Menopausal Changes in the Microbiome—A Review Focused on the Genitourinary Microbiome

Abstract

A balanced interaction between the host and its microbiome is crucial to health. Research regarding the significance of the gut and vaginal microbiomes in female health is substantial. However, less data regarding the urinary microbiome are available. Interactions between the gut, vaginal, and urinary microbiomes are also currently being researched. Hormone-induced dysbiosis after menopause is believed to have effects on physical changes and health consequences. Postmenopausal changes in the gut microbiome are associated with increased short-chain fatty acids and hydrogen sulfide levels. Increased vaginal pH caused by reduced estrogen alters the vaginal microbiome, resulting in reduced levels of Lactobacillus. Such changes influence the vaginal structure and functions, contributing to the onset of genitourinary syndrome of menopause. A dysbiosis of the urinary microbiome is associated with urgency and urinary incontinence and also related to interstitial cystitis/bladder pain syndrome and neuropathic bladder. As these diseases commonly affect postmenopausal women, hormone-induced changes in the microbiome may play a role. Menopause increases the alpha diversity of the urinary microbiome and lowers the percentage of Lactobacillus in urine, and such changes precede recurrent cystitis. More research regarding the effects of changes in the urinary microbiome due to menopause on urinary tract diseases is needed.

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

“…abundance and high in a diverse array of bacteria (DA/B/C), which is consistent with some previous studies of nonpregnant women of comparable age ranges and racial and ethnic backgrounds 16,33,36–38 . However, peri- and postmenopausal participants, who we expected to exhibit greater proportions of low- Lactobacillus profiles, 39 were not significantly different in composition from the premenopausal group. While mean θ YC indices reflected stability differences between composition profiles, they did not differ by reproductive stage in our study of limited sample size.…”

Menopause and facial skin microbiomes: a pilot study revealing novel insights into their relationship

“…This rapidly growing population now lives one-third of their lifetime in a state of estrogen deficiency, hence there is an unmet need to expand our knowledge on the role of skin microbiome in postmenopausal health. Several gut and vaginal microbiome-targeting therapies exist for treatment of menopause-associated burdens ( Park et al, 2023 ). However, the potential of skin microbiome-modulating strategies to manage skin disorders associated with menopausal states is waiting to be exploited.…”

From Gut to Hormones: Unraveling the Role of Gut Microbiota in (Phyto)Estrogen Modulation in Health and Disease

“…Menopausal changes in the microbiome-a review focused on the genitourinary microbiome. Park et al [ 191] Hormone changes during menopause lead to dysbiosis of the gut, vaginal, and urinary microbiomes, which are interconnected, resulting in various health consequences like genitourinary syndrome and increased risk of urinary tract infections.…”