We learn a lot about our bodies in school, but vaginal health barely makes it into the curriculum. And that gap doesn't close much as we get older. Conversations about the vaginal microbiome? Probably won’t come up during your annual OB-GYN visit. Microbiome science is still making its way into standard care.

Meanwhile, billions of microorganisms are shaping your risk of infections, fertility, sleep, and hormones. 

That's exactly why vaginal microbiome tests like Tiny Health and Evvy exist. Both use advanced sequencing technology. Both offer personalized insights. But they take different approaches to how you should handle your results. If you're unsure which one is right for you, here’s how they compare.   

This article includes a comparison with Evvy based on publicly available information at the time of writing. Product features, pricing, and offerings may change over time. We recommend verifying details on Evvy’s website before purchasing.

Tiny Health at a glance

Tiny Health is a precision microbiome wellness platform, started in 2020 by microbiome scientists and physicians. It offers gut microbiome testing for all ages, from infants through adults, and vaginal microbiome testing for women 18+.

The Vaginal Health Test (ages 18+) uses deep shotgun metagenomic sequencing. It identifies your vaginal community state type and whether your microbiome is Lactobacillus-dominant. It also flags microbes linked to bacterial vaginosis (BV), yeast infections, urinary tract infections (UTIs), aerobic vaginitis, STI-related microbes, Ureaplasma, and menopause. 

Results include proprietary biometrics like vaginal microbiome summary score (VMSS), fertility concerns, and menopause condition associations. Each marker is benchmarked against age-matched populations using Tiny Health's own pipeline, one of the world's largest longitudinal microbiome datasets. 

You'll also get targeted recommendations based on the latest microbiome research, carefully reviewed by our science and clinical teams with no commission-based incentives. 

Tiny Health doesn't sell its own supplements, and that's on purpose. Some microbiome companies profit when you keep buying products, which can shape what they recommend. Here, guidance is based on your actual microbiome data, and sometimes the most honest answer is that you don't need to take anything new at all.

Founded: 2020  Headquarters: Austin, TX  

Test type: Deep shotgun metagenomic sequencing (proprietary) 

Sample type: Vaginal swab (at-home) 

Best for: Proactive wellness, fertility optimization, vaginal symptom insight, and anyone wanting a detailed microbiome baseline with expert guidance 

Starting price: $249 one-time, currently discounted to $189; $169 per test with Tiny+ membership

Evvy at a glance

Evvy is a biotech company launched in 2021 that focuses on vaginal health. Their core product is an at-home metagenomic sequencing test that analyzes 700+ bacteria and fungi from a single swab.  Evvy's standard test is designed for wellness. It becomes a clinical tool when you add the expanded PCR panel ($89), which screens for STIs and 10 classes of antibiotic resistance. Evvy's platform is built around a test-to-treatment model, and the company also sells its own line of supplements and vaginal health products, including probiotics and suppositories, directly through their site. Every report comes with a custom care plan. Eligible customers can access prescription treatment through the platform without a separate practitioner visit, which is available at an additional cost. Evvy also offers a separate at‑home UTI test.

Founded: 2021 Headquarters: New York, NY 

Test type: Shotgun metagenomic sequencing 

Sample type: Vaginal swab (at-home) 

Best for: Active symptoms, recurrent infections, users who want clinical diagnosis and treatment in one platform 

