Impact of changes in the vaginal microbiome and chronic endometritis on the initiation of hyperplastic processes of the endometrium in women

Abstract

the article presents a review of the literature, which examines the impact of changes in the vaginal microbiome and chronic endometritis on the development of hyperplastic processes of the endometrium in women. Many studies have proven the undoubted role of these factors in the development of endometrial hyperplastic processes, such as atypical hyperplasia and endometrial polyposis. Chronic endometritis, on the background of which there was a course of endometrial hyperplasia, in 95.1% of women studied was caused by an infection of viral, bacterial or fungal origin. Numerous studies indicate the important role of chronic persistent infection in the development of hyperproliferative processes of the endometrium. The largest role in the pathological process is probably played by bacteria of the genus Gardnerella viridans as well as gram-positive cocci (Streptococcus). Herpes simplex virus, cytomegalovirus, human papilloma virus and pathogenic fungi represented by the genus Candida also influence the occurrence of this process. Further studies of the pathological action of these microorganisms will achieve greater accuracy in the diagnosis of hyperplastic processes of the endometrium.

Influence of microbial colonization of the endometry on its function and development of hyperproliferative conditions

“…Proliferative changes persist in the endometrium, which, with long-term estrogen stimulation, acquire the character of hyperplasia. Also, endometrial hyperplasia can be the cause of the development of endometrial cancer, which is the most common gynecological malignancy [2,[23][24][25]. In 20-25 % of cases, endometrial hyperplasia with atypia is the basis for the formation of malignant endometrial tumors, therefore, the study of all possible factors influencing the induction of endometrial proliferation is an urgent goal of modern research [5].…”

“…Representatives of the Enterobacteriaceae family (E. coli) and Gram-positive cocci (staphylococci and streptococci) prevailed among the aerobic flora. Patients with endometrial polyps showed the largest spectrum of isolated microorganisms [2,9].…”

“…Numerous studies testify to the important role of chronic persistence of infection in the development of endometrial hyperproliferative processes [2,15].…”

“…In modern literature, there is a large number of publications and evidence that change the old opinion about the sterile environment of the uterine cavity. Microbial colonization of the endometrium and its metabolic activity is involved in various processes in the endometrium, important for the functioning of the endometrium and possibly for the normal development of pregnancy [1,2]. Recent studies have investigated the relationship between the presence of bacteria in the uterus, the proliferative processes of the uterus, and reproductive difficulties and pregnancy complications [3,4].…”