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Sample Preparation for Metabolomics Vaginal samples were eluted from swabs (Starplex rayon swab) in 200 l phosphate buffered saline (PBS) and subjected to both gas chromatography mass spectrometry (GC-MS) and liquid chromatography mass spectrometry (LC-MS) with Orbitrap Elite accurate mass platforms (Thermo Scientific, Waltham, MA, USA)

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Chest Pain or Discomfort: While it is important to note that heartburn is not related to the heart, the discomfort it causes in the chest area can sometimes be mistaken for heart-related issues

Biomarkers were subsequently measured using highly selective mass spectrometric methods at the Centers for Disease Control and Preventions Division of Laboratory Sciences