Starting price: $159 base, $208 with PCR add-on, and $129/test on subscription

Tiny Health vs. Evvy: side-by-side comparison

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Feature Comparison

Feature	Tiny Health	Evvy
Sequencing method	Deep shotgun metagenomics	Shotgun metagenomics
Data depth	15-20M reads; detects microbes down to 0.005% relative abundance	10M reads; confident at 0.75% relative abundance and above
Microbial coverage	125,000 microbes	700+ bacteria and fungi
Strain-level ID	Yes	Yes
Lab certification	CLIA-certified, CAP-accredited	CLIA, CAP, NYS CLEP
Published validation	Vaginal-specific bioinformatics white paper; validation ongoing; Two published studies for our gut test in Pediatric Allergy and Immunology (2025) and Frontiers in Microbiomes (2026) using very similar methodology. Validation paper to be published soon.	Yes — Diagnostics journal, 2024 / 93.1% sensitivity, 90% specificity
Community state type (CST)	Included, plus Lactobacillus-dominance assessment	Included
Fertility insights	Included, fertility, and preterm birth associations	Included, diversity score, protective bacteria score, and fertility disruptor levels, mapped to research-based optimal ranges
Condition biomarkers	Yes, BV, yeast, UTIs, inflammation, fertility, menopause, and opportunistic pathogens	Yes; BV and BV subtypes, yeast, and antibiotic resistances (with add-on)
STI detection	Included, with reporting on the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasmoides genitalium, and Trichomonas vaginalis, identified via metagenomic sequencing	PCR panel add-on only (+$89) tests for gonorrhea, chlamydia, Trichomonas vaginalis, and Mycoplasma genitalium; not available in NY or Canada
GBS (Group B strep) detection	Yes, identified via metagenomic sequencing	PCR add-on only
Antibiotic resistance	No	10 classes via PCR add-on
Personalized action plan	Evidence-backed, bias-free, clinician-reviewed recommendations based on results and symptoms	If treatment is recommended, patients may choose to purchase prescription care through platform for an additional fee, your treatment options are your next steps
Expert support included	Personalized Results Review session with a microbiome specialist, 1:1 sessions included with Tiny+ membership	Free 1:1 certified health coach session
Prescription access	Available only when working with a Powered by Tiny affiliated practitioner who can prescribe	Yes, if eligible / Separate cost; not included in test price
Price	$189 with current discount, $249 regular price / $399 with a Tiny+ Vaginal Membership	$159 base, $208 with PCR add-on, and $129/test on subscription
Turnaround time	2-3 weeks	7–10 business days / Prelim upgrade available: 1–3 days
HSA/FSA eligible	Yes	Yes
Best for	Proactive wellness, fertility, and whole-body microbiome support, including gut health testing that connects to vaginal conditions like fertility and menopause	Active symptoms, recurrent infections, clinical care in one platform

Detailed comparison: Tiny Health vs. Evvy 

Technology and testing methodology

The sequencing method matters. It changes what a test can find and what it might miss. 

Both Evvy and Tiny Health use shotgun metagenomic sequencing. This method reads the DNA of every microorganism in your sample. It doesn’t work from a fixed species list. That makes it the most thorough approach available for microbiome testing. And a big step up from older PCR or culture-based methods, which can only find what they’ve been set up to look for [1].

The main difference between the two tests is depth. Tiny Health uses deep shotgun metagenomics with a proprietary pipeline. It can identify microbes down to 0.005% relative abundance. That level of detail helps surface patterns associated with functional and clinical outcomes. You learn which species are present, which strains, and what they're doing in your microbiome. 

Evvy identifies 700+ bacteria and fungi. Their method has been independently validated. Results were published in the peer-reviewed journal Diagnostics, with 93.1% sensitivity and 90% specificity [2].

Tiny Health has published a vaginal-specific bioinformatics white paper, and validation research is ongoing. Tiny Health's shotgun metagenomics methodology has been reviewed in peer-reviewed journals, including a randomized controlled trial in Pediatric Allergy and Immunology showing a six-month gut health program reduced eczema odds by 83% in C-section babies.

Both labs are CLIA-certified and CAP-accredited. Evvy also has a CLEP certification.

What's analyzed and reported

Both tests identify your vaginal community state type, or CST. Your CST tells you which bacterial species dominate your microbiome. There are five primary CSTs. Four are dominated by protective Lactobacillus species. (When your vaginal microbiome is in an optimal state, it’s dominated by Lactobacillus crispatus.) The fifth, CST IV, is characterized by a more diverse community that has been associated with a higher risk of BV and other vaginal infections [3].

