6,000 people made history with their vaginas (and why that changed everything)
How the Isala project became the world's largest study on the healthy vaginal microbiome, and what it means for the future of sexual health
4 min read
When I was diagnosed with pre-cancerous cervical cells from HPV, like every person with a cervix facing that news, I dove into research mode. I wanted answers. I wanted to understand what was happening in my body and what I could do about it.
I kept reading about the vaginal microbiome, how protective Lactobacillus bacteria help your body clear HPV, how dysbiosis (microbial imbalance) is linked to persistent infections and progression to cancer.
But here's what shocked me: almost no research existed on what a healthy vaginal microbiome actually looks like.
Nearly all the data came from studies on disease, infections, complications, pathology. We had research on what goes wrong, but zero baseline for what's the average and ‘healthy’ across diverse populations.
That's when I discovered Isala.
In 2020, researchers at the University of Antwerp launched Isala, a citizen science project to benchmark the vaginal microbiome. They were looking for 200 participants willing to self-sample at home.
Within 10 days, 6,007 people registered!
Let that sink in. They weren't looking for treatment. They weren't promised cures. They just wanted to contribute to research that had been ignored for f*cking decades.
That overwhelming response transformed Isala into the largest study on the vaginal microbiome in the world, with sister projects now underway in 20 countries.
Breaking the Taboo
Isala is named after Isala Van Diest (1842-1916), Belgium's first doctor who was a woman. Isala had to study abroad because women weren't allowed at Belgian universities. But she persisted. And thanks to her, a Royal Decree in 1884 finally allowed women to become doctors in Belgium.
The modern Isala project honours that legacy by making history again, this time with thousands of people volunteering their vaginal microbiome data to science.
But what made Isala revolutionary wasn't just the sample size. It was the approach.
Every research kit included conversation starter cards, questions designed to spark discussions about vaginal health. The team created an online platform where people could ask questions anonymously. They held community events, workshops, and museum booths.
Participants weren't just subjects. They were co-creators. And every participant received a personalised microbiome report; not a diagnosis, just transparent information about their vaginal bacteria. Personally I’d love to have this too!
The message was clear: Your vaginal health matters. Your data matters. Your voice matters.
What They Discovered
The participants in Belgium (ages 18-98) self-sampled with vaginal swabs and completed extensive questionnaires covering health, contraception, sexual habits, diet, and lifestyle.
The findings, published in Nature Microbiology (2023) and Nature Medicine (2024), a first for a citizen science project, revealed:
1. Lactobacillus dominance is more common than expected
78% of healthy vaginal samples were dominated by protective Lactobacillus bacteria. Researchers expected lower numbers based on disease-focused literature. This is good news as Lactobacillus creates an acidic environment that protects against infections.
2. The microbiome changes with life stages
Composition was strongly tied to age, childbirth, menstrual cycle phase, and oestrogen levels. People using hormonal contraception had different profiles than those who weren't.
3. The microbiome is dynamic
Unlike your genetics, your vaginal microbiome can change. Lifestyle, diet, hygiene practices, and products all influence it. Which means there's potential to improve vaginal health through informed choices.
4. Geographic diversity matters
Early data from African sister projects shows lower Lactobacillus levels in healthy populations, suggesting that what's the average in Belgium isn't universal. One-size-fits-all definitions of vaginal health don't work.
Why This Changed Everything for Me
Reading about Isala while dealing with my cervical dysplasia diagnosis was a turning point.
Here was research that treated women as partners, not patients.
Research that acknowledged we know nothing about baseline vaginal health because it's never been properly studied.
And research that proved thousands of people were desperate for this information!
If the research gap is this massive, what about products?
That's why I’m developing vögeln.
The science exists now, thanks to projects like Isala. We know what a healthy microbiome looks like. We know what supports it and what disrupts it. We know that the vaginal microbiome actively influences HPV clearance, infection prevention, and overall health.
Because if 6,000 people can volunteer their vaginal swabs to advance science, we can f*cking create products worthy of that data.
The Research Continues
Isala didn't stop at one sampling round. They're now investigating:
Effects of vitamins, menstrual products, and cycle phases on the microbiome
Links between vaginal bacteria and fertility, infections, and psychological wellbeing
Vaginal bacteria that produce vitamin B2, opening doors for probiotic applications
Whether oral probiotics can effectively impact vaginal health
And the global movement is expanding. Sister projects in 20 countries are mapping regional variations. In Peru, it's called Laura (after Peru's first female physician), studying the Amazon and Coastal regions.
Professor Sarah Lebeer, who leads Isala, says: ‘We hope that others are inspired and will also research in their home country, to help women have better diagnostics and better therapeutics’.
That's the dream. Research that leads to real-world solutions.
For too long, women's health has been under-researched and under-discussed. The vaginal microbiome, which is critical for infection prevention, fertility, and overall health, has barely been studied in healthy populations.
The research continues. The global movement expands. New discoveries about probiotics, fertility, and therapeutics are emerging.
Now it's time for products to catch up.
Want to learn more about Isala or participate? Visit https://isala.be/en/
vögeln: a f*cking gel for pleasure without compromise. Launching January 2026.
