, a strong fishy odor, and sometimes irritation or itching.
• Yeast infection often comes with thicker discharge and far more intense itching.
• Urinary symptoms can be confusing because odor noticed while urinating may still be coming from the vagina, not necessarily the bladder.

That said, symptoms overlap all the time. A lot of people self-diagnose incorrectly, then use over the counter products or get antibiotics online without confirming what is actually going on.

If recurrent symptoms are part of your story, it helps to understand common vaginal infections, their overlap, and why treatment should match the actual cause instead of the guess.

Why can over-treating make things worse?

Because every intervention affects the ecosystem. Antibiotics do not just target the bad actors. They can reduce protective bacteria too. Then the pH changes, the barrier weakens, and the vagina becomes more vulnerable.

Dr. Aliabadi sees people who become anxious, exhausted, and discouraged after treating themselves over and over. Sometimes the most helpful first step is to stop attacking every minor symptom and find out whether there is truly an infection that needs treatment.

That restraint can feel uncomfortable at first, but it is often exactly what the body needs.

How Evvy’s test works

So what does Evvy actually do?

Evvy offers an at-home vaginal health test using a self-swab. The sample is mailed to a lab, where it undergoes comprehensive sequencing that looks at the full range of bacteria and fungi present, rather than a narrow panel or a basic culture.

The idea is to move beyond simple yes or no answers. Instead of asking only whether a certain microbe is present, Evvy looks more deeply at the microbial makeup of the sample and combines that with symptoms and health history.

That gives people a more personalized educational report and a clearer next-step plan.

How is that different from standard testing?

Traditional evaluation often relies on culture, microscopy, smell testing, or limited PCR panels. Those tools can be useful, but they also leave a lot unseen. They may miss organisms outside the standard panel. They may not tell us much about proportions. They may not clarify whether symptoms are likely microbial at all.

Priyanka described a very important distinction. Sometimes someone has symptoms, but the microbiome itself is mostly healthy. In that case, the issue might be irritation, hormonal dryness, or something else entirely. Throwing antibiotics at that situation is unlikely to help.

That is why the test is designed not just to identify pathogens, but to help separate imbalance from other causes.

Does Evvy test for STIs too?

Yes, there is an add-on panel for a select group of STIs using the same swab, including trichomoniasis, chlamydia, gonorrhea, and mycoplasma genitalium.

However, Priyanka was also clear about what Evvy does not test for. It does not test for HPV or herpes from the vaginal swab because that is not considered the best validated way to test for those conditions. In those cases, people should still use the standard gold standard medical evaluation.

That point matters. Good innovation is not about claiming to do everything. It is about being precise about what a tool can do well.

What happens after the test results come back?

People receive education about what their results may mean for symptoms, fertility goals, pregnancy, menopause, or recurrent infections. They also receive action steps for what to discuss with a clinician.

If someone does not already have a doctor, Evvy can connect them with a provider in any state. And importantly, the company tries not to make antibiotics the default answer. The goal is to help restore healthy bacteria, support the vaginal environment, and personalize care.

That approach fits well with a broader push toward individualized medicine rather than one-size-fits-all treatment.

What recurrent BV and yeast infections really look like

What are the common triggers for recurrent vaginal infections?

Several came up repeatedly in this discussion:

• Antibiotic use for any reason, even when the infection being treated has nothing to do with the vagina
• Unprotected sex, because semen can raise vaginal pH
• Hormonal shifts
• Menstrual blood, which is less acidic than the normal vaginal environment
• Stress
• Extended moisture exposure
• Devices or situations that may allow biofilms or persistent imbalances

It is also why simple prevention habits matter. Some of the same basics covered in these vaginal health tips can support a healthier environment and reduce unnecessary irritation.

What about boric acid and suppressive treatment?

Dr. Aliabadi shared how she often uses boric acid vaginally in recurrent cases, especially when she wants to help restore pH without overusing antibiotics. In tougher situations, some people may need longer suppressive treatment, including weekly antifungal therapy for a period of time.

But she was equally clear that treatment should be tied to real symptoms and positive evidence. If someone has no symptoms and a test casually notes a small amount of yeast or low-level BV-related organisms, that alone may not warrant treatment.

