What happens when a woman has low testosterone?

A woman’s testosterone levels naturally change throughout her life, her menstrual cycle, and even at different times of the day. A woman with low testosterone does not contain enough to help produce new blood cells, maintain sex drive, or boost levels of other reproductive hormones. Testosterone belongs to a group of hormones known as androgens. Testosterone levels affect: fertility sex drive red blood cell production muscle mass and fat distribution Most people think of testosterone as a male sex hormone, but everyone requires a certain amount. While males have more testosterone than females, female adrenal glands and ovaries produce small amounts of this hormone. According to the University of Rochester Medical Center, a woman should have a total of 15–70 nanograms per deciliter (ng/dl) of testosterone in her blood. At this time, there are no conclusive guidelines for what should be considered “low” testosterone levels in women. Symptoms A woman with low testosterone may feel tired and lethargic. Low testosterone can cause one or more of the following symptoms in women: sluggishness muscle weakness fatigue sleep disturbances reduced sex drive decreased sexual satisfaction weight gain fertility issues irregular menstrual cycles vaginal dryness loss of bone density It is important to note that research in this area is still limited. Because the symptoms linked to low testosterone are so common, a doctor will look for signs of other issues or conditions before making a diagnosis. The doctor may check for: depression anxiety chronic stress thyroid disease transition to menopause Causes Testosterone levels naturally reduce with age and the menopause. The two main causes of low testosterone are: diminishing levels of the hormone as a normal result of menopause and aging problems with the ovaries or the pituitary or adrenal glands. Testosterone decreases naturally as a woman ages. Levels of other hormones, such as estrogen, also reduce over time, especially when a woman reaches menopause. Around the time that menopause begins, a woman may be more likely to have less testosterone because the ovaries are producing fewer hormones. Also, medications that combat the side effects of menopause can lower testosterone levels. One such medicine is oral estrogen. Problems with the ovariesTrusted Source and adrenal glandsTrusted Source can also cause lower levels of testosterone. A woman may have reduced levels if her ovaries have been removed, for example, or if she has adrenal insufficiency, which means that the adrenal glands do not work correctly. Diagnosis There is currently a lack of research into the treatment of low testosterone in women. Many doctors are much more concerned about testosterone levels that are too high. In 2014, a task force recommended against routinely measuring testosterone levels in women, as research has yet to prove a link between testosterone levels and symptoms. If a woman reports any of the symptoms listed above, a doctor will likely check for other, more common, conditions first. To diagnose low testosterone in women, a doctor will start with a physical exam and ask about any symptoms. If the doctor suspects low testosterone, they will order a blood test. If a woman has not yet reached menopause, the doctor will likely advise on the best time to test the testosterone levels. This is because they fluctuate throughout the menstrual cycle. Treatment Improving sleep quality may help the symptoms of low testosterone. Some estrogen replacement drugs contain testosterone. However, the quantity of testosterone in the drugs may not be enough to raise levels, or the body may not be able to absorb them sufficiently. A doctor may administer testosterone injections or pellets, expecting these treatments to have the same effect on women as on men: raising energy levels, decreasing fatigue, and increasing the sex drive. However, many doctors advise women not to take testosterone. Likewise, the United States Food and Drug Administration (FDA) have approved few testosterone-based treatments for women. This is because the side effects can include: hair loss acne excess facial hair a deepening voice an enlarged clitoris The 2014 task force advised against treating low testosterone levels in women due to a lack of research. However, they noted as an exception that women with a condition called hypoactive sexual desire disorder should receive treatment. A doctor may instead recommend alternative therapies to treat the symptoms of low testosterone in women. These treatments and lifestyle changes can include: sex therapy taking steps to manage stress getting enough sleep eating a healthful diet taking over-the-counter dehydroepiandrosterone (DHEA) supplements DHEA is a steroid hormone that is also produced by the adrenal glands. Supplements are also available to purchase online. The Endocrine Society advise against routine supplementation with DHEA, however, as researchers have yet to prove that supplementation is safe and efficient in the long term. The side effects of DHEA supplementation can be similar to those of excess testosterone. Takeaway Doctors and researchers still do not fully understand how low testosterone levels affect women or how best to treat the deficiency. Testosterone levels change as a person ages, and they may drop as a woman approaches menopause. If a woman experiences symptoms of low testosterone, the results of a blood test can help a doctor to make a diagnosis. Never take testosterone replacement therapy without a doctor’s recommendation. Supplements and replacement therapies may cause more unpleasant side effects than they relieve.