Tiny Health customers get a Vaginal Microbiome Summary Score, a single number that combines your CST, disruptive microbe levels, and overall community balance. It's then benchmarked against age-matched populations using both public and proprietary data. 

Tiny Health tracks a broader range of disruptive microbes, giving you a clearer picture of what's driving vaginal imbalances tied to symptoms. It also includes fertility biomarkers linked to conception, IVF success, and pregnancy.

Your results show whether your microbiome is Lactobacillus-dominant. We flag microbes linked to BV, yeast infections, UTIs, inflammation, and menopause. The report also maps STI-related organisms, including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasmoides genitalium, and Trichomonas vaginalis.

Condition biomarkers connect your results to specific health patterns. Your Action Plan tells you what to focus on first. If you're pregnant or planning to be, the Tiny Health report identifies preterm birth associations and a GBS metric.

Research now links vaginal microbiome composition to IVF success and pregnancy. Tiny Health's own data found that 39% of women testing their vaginal microbiome had low or absent Lactobacillus levels, a pattern directly tied to fertility complications.

The Evvy Vaginal Health Test is a CLIA, CAP, and CLEP certified test and is intended to screen for bacteria and fungi in the vaginal microbiome. Evvy does not test for STIs unless your test includes the Expanded PCR Panel. The results from the test are not designed to diagnose, treat, or cure any medical condition on its own. You always need to consult a provider to confirm a diagnosis, which is possible to do through the Evvy platform. For an additional fee, a licensed Evvy clinician can review results and prescribe a treatment plan (if needed) through the platform. Evvy is not intended to replace the advice of your doctor, your Pap smear, or regular OB-GYN visits.

Evvy's report shows your full microbiome composition by condition, so you can see how your results connect to your symptoms and treatment history. It includes condition-specific health scores for BV, fertility, and menopause. Their report also includes a Protective Score, Disruptive Score, and Diversity Score. 

Every Evvy test includes a free one-on-one session with a certified health coach. EvvyAI, Evvy's AI tool built on customer microbiome data, lets you ask questions about your results. The PCR panel add-on ($89) covers STIs and 10 classes of antibiotic resistance. It's not available in NY or Canada.

Which test best fits your needs

The right test isn't about which one is better. It's about what you're trying to learn. Evvy is built around a clinical pathway: test, diagnosis, and treatment access in one platform. Tiny Health is built as a biological intelligence layer: deep microbiome insights that help you optimize, track changes over time, and make informed decisions, either on your own or with your practitioner.

If you're trying to conceive or preparing for IVF, both tests offer useful fertility insights. Tiny Health's shotgun metagenomics sequencing gives you a detailed baseline before you start treatment. Evvy's fertility markers and prescription access may help if testing turns up an issue that needs clinical care.

If you have recurring symptoms like BV, yeast infections, and aerobic vaginitis, Evvy's test-to-treatment model is a strong fit. Evvy also offers a standalone UTI test. You get results, a clinical review, and a treatment plan without a separate provider visit. Practitioner support is available through Powered by Tiny, a network of clinicians who use the Tiny Health vaginal test in their practice.

If you're being proactive without active symptoms, Tiny Health's depth of sequencing, condition associations, and specialist support give you detailed insights and personalized guidance. The longer turnaround reflects deeper sequencing and analysis. The Personalized Results Review means you have expert help when your results arrive.

If you're pregnant or postpartum, both tests offer relevant microbiome context. Tiny Health has a strong focus on the microbiome's role in pregnancy and associated health conditions, and it also provides gut microbiome testing that can offer additional insights into digestion, immune health, metabolism, inflammation, and the gut-vaginal microbiome connection during and after pregnancy. Evvy's platform does not treat actively pregnant women.

Personalized recommendations: how actionable are the insights?

Microbiome data is only useful if you can act on it. Both companies offer personalized recommendations, but their approaches differ.

