just came across this article while reading about
skin manifestations of lyme and Morgellons
the points of interest to me were
1, that it raises lyme and a direct cause of ulcerative vulvovaginitis - something not widely known
2, that in their tests they found lyme spirochetes in vagina secretions and this raises the likelyhood of sexual transmission of lyme disease - in similar manner to syphilis
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6498767/