Q&A: Priyanka Jain on what the microbiome has to do with fertility, menopause, and long-term health

Priyanka Jain is the co-founder and CEO of Evvy, a precision medicine company using microbiome data to improve women’s health outcomes. Evvy serves over 90,000 patients and has built the world’s largest dataset on the vaginal microbiome—designed to unlock solutions across infertility, preterm birth, gynecological cancers, and menopause.

In this Q&A, Jain explains why so many symptoms get dismissed as “normal,” how the microbiome shifts across life stages, and why testing before problems appear may be the most important step you can take.

Why suffering is still normalized

What’s something you’ve learned since starting Evvy that’s changed how you think about women’s health?

PJ: One of the biggest things I’ve learned is how normalized prolonged suffering is in women’s health. We hear from so many Evvy users who’ve spent years cycling through treatments that didn’t work, being told their symptoms were “normal,” or feeling dismissed entirely. What’s stuck with me most is how often people say, “I thought this was just something I had to live with.”

That feedback fundamentally changed how I think about care. It’s not just about access—it’s about effectiveness, precision, and dignity. Women aren’t asking for miracles; they’re asking for care that actually listens and adapts with their bodies.

Common doesn’t mean normal

What do most people misunderstand about what’s considered “normal” when it comes to vaginal health?

PJ: A lot of people assume that recurring symptoms, discomfort, or long treatment timelines are just part of being a woman—especially during life transitions like menopause. But “common” doesn’t mean “normal,” and it definitely doesn’t mean inevitable.

What we see over and over is ineffective care being mistaken for the natural state of the body. If someone is dealing with ongoing odor, discharge, irritation, or discomfort, or spending months on treatments that don’t work, that’s not something to just power through. It’s often a signal that we’re missing important context about what’s actually happening in the microbiome.

How the microbiome shifts across life stages

How does the vaginal microbiome typically shift during major life stages like trying to conceive or entering menopause?

PJ: The vaginal microbiome plays an important role across the female lifespan, including during fertility and menopause. During the reproductive years, research suggests that a Lactobacillus-dominant microbiome is commonly associated with a stable, acidic environment that supports natural defenses and overall reproductive health. While fertility is complex and influenced by many factors, emerging research continues to explore how microbial balance may be connected to conception and early pregnancy outcomes.

During menopause, declining estrogen levels can shift the microbiome, often reducing protective Lactobacillus species and increasing pH. These changes may contribute to new or unfamiliar symptoms and can vary significantly from person to person. There is no one-size-fits-all microbiome—even at the same life stage—which is why personalized insight matters.

Testing before symptoms appear

What’s one proactive step someone can take to support vaginal health before issues like infections, fertility challenges, or discomfort show up?

PJ: One of the most powerful steps people can take is testing their microbiome—not just once, but over time. Research suggests that roughly 30% of women have a dysbiotic microbiome, and more than 80% of the time, it’s asymptomatic, meaning many people don’t realize they may be at risk for future symptoms or other downstream health impacts.

Establishing a baseline and tracking changes over time can provide early insight into shifts that might otherwise go unnoticed.

This is especially relevant as research continues to explore the relationship between the microbiome and reproductive outcomes. At Evvy, we’re conducting an ongoing fertility study with leading researchers to better understand correlations between the microbiome and IVF outcomes—reinforcing the value of proactive, personalized insight rather than waiting for symptoms to appear.

The quiet and common disruptors

How do factors like stress, hormones, or antibiotics quietly impact the microbiome over time?

PJ: These factors can have a surprisingly cumulative effect. Antibiotics, for example, don’t just target harmful bacteria—they can also reduce protective species, sometimes long after a course ends. Hormonal changes, whether from stress, birth control, pregnancy, or menopause, can reshape the microbial environment in subtle ways.

What makes this tricky is that these shifts often happen quietly. Someone may not feel immediate symptoms, but over time the ecosystem becomes more fragile, making it easier for imbalances to show up later.

A data-informed approach

If someone wants to take a lower-intervention, data-informed approach to vaginal health, where should they start?

PJ: A data-informed approach means understanding what’s actually happening in your body before jumping into interventions. Testing, education, and tracking over time allow people to make thoughtful, proactive decisions rather than reactive ones.

The goal isn’t to medicalize everything—it’s to replace guesswork with clarity, so care can be as targeted and supportive as possible. That’s what we believe the future of women’s health should look like.

Jain’s perspective reinforces a shift in women’s health from reactive care to proactive insight. The same way we’ve come to expect personalized data in fitness and nutrition, microbiome testing may become a standard part of understanding your body before symptoms force the conversation.