Impact of Internal Menstrual Protections on Immunity and Vaginal Microbiota

The aim of this study is to investigate potential links between the type of menstrual protection used and variations in vaginal health, including microbial composition, immune responses, and exposure to environmental pollutants. The project consists of two complementary components: \- Epidemiological Study: An online survey will be conducted with 1,500 to 1,800 participants, collecting detailed information on the usage habits of menstrual protection products (such as menstrual cups, tampons, and external pads), as well as self-reported symptoms and history of urogenital infections. This dataset will allow for large-scale correlation analyses between menstrual hygiene practices and women's health indicators. \- Clinical Study: A total of approximately 300 women will be recruited and divided into three groups based on their primary menstrual protection method: Group 1: Menstrual cup users Group 2: Tampon users Group 3: External sanitary pad users All clinical participants will undergo a gynecological examination and provide vaginal, cervical, urinary, and blood samples. These biological samples will be used for in-depth analysis across three main areas: * Microbiology: studying the vaginal microbiota composition and identifying infectious or dysbiotic profiles. * Immunology: assessing local immune responses, including cytokine levels and antibody titers. * Toxicology: measuring exposure to potential environmental pollutants through menstrual product use. Sequencing, immune profiling, pollutant quantification, and cytobacteriological screening will be conducted to evaluate potential differences between groups. These analyses aim to provide a better understanding of how menstrual protection methods may influence vaginal ecosystem balance, immune activity, and overall urogenital health.