The role of the vaginal microbiota in the preservation of female reproductive health: A literature review (part 2)
DOI:
https://doi.org/10.37800/RM.2.2022.45-54Keywords:
microbiome, vaginal microbiota, types of microbial communities, vaginal dysbiosis, bacterial vaginosis, vulvovaginal candidiasis, probiotics, menopausal hormone therapyAbstract
Relevance: The vaginal microbiota plays an important role in host defense against various infectious and non-infectious gynecological diseases. The emergence of new molecular genetic diagnostic methods and the development of computer technologies significantly expand our understanding of the vaginal microbiome, and the current classification of types of microbial communities opens up new perspectives in the diagnosis and treatment of diseases of the female genital area.
The purpose of the study is to analyze current data on the state of the vaginal microbiota, types of microbial communities, and their impact on women’s reproductive health.
Methods: For the review (Parts 1 and 2), the search for scientific literature over the past decade was done on PubMed by
the following keywords: “vaginal microbiome,” “vaginal microbiota,” “vaginal dysbiosis,” “bacterial vaginosis,” “bacterial
vaginosis and age, bacterial vaginosis and ethnicity, bacterial vaginosis and stress, bacterial vaginosis and pelvic inflammatory
disease, bacterial vaginosis, pregnancy, preterm birth, probiotics, and vaginal microbiota, menopausal hormone therapy, and
vaginal microbiota. The article includes original articles and reviews from peer-reviewed publications indexed by PubMed. The
first part of the review was published in Reproductive Medicine No.1, 2022.
Results: In the second part of the literature review, diseases associated with bacterial vaginosis (BV) were considered. BV is the most common variant of vaginal dysbiosis. Its cure rate ranges from 50% to 80% after treatment with metronidazole,
and relapses are frequent. This urges us to identify risk factors and search for more effective treatments. Particular attention is paid to the potential impact on the composition of the vaginal microbiota of diet, probiotics, contraceptives, and menopausal hormone therapy (MHT). This article discusses therapeutic strategies, including the use of probiotics, to maintain or restore a healthy microbiome.
Conclusion: The use of probiotics to restore a functional vaginal microbiome warrants their regulation as medicines, not as food or supplements. Further research should focus on aspects such as finding different effective combinations of strains of probiotic species in the restoration of the vaginal microbiota, consensus on the duration of treatment with probiotics and the number of colony-forming units, and evaluating the effectiveness of the combined use of antibiotics and probiotics.
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