Cultures and microbiological tests

Tests to understand where your symptoms come from before deciding anything.

They are not only for diagnosing sexually transmitted infections: in premenstrual syndrome they can be the key.

A swab from the cervix or vagina, or a urine sample, identifies bacteria, fungi and other microorganisms, and antibiotic or antifungal susceptibility testing shows which treatment will work. As well as sexually transmitted infections (chlamydia, gonorrhoea, mycoplasmas, trichomonas…), I look for low-grade infections that cause few obvious symptoms.

That is why cultures can be the key to diagnosing and treating PMS: chronic inflammation or infection of the cervix and genital tract can be the source of inflammatory mediators that make every cycle worse. Finding it means we can treat the origin, not just the symptoms.

Vaginal and endometrial microbiome testing My approach to PMS

Frequently asked questions

I have already had tests and everything came back normal. Why repeat the cultures?

Because, as well as sexually transmitted infections, I look for low-grade infections: the ones that cause few obvious symptoms and therefore go unnoticed. They are identified with a swab from the cervix or vagina, or a urine sample.

What do cultures have to do with premenstrual syndrome?

Chronic inflammation or infection of the cervix and genital tract can be the source of inflammatory mediators that make every cycle worse. Finding it means we can treat the origin rather than only the symptoms, and that is why cultures are central to the way I investigate PMS.

What is susceptibility testing for?

To choose a targeted treatment instead of a generic one: it shows which antibiotic the bacteria found will respond to. Antifungal susceptibility testing does the same for fungi.

Other diagnostic tests

Gynaecological ultrasound
The basic imaging test to see the uterus and ovaries, during the same appointment.
Colposcopy and cervical biopsy
A magnified look at the cervix when your smear or HPV test suggests it.
Smear test and human papillomavirus (HPV) typing
Cervical cancer screening, including the virus genotype when it is present.
Vaginal and endometrial microbiome testing
A genetic analysis of the bacteria and fungi living in your vagina or endometrium.
Cytokine profile in endometriosis
A blood test measuring inflammatory markers associated with endometriosis.
Non-invasive prenatal test (NIPT)
Screening for the main chromosomal conditions in the baby from a blood sample taken from the mother.
Thrombophilia testing
A genetic test for variants that increase the tendency to form blood clots.
Genetic testing for coeliac disease (HLA-DQ2 and HLA-DQ8)
Finding out whether you carry the genetic predisposition to coeliac disease.
Oxidative stress testing
A test measuring the balance between oxidative damage and your antioxidant defences.
Microbiological testing of your partner
When infections keep coming back, sometimes your partner needs to be tested too.

From the blog

See the whole blog

Gynaecology · 6 May 2015

Evidence of the infectious origin of PMS was already known 33 years ago

From Dr Attila Toth's 1982 doxycycline study to Dr Bertone-Johnson's work on cytokines: early evidence of an infectious origin of premenstrual syndrome.

Whether a test or treatment is right for you is decided together, in consultation, after assessing your case. This page is for information only and does not replace a medical assessment.

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