Cervicovaginal microbiota (CVM) (CVM)

The cervicovaginal microbiota (CVM) is a complex ecological niche comprising the community of microorganisms residing in the lower female reproductive tract. In healthy individuals, the CVM is typically characterized by low species diversity and is predominantly dominated by members of the genus Lactobacillus, which maintain an acidic environment (pH <4.5) through the production of lactic acid and antimicrobial compounds [3, 12]. This homeostatic state provides a critical barrier against the colonization of pathogens, including human papillomavirus (HPV), human immunodeficiency virus (HIV), and agents of sexually transmitted infections [4, 7, 12]. A shift toward a high-diversity, anaerobic-dominant state, known as dysbiosis or bacterial vaginosis, is associated with increased risks of cervical intraepithelial neoplasia, preterm birth, and pelvic inflammatory disease [8, 9, 13]. Therapeutic modulation of the CVM involves the use of antibiotics to clear anaerobic overgrowth, the administration of live biotherapeutic products (probiotics) such as LACTIN-V to restore Lactobacillus dominance, and experimental approaches like vaginal microbiota transplantation [8, 11, 15]. Emerging research also highlights the role of the CVM in pharmacomicrobiomics, where specific bacterial species can metabolically degrade drugs, significantly impacting the efficacy of topical microbicides like tenofovir [10, 14].

Other names

Vaginal microbiomeVaginal microbiotaCervicovaginal microbiomeVaginal floraFemale genital tract microbiota

The cervicovaginal microbiota is modulated through the eradication of dysbiotic anaerobic bacteria using antibiotics, the replenishment of beneficial Lactobacillus species via live biotherapeutic products, and the maintenance of an acidic environment to inhibit pathogen growth. It also acts as a biological filter that influences the pharmacokinetics and efficacy of topically administered drugs, such as microbicides, through microbial-mediated metabolic degradation.