Characteristics of the vaginal microbiome in women with and without clinically confirmed vulvodynia

Bedford, Lisa M; Parker, Samantha E.; Davis, Elyse; Salzman, Elizabeth; Hillier, Sharon L.; Foxman, Betsy; Harlow, Bernard L.

doi:10.1016/j.ajog.2020.02.039

Cited by 21 publications

(15 citation statements)

References 31 publications

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“…All studies focused on premenopausal White women, except for one primarily studying postmenopausal Asian women (Park et al, 40 2021). Four studies used the International Society for the Study of Vulvovaginal Disease (ISSVD) or the first 2 Friedrich criteria for vulvodynia diagnosis (Awad-Igbaria et al, 42 2022; Panzarella et al, 41 2022; Bedford et al, 39 2020; Murina et al, 38 2020), while the remaining 4 studies provided no information on their diagnostic criteria. All studies collected samples from the vagina, with 4 also including vulvar samples (Awad-Igbaria et al, 42 2022; Panzarella et al, 41 2022; Murina et al, 38 2020; Jayaram et al, 36 2014).…”

Section: Resultsmentioning

confidence: 99%

Is Vulvodynia Associated With an Altered Vaginal Microbiota?: A Systematic Review

Sacinti,

Razeghian,

Awad-Igbaria

et al. 2023

J Low Genit Tract Dis

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Introduction Vulvodynia is defined as vulvar pain of at least 3 months' duration, without clear identifiable cause, which may have potential associated factors. It can have a significant impact on women's quality of life due to a combination of physical pain, emotional distress, and limited treatment options. Despite affecting a considerable number of women worldwide, the causes and underlying mechanisms of vulvodynia remain poorly understood. Given the recognized association of the vaginal microbiota with various gynecologic disorders, there has been growing interest in exploring the potential role of the vaginal microbiota in the etiology of vulvodynia. This systematic review aims to evaluate the current literature on the association between the vaginal microbiota and vulvodynia. Material and Methods A systematic search of multiple databases, including PubMed, Scopus, Web of Science, Cochrane Library, and Ovid MEDLINE, was conducted to identify relevant peer-reviewed studies up to May 12, 2023. The following search terms were used across these databases: “vulvodynia,” “vestibulodynia,” “vulvar vestibulitis,” “microbiome,” “microbiota,” and “flora.” Results A total of 8 case-control studies were included, the quality of which was assessed using the Newcastle-Ottawa Scale. Data extraction and synthesis were performed using a standardized protocol. In most studies, no major differences were found between the vaginal bacterial composition of women with vulvodynia and that of controls. No specific bacterial taxa were consistently associated with vulvodynia. The relationship between vaginal microbiota diversity and vulvodynia remains to be fully understood. Conclusions The role of vaginal microbiota in vulvodynia, if any, remains unclear. Because of the cross-sectional nature of the included studies, it is not possible to make any causal inferences. Further research, using larger and more diverse study populations and advanced sequencing techniques, is necessary to gain a better understanding of the potential relationship between the vaginal microbiota and vulvodynia.

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Section: Resultsmentioning

confidence: 99%

Is Vulvodynia Associated With an Altered Vaginal Microbiota?: A Systematic Review

Sacinti,

Razeghian,

Awad-Igbaria

et al. 2023

J Low Genit Tract Dis

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“…Other, small, case-control studies found associations between vulvodynia and Streptococcus, L. iners, BV, and Candida, as well as with an overall lower number of lactobacilli in the vagina. 109,[111][112][113] In a substantially larger casecontrol study, Bedford et al 114 reported no differences in the VMB profile of women with vulvodynia and those without it.…”

Section: The Vaginal Microbiome Nonspecific Symptoms and Vulvodyniamentioning

confidence: 95%

“…A history of yeast infections is strongly associated with vulvodynia, but because of the vast majority of these infections are self-reported or not confirmed by culture, it is still unknown whether these are true or only perceived yeast infections 115 . Bedford et al 114 found a strong association between vulvodynia and a history of more frequent yeast infections, among women with a low alpha diversity (the diversity of microbiome profile within a sample). Similarly, the association between prior yeast infections and vulvodynia was mainly confined to women with L. crispatus and L. iners dominance.…”

Section: The Vaginal Microbiome Nonspecific Symptoms and Vulvodyniamentioning

confidence: 99%

The Vaginal Microbiome: III. The Vaginal Microbiome in Various Urogenital Disorders

