Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy

Brotman, Rebecca M.; Shardell, Michelle; Gajer, Pawel; Fadrosh, Doug; Chang, Kathryn; Silver, Michelle I.; Viscidi, Raphael P.; Burke, Anne E.; Ravel, Jacques; Gravitt, Patti E.

doi:10.1097/gme.0000000000001236

Cited by 133 publications

(149 citation statements)

References 64 publications

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“…was dominant in 83% of precompared with only 54% of postmenopausal women. 14,23 Our results confirmed results from previous studies where one or two predominant Lactobacillus species were isolated, the most common being of these included Lactobacillus crispatus, Lactobacillus iners, Lactobacillus jensenii, and Lactobacillus gasseri. 24,25 We found a modified distribution of these species in favour of Lactobacillus gasseri in the contraction group without statistical significance though (Table 2).…”

Section: Commentssupporting

confidence: 90%

Abnormal vaginal microbiome associated with vaginal mesh complications

Veit‐Rubin

Tayrac²,

Cartwright

et al. 2019

Neurourology and Urodynamics

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AimsTo identify differences in the vaginal microbiomes of women after transvaginal mesh (TVM) surgery for pelvic organ prolapse with and without mesh‐associated complications.MethodsPatients with complications were eligible as cases, patients without as controls. DNA was isolated and the V1‐2 region of the 16S ribosomal RNA gene was amplified and sequenced. Overall richness was quantified using Chao1. Overall diversity was expressed as Shannon diversity and screened for group differences using analysis of variance. Multivariate differences among groups were evaluated with functions from R.ResultsWe recruited 14 patients after mesh exposure, 5 after contraction, and 21 as controls. The average number of operational taxonomic unit was 74.79 (SD ± 63.91) for controls, 57.13 (SD ± 58.74) after exposures, and 92.42 (SD ± 50.01) after contractions. Total 89.6% of bacteria in controls, 86.4% in previous exposures, and 81.3% in contractions were classified as either Firmicutes, Proteobacteria, or Actinobacteria (P < .001). Veillonella spp. was more abundant in patients after contraction (P = .045). The individual microbiomes varied, and we did not detect any significant differences in richness but a trend towards higher diversity with complications.ConclusionsThe presence of Veillonella spp. could be associated with mesh contraction. Our study did not identify vaginal microbiotic dysbiosis as a factor associated with exposure. Larger cohort studies would be needed to distinguish the vaginal microbiome of women predisposed to mesh‐related complications for targeted phenotyping of patients who could benefit from TVM surgery.

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Section: Commentssupporting

confidence: 90%

Abnormal vaginal microbiome associated with vaginal mesh complications

Veit‐Rubin

Tayrac²,

Cartwright

et al. 2019

Neurourology and Urodynamics

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“…59 Furthermore, menopause status (characterized by low levels of estrogen) is associated with low levels of vaginal Lactobacillus. 60 As…”

Section: Discussionmentioning

confidence: 99%

The vaginal microbiome amplifies sex hormone‐associated cyclic changes in cervicovaginal inflammation and epithelial barrier disruption

Bradley

Birse

Hasselrot

et al. 2018

American J Rep Immunol

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“…This reduction of a dominating species and overall increase in the diversity of the vaginal microbiome is associated with an overall reduction in vaginal health in postmenopausal women (8). Postmenopausal women are 7.8 times more likely to have a more diverse vaginal microbiome than are premenopausal women (9), and this may be due to decreases in their concentrations of ovarian hormones (10). This suggests that hormone changes associated with menopause may have an effect on the vaginal microbiome.…”

Section: Introductionmentioning

confidence: 99%

The rodent vaginal microbiome across the estrous cycle and the effect of genital nerve electrical stimulation

Levy

Bassis

Kennedy

et al. 2019

Preprint

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Treatment options are limited for the approximately 40% of postmenopausal women worldwide who suffer from female sexual dysfunction (FSD). Neural stimulation has shown potential as a treatment for genital arousal FSD, however the mechanisms for its improvement are unknown. One potential cause of some cases of genital arousal FSD are changes to the composition of the vaginal microbiome, which is associated with vulvovaginal atrophy. The primary hypothesis of this study was that neural stimulation may induce healthy changes in the vaginal microbiome, thereby improving genital arousal FSD symptoms. This study also sought to examine the composition of the rat vaginal microbiome, which is understudied. Nulliparous female rats were used. Treatment animals (n=5) received 30 minutes of cutaneous electrical stimulation targeting the genital branch of the pudendal nerve, and Control animals (n=4) had 30-minute sessions without stimulation. Vaginal lavage samples were taken during a 14-day baseline period including multiple estrous periods and after twice-weekly 30-minute sessions across a six-week trial period. Samples were sequenced at the University of Michigan Host Microbiome Initiative and analyzed for baseline bacterial trends and for changes due to stimulation. We found that the rat vaginal microbiome is dominated by Proteobacteria, Firmicutes, and Actinobacteria phyla bacteria, which changed in abundance during the estrous cycle and in relationship to each other. While the overall stimulation effects were unclear, some Treatment animals had lower variance in the microbiome diversity for sequential samples than Control animals, suggesting that stimulation may help normalize the vaginal microbiome. Future studies may consider additional physiological parameters, in addition to the microbiome composition, to further examine vaginal health and the effects of stimulation.

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Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy

Cited by 133 publications

References 64 publications

Abnormal vaginal microbiome associated with vaginal mesh complications

Abnormal vaginal microbiome associated with vaginal mesh complications

The vaginal microbiome amplifies sex hormone‐associated cyclic changes in cervicovaginal inflammation and epithelial barrier disruption

The rodent vaginal microbiome across the estrous cycle and the effect of genital nerve electrical stimulation

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