Tiny Health's action plan covers diet, supplements, and lifestyle changes based on your specific results. A Personalized Results Review with a microbiome specialist is included with every report. You also get a PDF of your test to share with your practitioner.

If you're working with a Powered by Tiny practitioner, your doctor can combine your test insights with your health history for more personalized recommendations.

Evvy’s results are reviewed by a licensed clinician. If a prescription is appropriate, a clinician can create a care plan based on your microbiome data and health history. Eligible users can access prescription treatment through the platform, with prescription costs billed separately from the test price. Every Evvy test also includes a free session with a certified health coach.

But for many women, the most valuable next step isn't a prescription. It's understanding why symptoms keep coming back, what their microbiome means for their fertility, and what to change to feel better.

Pricing, turnaround, and support

Tiny Health's Vaginal Health Test is currently discounted from $249 to $189, or you can choose Tiny+ Vaginal Membership for $399/year for two tests, a one-on-one session with a microbiome expert, and ongoing support.

Results take approximately 2–3 weeks. Evvy's base test is $159 one-time or $129 per test on a subscription, with standard results in 7–10 business days from receipt by the lab. Evvy also offers a preliminary results upgrade for 1–3 business days if you're symptomatic and want faster answers. Both tests are HSA/FSA eligible.

The turnaround difference reflects the sequencing approach. Evvy's faster results likely reflect smaller batch processing, while Tiny Health's longer timeline reflects deeper sequencing depth and more extensive functional analysis.

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What to Consider Before You Choose

Cost dimension	Tiny Health	Evvy
Base price	$189 with current discount, $249 regular price	$159
Membership option	$399 via Tiny+	$129/test (subscription)
HSA/FSA eligible	Yes	Yes
Turnaround	2–3 weeks	7–10 business days (prelim 1–3 days)
Clinician/specialist review	Personalized Results Review session with a microbiome specialist	Non-clinical 1:1 coaching session
Prescription access	Available only when working with a Powered by Tiny affiliated practitioner who can prescribe	Yes, if eligible (separate cost)
PCR add-on	No	Yes ($89; not available in NY/Canada)
Pricing last checked	June 2026	June 2026

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Which test is better for you?

There's no wrong answer here. It comes down to where you are right now and what you need most.

Choose Tiny Health if you want a deep, detailed picture of your vaginal microbiome. It's a great fit if you're being proactive, working toward conception, or want insights you can bring to your practitioner and build on over time. Plus, your gut and vaginal microbiomes are closely connected, especially when it comes to fertility, hormones, and menopause, and Tiny Health’s platform lets you test both for a clearer idea of what’s going on. 

Choose Evvy if you're dealing with active symptoms or a recurring condition and want to go from test to treatment in one place. The PCR panel add-on is worth considering if STI or antibiotic resistance screening is relevant to you.

Consider both if you're navigating a complex fertility journey. Tiny Health gives you the most detailed picture of your vaginal (and gut) microbiome. Evvy provides a clinical path to act on it if your results indicate treatment.

Why Tiny Health stands out

Tiny Health was built on one core idea: understanding your microbiome is the foundation of proactive health. That means full-body microbiome support. Gut and vaginal health are more connected than most people realize, and what's happening in one can show up in the other, especially when it comes to fertility, hormonal health, and menopause. Tiny Health is one of the few platforms that tests both.

Our Vaginal Health Test is designed for women who want to better understand and support their vaginal microbiome, whether they're experiencing vaginal symptoms, trying to conceive, or simply taking a proactive approach to their health. It helps you take charge of your vaginal and reproductive health by giving you information to address symptoms of BV, UTIs, yeast infections, and other issues that can affect fertility, preterm birth, and more. 

Your vaginal microbiome isn't static. It shifts with your cycle, birth control, stress, antibiotics, and menopause. Understanding what's happening is the first step. Tracking changes over time with a Tiny+ Vaginal Membership shows you patterns and progress, so you're not just reacting to symptoms. You're staying ahead of them.