What causes high testosterone in women?

While testosterone is considered a male sex hormone, females produce small amounts in the ovaries and adrenal glands. High levels can be caused by certain conditions and may affect physical appearance and overall health. Together with the female sex hormone estrogen, testosterone plays a role in the growth and maintenance of female reproductive tissue and bone mass. These hormones also influence behavior. In this article, learn about conditions that cause high testosterone in females, as well as about symptoms and treatment. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. ‘Normal’ testosterone levels According to the American Urology Association, average blood levels of testosterone in males are at least 300 nanograms per deciliter (ng/dL). Females secrete much lower amounts, with average levels considered to be between 15 and 70 ng/dL. The level of hormones produced in the body varies each day and throughout the day. However, testosterone levels are generally highest in the morning. Symptoms of high testosterone in females may include mood changes, a deep voice, thinning hair, and acne. Image credit: iStock Testosterone imbalances in females can affect their physical appearance and overall health. Symptoms of high testosterone in females includeTrusted Source: acne deep voice excess hair on the face and body increased muscle mass irregular periods larger-than-average clitoris loss of libido mood changes reduction in breast size thinning hair Severely high levels of testosterone in females can cause obesity and infertility. Causes of high testosterone in females High testosterone in females is usually caused by an underlying medical condition, such as: Congenital adrenal hyperplasia (CAH) CAH is the term given to a group of inherited disorders that affect the adrenal glands. These glands secreteTrusted Source the hormones cortisol and aldosterone, which play a role in managing metabolism and blood pressure. The adrenal glands also produce the male sex hormones DHEA and testosterone. People with CAH lack one of the enzymes necessary to regulate the production of these hormones, so they secrete too little cortisol and too much testosterone. CAH may be mild (nonclassic CAH) or severe (classic CAH). Symptoms in females includeTrusted Source: deep voice early appearance of pubic hair enlarged clitoris excess body hair facial hair irregular or absent menstrual periods severe acne shorter height as an adult after rapid childhood growth While there is no cure for CAH, most people with the condition can receive treatment that will reduce symptoms and improve their quality of life. Hirsutism Hirsutism is characterized by unwanted hair growth in females. It is a hormonal condition thought to be linked to genetics. Symptoms include male-pattern hair growth that is dark and coarse. It typically affects the: back chest face In cases of excessively high testosterone, other symptoms will also be present, includingTrusted Source: acne balding deepening voice enlarged clitoris increased muscle mass reduced breast size Home remedies and medical treatments help many people control the symptoms of hirsutism. Polycystic ovary syndrome (PCOS) PCOS is a common hormonal disorder that affects females of reproductive age. It is estimated that PCOS affects between 6–12%Trusted Source of people in the United States. People are not usually diagnosed until they are in their 20s and 30s. However, children as young as 11 years old can be affected. Symptoms of PCOS includeTrusted Source: enlarged ovaries that develop follicles and do not release eggs regularly excess body hair irregular, infrequent, or long menstrual periods PCOS may leadTrusted Source to several health complications, including: depression heart disease infertility miscarriage obesity sleep apnea type 2 diabetes Doctors do not know what causes PCOS, although excess insulin and genetics may playTrusted Source a role. Diagnosis of high testosterone in females A doctor may order a blood sample to diagnose high testosterone in females. Image credit: Shutterstock A doctor can diagnose high testosterone in