Seta

Lonnée-Hoffmann

Campisciano

et al. 2022

J Low Genit Tract Dis

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This series of articles, titled The Vaginal Microbiome (VMB), written on behalf of the International Society for the Study of Vulvovaginal Disease, aims to summarize the recent findings and understanding of the vaginal bacterial microbiota, mainly regarding areas relevant to clinicians specializing in vulvovaginal disorders.Materials and Methods: A search of PubMed database was performed, using the search terms "vaginal microbiome" with "Candida," "vaginitis," "urinary microbiome," "recurrent urinary tract infections," "sexually transmitted infections," "human immunodeficiency virus," "human papillomavirus," "nonspecific vaginitis," "vulvodynia," and "vulvovaginal symptoms." Full article texts were reviewed. Reference lists were screened for additional articles. The third article in this series describes VMB in various urogenital disorders.Results: Variable patterns of the VMB are found in patients with vulvovaginal candidiasis, challenging the idea of a protective role of lactobacilli. Highly similar strains of health-associated commensal bacteria are shared in both the bladder and vagina of the same individual and may provide protection against urinary tract infections. Dysbiotic VMB increases the risk of urinary tract infection. Loss of vaginal lactic acid-producing bacteria combined with elevated pH, increase the risk for sexually transmitted infections, although the exact protective mechanisms of the VMB against sexually transmitted infections are still unknown. Conclusions:The VMB may constitute a biological barrier to pathogenic microorganisms. When the predominance of lactobacilli community is disrupted, there is an increased risk for the acquisition of various vaginal pathogents. Longitudinal studies are needed to describe the association between the host, bacterial, and fungal components of the VMB.

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“…The results demonstrated that in the group of patients after prolonged preventive therapy, there was a statistically significant decrese in laboratory criteria for BV, clinical and laboratory markers of BV three and six months after the treatment, respectively. Other studies showed a high clinical and laboratory efficiency of using intimate hygiene products based on ammonium glycyrrhizinate and lactic acid, both in the complex therapy for patients with vaginal microbiome disorders and concomitant viral infections, and in monotherapy for restoring microbiocenosis disorders [22,29,30]. In a study by Pagano et al, bioadhesive, vaginal emulgels loaded with the hybrids of 18β -glycyrrhetinic acid as the main bioactive component of licorice roots and rhizomes of Glycyrrhiza glabra species were developed for systemic and local application.…”

Section: Microbiological Assessment Of Glycyrrhizic Acid Effectivenes...mentioning

confidence: 99%

Microbiological Assessment of Glycyrrhizic Acid Effectiveness in Bacterial Vaginosis – A Comparative Study

et al. 2022

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Background. Bacterial vaginosis (BV) is one of the most common female diseases, which is currently characterized by an increasing rate of clinical sign reccurence, the appearance of asymptomatic carriers, and atypical forms. This study was aimed to evaluate the effectiveness of glycyrrhizic acid administration in the prevention of BV recurrence. Materials and Methods. The study involved 88 women after BV treatment (metronidazole per os for seven days). Participants were randomly divided into two groups: the main group included 46 patients who were administered 0.1% glycyrrhizic acid intravaginally for three months after the main treatment; the control group comprised 42 women who received no anti-recurrence BV course. The effectiveness was assessed three and six months after the beginning of treatment and included gynecological examination and laboratory assessments (pH, amine test, microbiological investigation). Results. After recommended BV treatment without anti-recurrence course, the recurrence of laboratory criteria for BV increased three months after the treatment, including the increase in vaginal pH to > 4.5 in all subjects, positive amine test in 35.7% of patients, the presence of Gardnerella vaginalis at a concentration of 104-105 CFU/ml in 31.0% of women, reduction in the frequency of Lactobacillus detection with worsening of the condition and the onset of clinical manifestations of the disease six months later. In the main group, after glycyrrhizic acid administration, laboratory criteria of BV recovery three months after the treatment, and clinical and laboratory markers of BV recovery six months after the treatment were lower as compared to the control group. Conclusions. The anti-recurrence course of BV (vaginal administration of 0.1% glycyrrhizic acid) demonstrated a decrease in the frequency of complaints, clinical and laboratory markers, stabilization of the species composition of Lactobacillus, and a decrease in facultative anaerobe concentration in the vaginal microbiome as compared to group without anti-recurrence treatment.

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Characteristics of the vaginal microbiome in women with and without clinically confirmed vulvodynia

Cited by 21 publications

References 31 publications

Is Vulvodynia Associated With an Altered Vaginal Microbiota?: A Systematic Review

Is Vulvodynia Associated With an Altered Vaginal Microbiota?: A Systematic Review

The Vaginal Microbiome: III. The Vaginal Microbiome in Various Urogenital Disorders

Microbiological Assessment of Glycyrrhizic Acid Effectiveness in Bacterial Vaginosis – A Comparative Study

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