Is the vaginal microbiome a marker or an effector of vaginal health?

Mitchell, Caroline

doi:10.1097/gme.0000000000002174

Cited by 2 publications

(4 citation statements)

References 15 publications

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“…Future research may also conduct deeper explorations of the mechanisms and implications surrounding temporal dynamics in the vaginal microenvironment through metagenomics, metatranscriptomics, metabolomics, and immunologic approaches to expand upon the descriptive analyses provided here. 13…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the study may inform the design of a larger and longer-term cohort to examine vaginal microbiota stability as a potential determinant of health outcomes, such as the genitourinary syndrome of menopause. Future research may also conduct deeper explorations of the mechanisms and implications surrounding temporal dynamics in the vaginal microenvironment through metagenomics, metatranscriptomics, metabolomics, and immunologic approaches to expand upon the descriptive analyses provided here 13 …”

Section: Discussionmentioning

confidence: 99%

“…have been associated with lowered risk of genitourinary syndrome of menopause (GSM) symptoms and signs, such as vaginal dryness and vulvovaginal atrophy, [9][10][11] although, to date, there is no strong evidence to conclude that changes in vaginal microbiota composition lead to improvement in GSM symptom severity. 12,13 The composition of the vaginal microbiota during reproductive age can be highly dynamic due to the influence of the menstrual cycle, pregnancy-driven hormonal changes, and the effect of extrinsic factors such as certain sexual and hygiene behaviors. [14][15][16][17] Stability of the composition of the vaginal microbiota is thought to be important, as intervals of transition to lowered Lactobacillus spp.…”

mentioning

confidence: 99%

“…High abundances of vaginal Lactobacillus spp. have been associated with lowered risk of genitourinary syndrome of menopause (GSM) symptoms and signs, such as vaginal dryness and vulvovaginal atrophy, 9-11 although, to date, there is no strong evidence to conclude that changes in vaginal microbiota composition lead to improvement in GSM symptom severity 12,13 …”

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confidence: 99%

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Longitudinal profiles of the vaginal microbiota of pre-, peri-, and postmenopausal women: preliminary insights from a secondary data analysis

Stennett,

France,

Shardell

et al. 2024

Menopause

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Objective Menopause is often accompanied by lowered Lactobacillus spp. relative abundance and increased abundance of diverse anaerobic/aerobic bacteria in the vaginal microbiota due in part to declines in estrogen. These microbiota are associated with urogenital symptoms and infections. In premenopause, vaginal microbiota can fluctuate rapidly, particularly with menstrual cycles and sexual activity; however, the longitudinal dynamics of vaginal microbiota are understudied in peri- and postmenopause. We described vaginal community stability across reproductive stages. Methods Pre- (n = 83), peri- (n = 8), and postmenopausal (n = 11) participants provided twice-weekly mid-vaginal samples (total, 1,556; average, 15 per participant) over 8 weeks in an observational study. Composition of the vaginal microbiota was characterized by 16S rRNA gene amplicon sequencing, and a community state type (CST) was assigned to each sample. Clustering of longitudinal CST profiles, CST transition rates, duration of low-Lactobacillus/high bacterial diversity CSTs, and other metrics of bacterial community dynamics were assessed across reproductive stages. Results The proportion of participants with longitudinal CST profiles characterized by low-Lactobacillus CSTs was similar among pre- (38.6%), peri- (37.5%), and postmenopausal (36.4%) participants (P = 0.69). CST transition rates between consecutive samples were 21.1%, 16.7%, and 14.6% for pre-, peri-, and postmenopausal participants, respectively (P = 0.49). Low-Lactobacillus CST tended to persist for at least 4 weeks, irrespective of reproductive stage. Conclusions Findings from this small yet frequently sampled cohort revealed vaginal bacterial fluctuations over 8 weeks that were similar across reproductive stages. Larger and longer-term studies based on these preliminary data could provide insights into the influence of microbiota dynamics on urogenital outcomes during menopause.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Longitudinal profiles of the vaginal microbiota of pre-, peri-, and postmenopausal women: preliminary insights from a secondary data analysis

Stennett,

France,

Shardell

et al. 2024

Menopause

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VagiBIOM Lactobacillus suppository improves vaginal health index in perimenopausal women with bacterial vaginosis: a randomized control trial

Vivekanandan,

Khan,

Venugopal

et al. 2024

Sci Rep

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Bacterial vaginosis (BV) can cause vaginal dysbiosis that may influence general vaginal health and pregnancy complications. Balancing vaginal microbiome using Lactobacillus spp. may be a new way to prevent and treat mild BV. We conducted a randomized, double-blind, placebo-controlled pilot study aimed at evaluating the effect of the product VagiBIOM, a multi-Lactobacillus vaginal suppository, on peri- and premenopausal women with BV in restoring vaginal pH and overall vaginal health by resetting the vaginal microbiome composition. Sixty-six peri- and premenopausal women with BV symptoms were randomized with a 2:1 ratio to be treated with VagiBIOM or placebo suppositories. Vaginal pH, VAS itching score, total Nugent score, and vaginal health index (VHI) were measured. Vaginal microbiome changes before and after the treatment were analyzed by 16S rRNA sequencing and bioinformatics analysis. After 4 weeks of intervention with VagiBIOM or a placebo, the mean score for vaginal pH, VAS itching, and total Nugent score was significantly decreased from the baseline. Compared to the baseline scores, the VHI scores improved significantly following 28-day intervention (p < 0.001). Our results revealed two Lactobacillus species, L. hamsteri, and L. helveticus, as indicator species occurring differentially in the VagiBIOM-treated group. Furthermore, the regression and species network analyses revealed significant bacterial associations after VagiBIOM treatment. Lactobacillus hamsteri was positively associated with the Nugent score and negatively associated with vaginal pH. L. iners and L. salivarius were positively and inversely associated with VHI. As is typical, Bacteroides fragilis was positively associated with vaginal pH and negatively associated with the Nugent score. Interestingly, the Lactobacillus spp. diversity improved after VagiBIOM treatment. The VagiBIOM suppository treatment for peri- and premenopausal women with BV significantly relieved vaginal itching by decreasing vaginal pH and Nugent scores and improving the overall VHI after 4 weeks’ intervention. This effect was primarily the result of VagiBIOM improving vaginal Lactobacillus diversity.Trial Registration ClinicalTrials.gov registration: NCT05060029, first registration 09/28/2021: Title: A Pilot Study to Evaluate the Efficacy and Safety of Lactobacillus Species Suppositories on Vaginal Health and pH.

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Is the vaginal microbiome a marker or an effector of vaginal health?

Cited by 2 publications

References 15 publications

Longitudinal profiles of the vaginal microbiota of pre-, peri-, and postmenopausal women: preliminary insights from a secondary data analysis

Longitudinal profiles of the vaginal microbiota of pre-, peri-, and postmenopausal women: preliminary insights from a secondary data analysis

VagiBIOM Lactobacillus suppository improves vaginal health index in perimenopausal women with bacterial vaginosis: a randomized control trial

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