females based on the following: Physical examination During a physical examination, the doctor will look for symptoms such as: acne excess body hair facial hair growth They will also inquire about: libido menstrual cycle abnormalities mood changes If PCOS is suspected, the doctor may visually and manually examine the pelvic region to look for abnormalities. Blood test If symptoms suggest high testosterone levels, the doctor will take a blood sample and have hormone levels tested. They may also check glucose and cholesterol levels. Usually, the blood will be drawn in the morning when testosterone levels are highest. Ultrasound To check for PCOS, the doctor may perform an ultrasound of the ovaries and uterus. Treatment of high testosterone in females The treatment recommended for high testosterone will depend on its underlying cause. Typically, a doctor will recommend both lifestyle changes and medication. Some treatments may also be used to control unwanted hair. Medication High testosterone and associated conditions can be treated with the following medications: Eflornithine: This is a cream applied directly to the skin that slows the growth of new facial hair. Glucocorticosteroids: This is a type of steroid hormone that reducesTrusted Source inflammation in the body. Metformin: This is a treatment for type 2 diabetes, which is sometimes used to lower blood sugar and insulin levels in people with PCOS. Progestin: This is a hormone that may regulateTrusted Source periods and improve fertility. Spironolactone: This is a diuretic that helps balance water and salt levels and reduces excessive female hair growth. Oral contraceptives may also be prescribed, as this treatment helps to block excess testosterone. According to a 2019 review, pairing oral contraceptives that contain estrogen and progestin with antiandrogens and metformin may be most effective for the treatment of hirsutism. However, keep in mind that oral contraceptives may not be suitable for people who are trying to get pregnant, and they can also cause adverse side effects. Hair removal treatments Laser therapy may help to control unwanted hair. Image credit: Gilaxia/iStock Both electrolysis and laser therapy may be used to control unwanted hair. However, these treatments will not resolve an underlying hormonal imbalance. Electrolysis: This involves inserting a tiny needle into each hair follicle. A pulse of electric current travels through the needle and damages the follicle so that it cannot grow new hair. Multiple treatments may be required. Laser therapy: During this treatment, laser light is applied to the hair follicles to damage them. Again, multiple treatments may be required. Note that these hair removal treatments can cause adverse reactions and may have other associated risks. Anyone with a hormonal imbalance should speak with a doctor before trying medical treatments for excess hair growth. Lifestyle changes Some lifestyle changes can reduce high testosterone in females, while others simply manage symptoms. Here are a few lifestyle changes that may be beneficial: Reach and maintain a moderate weight: Some research shows that losing even 5–10%Trusted Source of body weight can improve fertility, help to balance menstrual cycles, and reduce symptoms in people with PCOS. Follow a balanced diet: A person can improveTrusted Source symptoms of PCOS by following a nutritious, well-rounded diet and limiting their intake of foods high in sugar, refined carbs, saturated fat, and trans fat. Manage unwanted hair growth: A person can choose to treat their facial and body hair growth by plucking, shaving, waxing, or using chemical depilatories. Others bleach their hair to make it less visible. Takeaway High testosterone in females can cause a range of symptoms, from excess facial hair to infertility, and is usually caused by an underlying medical condition. Treating the underlying disorder will often reduce symptoms and improve a person’s quality of life. People who are or think they may be experiencing high testosterone symptoms should consult a doctor to determine the cause and to determine the best course of treatment.

