Figure 2. β Diversity Plots Depicting Shifts in the Vaginal Microbiota and Metabolome With Estradiol, Moisturizer, or Placebo Use.

Each dot represents the vaginal bacterial community or metabolic profile in a single participant. Overlapping circles indicate no differences between the groups. By week 4, women in the estradiol group had different vaginal bacterial communities (P < .001) and metabolic profiles (P < .001) compared with women in the placebo group. These changes were maintained at week 12. Such significant shifts in the microbiota (P = .08) or metabolic profiles was not observed among women in the moisturizer group (P = .72). PC indicates principal coordinates.