This is where nuance matters. Presence is not the same thing as disease.

Why does proportion matter more than presence?

Priyanka gave a useful example. If a potentially disruptive organism makes up a tiny percentage of the microbiome, it may not be causing trouble. If it dominates the sample, that is a different story.

That is one of the limitations of simplistic culture-based thinking. A microbe can be there without being the problem. Better testing gives us a chance to ask not just what is there, but what the whole ecosystem looks like.

What Evvy’s data is beginning to reveal

What has Evvy learned from its growing dataset?

One of the most exciting parts of this conversation was hearing that Evvy now has a massive dataset built from tens of thousands of patients who consented to contribute their anonymized information to research.

That matters because women’s health has suffered for so long from a shortage of large, detailed, diverse datasets. Priyanka said that a very high percentage of participants actively opt into research, often because they want the next generation to have better answers than they did.

What the company is seeing so far is that broad labels like bacterial vaginosis or vaginitis may lump together many very different patterns. Different microbial signatures seem to cluster with different symptom profiles and life stages.

Pregnancy, postpartum recovery, menopause, and birth control use may all influence the microbiome in specific ways. That suggests the future of care should be much more personalized.

Why is that important for treatment?

If not all BV is the same, then not all treatment should be the same either.

A person whose microbiome still contains a high percentage of protective bacteria may need a very different plan from someone whose microbiome is almost completely overtaken by disruptive organisms. Precision care starts with precision data.

That can mean fewer unnecessary antibiotics, more targeted support, and better odds of actually resolving the problem rather than temporarily suppressing it.

Birth control, sex, menopause, and other major influences

How does sex affect the vaginal microbiome?

It is one of the biggest influences. Priyanka called sex one of the most common triggers of vaginal infections, and not only because of STI exposure. Semen changes pH. Oral sex can introduce oral bacteria. A new partner introduces a new microbial dynamic.

That does not mean sex is inherently unhealthy. It means sex is biologically relevant to vaginal health and should be part of the clinical conversation.

What about birth control and IUDs?

The relationship between hormonal contraception and the vaginal microbiome is still not fully understood. Studies so far are small and mixed. Some people seem to experience more infections, others fewer, and there is not a definitive answer yet.

The copper IUD, however, appears in current research to be more associated with infections than some other options. Priyanka described two possible reasons. One is that the device may allow bacteria to build biofilms. The other is that copper IUDs often lead to heavier bleeding, and more prolonged exposure to menstrual blood may raise pH in ways that allow disruptive microbes to grow.

Why is douching such a bad idea?

Because it disrupts exactly the protective system we are trying to preserve. Douching can wash away the natural lining, alter pH, and interfere with the healthy microbial balance. There is simply no good reason to do it.

Gentle hygiene externally is one thing. Trying to clean the vagina internally is another, and it usually causes more problems than it solves.

What changes in menopause?

Hormones, especially estrogen, are a major part of vaginal health. Estrogen supports glycogen production, and glycogen helps nourish the healthy bacteria that protect the vagina.

When estrogen drops, those helpful bacteria can drop too. That opens the door to more BV, more yeast infections, more irritation, and more recurrent urinary tract infections.

On top of that, menopause affects the tissues themselves. Dryness increases. Elasticity decreases. Collagen decreases. The urethral area becomes more fragile, which can make bladder symptoms and UTIs more likely.

That is why local vaginal estrogen can be so helpful, even when someone is already using systemic hormone therapy. For many people, direct local treatment is what truly addresses dryness and tissue health.

For a deeper look at those changes, the topic overlaps closely with vaginal atrophy in menopause, including dryness, recurrent UTIs, and the role of local estrogen support.

When it is not a vaginal infection at all

Can bladder symptoms be mistaken for something else?

All the time. This was one of the most important clinical reminders in the whole interview.

Dr. Aliabadi talked about people with endometriosis who have urinary urgency, frequency, and irritation because endometriosis lesions are affecting the bladder area. They get treated over and over for UTIs, often without positive cultures, and keep taking systemic antibiotics they never needed.

That is a huge problem.

The lesson is simple but powerful. Before taking antibiotics for a suspected UTI, get a culture whenever possible. A lot of pelvic and bladder symptoms have causes other than infection.