What are some medications for edema?

Edema refers to swelling caused by liquid trapped in the body’s tissue. It can occur anywhere in the body, but a person is more likely to notice it in the hands, feet, arms, or legs. Edema can have many causesTrusted Source, such as heart failure, diabetes, pregnancy, liver disease, and kidney disease. Some cases of edema do not require treatment. However, when they do, a doctor will typically treat the underlying cause to help the condition. They may also prescribe medications to help reduce fluids in the body. This article reviews some of the medications doctors may use to treat edema. Learn more about edema here. Prescription medications at a glance Westend61/Getty Images Treatment may include either prescription diuretics or anticoagulants. The tables below outline common medications to treat edema. What is the first-line medication to treat edema? Treatment for edema can vary widely basedTrusted Source on the underlying condition. People over the age of 50 may develop edema due to poor circulation. Younger people can develop the condition due to pregnancy, heart failure, liver failure, renal failure, or trauma. When treating edema directly, the first-line medication choice tends to be loop diuretics. In some cases, a doctor may recommendTrusted Source using nonsteroidal anti-inflammatory drugs (NSAIDs) to treat pain and swelling. A person who experiences swelling for unknown reasons should talk with a doctor about it, particularly if it lasts longer than a few days. Learn more about NSAIDs here. Over-the-counter medications Over-the-counter (OTC) medications are not available to treat edema. A person can buy OTC diuretics, but they are primarily for helping a person lose water weight associated with their menstrual cycle or other mild conditions. If someone has unexplained swelling and puffiness, they should inform a doctor. A doctor mayTrusted Source perform a thorough physical exam and order blood tests and ultrasounds to determine the cause. They may also review a person’s current medications. Certain medications can trigger edema, includingTrusted Source: certain vitamins NSAIDs hormone treatments calcium channel blockers A closer look at loop diuretics A doctor may prescribe medication to treat the underlying cause of edema. They may also prescribe either loop diuretic or anticoagulant medication. Loop diuretics include: Furosemide (Lasix) Furosemide is a type of loop diuretic. Doctors may prescribe it for various conditions that can cause edema, includingTrusted Source congestive heart failure, liver failure, or renal failure. The brand name is Lasix. It comes in several doses based on the formulationTrusted Source: oral tablet: 20, 40, and 80 mg injectable solutions: 10 mg/ml oral solutions: 8 or 10 mg/ml If a person experiences the following side effects from furosemide, and they are persistent and severe, they should tell a doctor: frequent urination blurred vision headache constipation diarrhea If a person experiences the following side effects, they should seek immediate medical treatment: decreased urination dry mouth thirst nausea vomiting weakness drowsiness confusion muscle pain or cramps pounding or fast heart rate fever ringing in the ears loss of hearing rash hives blisters or peeling skin itching difficulty breathing or swallowing yellowing of the skin or eyes Learn more about furosemide here. Bumetanide (Bumex) Bumetanide is a diuretic that doctors prescribeTrusted Source to treat edema caused by kidney, liver, or heart failure. The brand name is Bumex. Bumetanide comes in several doses, includingTrusted Source:

9 of the best multivitamins for women 2022

and overall health. Some multivitamins are targeted toward females specifically to meet their unique nutritional needs. Multivitamins can benefit pregnancy and overall health, though they may not contain the daily amount of each vitamin or mineral recommended. Sex and gender exist on spectrums. For the purposes of this article, we use “male” and “female” to refer to a person’s sex assigned at birth. Learn more. A quick look at the best multivitamins for women Best for traceable ingredients: Ritual Essential for Women: Multivitamin 18+ Best personalized: Care/of Multivitamins Best sustainable: Persona Best low cost: Nature Made Women’s Multivitamin 50+ Softgels Best organic: Garden of Life mykind Organics Women’s Multi Best for older adults: Thorne Women’s Multi 50+ Best prenatal and nursing: Rainbow Light Prenatal One Best for athletes: Optimum Nutrition Opti Women Multivitamin Best chewable: OLLY The Perfect Women’s Multi When researching multivitamins to try, a person may wish to look for independent tests of the product they are interested in taking. These test standards include the United States Pharmacopeial Convention (USP), which tests products for purity. This is because the Food and Drug Administration (FDA)Trusted Source does not evaluate the safety of multivitamin products before they become available for sale. This article explains why a person may need to take multivitamins, what ingredients they typically include, and some multivitamin brands to try. Males and females often benefit from differing vitamin and mineral types, quantities, and combinations. With this in mind, some pharmaceutical companies develop specific formulas of supplements, vitamins, shakes, and health bars to benefit either male or female biology. A person should discuss their options with a doctor or healthcare professional who can help them decide, and choose the product they feel works best for them and their needs. What are multivitamins? When a person talks about multivitamins, they may be referring to those that people typically take once daily. According to the National Institutes of Health (NIH)Trusted Source, these multivitamins often include all the essential nutrients an individual needs daily. Experts have linked vitamin deficiencies to several chronic conditions, including: coronary heart disease cancer osteoporosis A 2017 studyTrusted Source states that vitamin D deficiency may lead to chronic disorders, such as bone metabolic disorder, tumors, cardiovascular disease, and diabetes. The National Academy of Sports Medicine (NASM) notes that multivitamins may help reduce a person’s risk of developing eye disease and type 2 diabetes. However, it is important to note that the studies it references are around 15 years old. More recent studies do not confirm the benefits of taking multivitamins. For example, in a 2020 study, the researchers stated that although participants self-reported improvements in their health after using multivitamins, there were no measurable health changes. The authors conclude that the participants’ positive expectations and views on their health contributes to use of multivitamins.

4 vaginal pH tests for at-home use

The vagina is a slightly acidic environment, with a pH of less than 4.5. Higher pH levels allow bacteria and yeasts to thrive, and this can result in bacterial and yeast infections. Vaginal pH tests measure the acidity of the vagina on a scale of 1–14, with lower readings indicating greater acidity. They can help indicate whether vaginal symptoms may be due to an infection that requires treatment. This article describes what a vaginal pH test is and lists some of the best at-home vaginal pH tests available. We also provide information on when to get a vaginal pH test, how to choose the best one, and what to do if vaginal pH levels are outside the normal range. Finally, we answer some FAQs about vaginal pH. Quick links Most discreet: Stix Vaginal pH Test for Yeast Infections Best for regular use: Nutrablast Feminine pH Test Strips Full Range 1–14 Best for pH monitoring: Loyal All My [pH]eels Full Range pH Test Strips Most secure: SEROFlora Feminine pH Test Strips What is a vaginal pH test? A vaginal pH test measures the acidity of the vagina on a scale of 1–14Trusted Source, with lower readings indicating greater acidity. People who experience vaginal symptoms may use a vaginal pH test to help determine whether they have a bacterial or yeast infection. The test involves placing a swab against the wall of the vagina for a specified amount of time. The swab holds a piece of pH paper that changes color. The test kit contains a chart that allows a person to match the color of their test strip with the corresponding color on the chart to determine their vaginal pH. How we chose MNT chooses at-home tests that meet the following criteria: Laboratories: Where possible, MNT will choose companies that process test samples in CLIA-certifiedTrusted Source labs. This means they follow state and federal regulations. Budget: MNT chooses at-home tests that suit a wide range of budgets. Privacy: MNT includes companies that offer robust and transparent privacy measures, such as data protection and discreet packaging. Test result speed: MNT selects companies that inform customers of when they will receive their test results and whether they will receive them via email, app, or phone. Further support: MNT will indicate whether a company offers further support, such as a follow-up phone consultation with a doctor to discuss test results. Best vaginal pH tests Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication. Medical News Today follows a strict product selection and vetting process. Learn more here. Most discreet: Stix Vaginal pH Test for Yeast Infections Cost: $11 for two tests Stix is a company that manufactures tests for the following uses: measuring vaginal pH levels detecting urinary tract infections detecting pregnancy understanding other women’s health issues Stix Vaginal pH Test for Yeast Infections is a discrete vaginal pH testing kit. The website states that the test delivers results in 2 minutes. The kit includes easy-to-follow instructions. Stix offers a subscription service for regular test delivery. Despite company claims, the test cannot tell a person whether they have a yeast infection. However, it can indicate whether a person should book an appointment with their doctor.