The same is true in postmenopausal itching. Many people assume recurrent yeast, keep treating with antifungal products, and do not improve because the real issue is dryness from low estrogen.

If symptoms keep recurring despite treatment, it is worth stepping back and asking whether the diagnosis itself is wrong.

PCOS, insulin resistance, and the vaginal microbiome

Is there a connection between PCOS and vaginal health?

There may be. Priyanka said existing research suggests that people with PCOS, who often have hormone imbalances and insulin resistance, may also be more prone to vaginal infections.

The details are not fully worked out yet, but two ideas are emerging. One is that the hormonal disruptions associated with PCOS may increase infection risk. The other is that the vaginal microbiome itself may eventually offer useful biomarkers for identifying or understanding PCOS.

That is especially exciting because better diagnostics for PCOS are badly needed. If research continues in that direction, noninvasive tools could someday help patients get answers earlier.

For anyone navigating that condition more broadly, it can also help to understand the role of insulin resistance, food patterns, and movement in PCOS management through resources like this guide to PCOS diet and exercise.

What about endometriosis?

Priyanka also mentioned emerging work suggesting there may be vaginal microbiome signatures associated with endometriosis. If that research develops, an at-home swab might one day assist in identifying patterns linked to endometriosis, which would be a major breakthrough in a condition known for delayed diagnosis.

There is also curiosity about whether bacteria may play some role in disease progression. It is too early to say definitively, but it is exactly the kind of question better datasets can finally help answer.

Five practical takeaways for a healthier vaginal microbiome

If we had to narrow this conversation down to a few practical habits, what matters most?

Priyanka’s advice was clear and useful, and we would frame it like this:

1. Do not assume you know what every symptom means. Get proper testing before repeatedly self-treating.
2. Learn your own baseline. The more you understand what is normal for your body, the easier it is to spot real change.
3. Advocate for yourself. If you feel something is wrong, keep asking questions and bring data when you can.
4. Remember that sex changes the vaginal environment. It is a major factor in symptoms, even when an STI is not involved.
5. Talk about it. Shame thrives in silence. Vaginal discomfort is common, and open conversation helps people get help earlier.

FAQ

Is it normal to have some discharge every day?

Yes. Discharge often changes across the menstrual cycle in amount, texture, and appearance. A change is more concerning when it comes with strong odor, significant itching, burning, pain, or a persistent new pattern.

Should we treat every vaginal culture result that shows bacteria or yeast?

No. Presence alone does not always mean infection. Many microbes can be present without causing symptoms. Treatment decisions should consider symptoms, proportions, and the broader clinical picture.

Can taking antibiotics for something unrelated affect vaginal health?

Yes. Antibiotics taken for another infection can still disrupt the vaginal microbiome because they affect bacterial communities throughout the body.

Does semen really change vaginal pH?

Yes. Semen is less acidic than the normal vaginal environment, so it can temporarily raise pH and create conditions that allow disruptive bacteria to grow more easily.

Are oral probiotics enough to fix recurrent vaginal infections?

Current evidence does not suggest that oral probiotics are the best direct way to change the vaginal microbiome. Some clinicians use vaginal probiotic suppositories instead, and gut support may still help indirectly over time.

Can menopause cause itching that is not a yeast infection?

Absolutely. Lower estrogen can cause dryness, thinning, and irritation that may feel like infection but is actually related to tissue changes and loss of healthy microbial support.

What is the biggest mistake people make with recurrent vaginal symptoms?

Repeatedly self-diagnosing and self-treating without confirming the cause. That can prolong symptoms, disrupt the vaginal environment, and make it harder to recognize the true problem.

What we loved most about this conversation is that it reframed vaginal health as something measurable, knowable, and worth taking seriously. Not mysterious. Not shameful. Not something to just tolerate.

The future of women’s health will be built on better data, better diagnostics, and a lot more honesty about what women actually experience. And the vaginal microbiome is a perfect example of how much we still have to learn, and how much better care could become once we do.

This article was created from the video How to Understand Your Vaginal Health with Priyanka Jain, CEO of Evvy | SHE MD for Dr. Thais Aliabadi’s website.