Vaginal pH balance: Symptoms, remedies, and tests

Typical vaginal pH level What causes unbalanced vaginal pH?? How to maintain vaginal pH balance Summary Maintaining the pH balance of the vagina is essential to keeping it healthy. The normal pH level of the vagina is between 3.8 and 5. Doctors can take a vaginal pH measurement to determine how acidic the vaginal environment is. It is also possible to test this at home. In the vagina, a high pH may cause infections as it can allow bacteria and yeast to thrive. In this article, learn more about normal vaginal pH levels, how to test them at home, and what to do to restore vaginal pH balance. Typical vaginal pH level Clique Images/Stocksy A normal vaginal pH is between 3.8 and 5Trusted Source. A pH level within this range can help to keep bacterial and fungal infections at bay. This range is moderately acidic. What is considered a “normal” vaginal pH level varies by age. A woman of reproductive age would have a normal vaginal pH between 4.0 to 4.5Trusted Source, while women who have yet to begin menstruating or who are postmenopausal may have a normal vaginal pH higher than 4.5Trusted Source Lactobacilli bacteria live in the vagina and secrete lactic acid and hydrogen peroxide, which give the vagina its acidic pH level. Vaginal pH is usually less than 4.5 during a woman’s reproductive years unless a condition or infection raises it. What causes unbalanced vaginal pH? Several conditions and infections can affect the vaginal pH balance, usually by increasing pH levels. Causes of changes in vaginal pH include the following: Bacterial vaginosis Bacterial vaginosis is a medical condition that occurs when too much bacteria is present in the vagina. This can cause an increase in vaginal pH levels. A person with bacterial vaginosis may experience itching, burning, or pain in the vagina. They may also feel a burning sensation when urinating and notice a white or gray discharge. Douching Douching refers to washing or cleaning the vagina using particular solutions, such as those containing vinegar or baking soda. These solutions claim to reduce vaginal odor, but, in fact, they may worsen the smell. This is because they wash out good bacteria, which affects the vaginal pH balance and can make someone more prone to infections. Menopause Vaginal pH levels can be an indication of menopausal statusTrusted Source. Women who are postmenopausal may have a slightly higher vaginal pH than women of reproductive age. Reduced estrogen levels during menopause may affect a person’s vaginal pH. Other vaginal infections The presence of infections other than bacterial vaginosis may also increase the vaginal pH. Examples include Trichomonas vaginalis and group B Streptococcus (GBS). Presence of menstrual blood Blood has a higher pH than the vaginal environment. When a person is menstruating, the presence of menstrual blood can increase vaginal pH levels. Presence of semen Semen is basic, which is the opposite of the vagina’s acidic environment. When semen enters the vagina, it may temporarily increase the pH. Taking antibiotics People use antibiotics to kill harmful bacteria, but these medications can kill good bacteria as well. This will include bacteria in the vagina. If a person is taking antibiotics, their vaginal pH may be out of balance. Urinary tract infections (UTIs) UTIs do not cause a higher vaginal pH, but having a high pH can increase a person’s risk of developing a UTI. Reduced estrogen levels during perimenopause and menopause can put a person at risk of developing more frequent UTIs, as lower estrogen allows the vaginal pH to rise. Doctors may prescribe estrogen treatments to lower the vaginal pH and to prevent further UTIs. Other conditions How to maintain vaginal pH balance People can purchase home-testing kits that measure the pH balance of the vagina. These kits are available in some pharmacies and online. At-home testing can reveal elevated pH levels, which could indicate the presence of an infection. The test involves placing a strip of paper that measures pH against the wall of the vagina for a designated amount of time. After removing the paper, a person can compare the resulting color to those on a chart in the kit. Each color corresponds to a pH value. People should read all of the information that the test kit includes. This will include recommendations on the timing of the test, including not performing the test while menstruating or too soon after sex. If a person’s vaginal pH levels are routinely high without any symptoms of an infection, they can take several steps at home to reduce their pH levels. These include: Avoiding harsh soaps and douching. Soaps typically have a high pH, and using them to clean the vaginal area may increase vaginal pH. It is best to use warm water and a gentle cleanser to clean the vulva but to refrain from using soap inside the vagina. This will help to maintain the vaginal pH balance. Changing tampons regularly. Tampons should be changed every four to eight hours. This also helps reduces the risk of bacterial infections, including toxic shock syndrome (TSS). Using barrier protection during sex. Using barrier protection, such as condoms or dental dams, not only helps to prevent pregnancy and STIs but can prevent semen and other fluids from affecting pH levels in the vagina. Avoiding scented feminine hygiene products. Sprays, bubble baths and scented pads or tampons can increase the risk of yeast infections which can impact the pH of the vagina. Doctors can also prescribe creams, such as estrogen cream, which may help to reduce the vagina’s pH levels.

Complex Link Between Gut Microbiome and Immunotherapy Response in Advanced Melanoma

A large-scale meta-analysis has verified that the gut microbiome does influence patients' response to immune checkpoint inhibitor (ICI) therapy in advanced melanoma, but the relationship appears to be more complex than previously thought. Overall, researchers identified a panel of species, including Roseburia spp. and Akkermansia muciniphila, associated with responses to ICI therapy. However, no single species was a "fully consistent biomarker" across the studies, the authors explain. This "machine learning analysis confirmed the link between the microbiome and overall response rates (ORRs) and progression-free survival (PFS) with ICIs but also revealed limited reproducibility of microbiome-based signatures across cohorts," Karla A. Lee, PhD, a clinical research fellow at King's College London, UK, and colleagues report. The results suggest that "the microbiome is predictive of response in some, but not all, cohorts." The findings were published online February 28 in Nature Medicine. Despite recent advances in targeted therapies for melanoma, less than half of the those who receive a single-agent ICI respond and those who receive combination ICI therapy often suffer from severe drug toxicity problems. That is why finding patients more likely to respond to a single-agent ICI has become a priority. Previous studies have identified the gut microbiome as "a potential biomarker of response as well as a therapeutic target" in melanoma and other malignancies, but "little consensus exists on which microbiome characteristics are associated with treatment responses in the human setting," the authors explain. To further clarify the microbiome–immunotherapy relationship, the researchers performed metagenomic sequencing of stool samples collected from 165 ICI-naive patients with unresectable stage III or IV cutaneous melanoma from 5 observational cohorts in the Netherlands, United Kingdom, and Spain. These data were integrated with 147 samples from publicly available datasets. First, the authors highlighted the variability in findings across these observational studies. For instance, they analyzed stool samples from one UK-based observational study of patients with melanoma (PRIMM-UK) and found a small but statistically significant difference in the microbiome composition of immunotherapy responders vs nonresponders (P = .05) but did not find such an association in a parallel study in the Netherlands (PRIMM-NL, P = .61). The investigators also explored biomarkers of response across different cohorts and found several standouts. In trials using ORR as an endpoint, two uncultivated Roseburia species (CAG:182 and CAG:471) were associated with responses to ICIs. For patients with available PFS data, Phascolarctobacterium succinatutens and Lactobacillus vaginalis were "enriched in responders" across 7 datasets, and significant in 3 of the 8 meta-analysis approaches. A muciniphila and Dorea formicigenerans were also associated with ORR and PFS at 12 months in several meta-analyses. However, "no single bacterium was a fully consistent biomarker of response across all datasets," the authors wrote. Still, the findings could have important implications for the more than 50% of patients with advanced melanoma who don't respond to single-agent ICI therapy. "Our study shows that studying the microbiome is important to improve and personalize immunotherapy treatments for melanoma," study co-author Nicola Segata, PhD, principal investigator in the Laboratory of Computational Metagenomics, University of Trento, Italy, said in a press release. "However, it also suggests that because of the person-to-person variability of the gut microbiome, even larger studies must be carried out to understand the specific gut microbial features that are more likely to lead to a positive response to immunotherapy." Co-author Tim Spector, PhD, head of the Department of Twin Research & Genetic Epidemiology at King's College London, added that "the ultimate goal is to identify which specific features of the microbiome are directly influencing the clinical benefits of immunotherapy to exploit these features in new personalized approaches to support cancer immunotherapy." In the meantime, he said, "this study highlights the potential impact of good diet and gut health on chances of survival in patients undergoing immunotherapy." This study was coordinated by King's College London, CIBIO Department of the University of Trento and European Institute of Oncology in Italy, and the University of Groningen in the Netherlands, and was funded by the Seerave Foundation. Lee, Segata, and Spector have disclosed no relevant financial relationships.