Normal vaginal microbiota

The normal vaginal microbiota is a dynamic ecosystem of microorganisms that plays a fundamental role in female reproductive health. In healthy individuals of reproductive age, the community is typically dominated by Lactobacillus species, which maintain an acidic environment (pH < 4.5) through the production of lactic acid, thereby inhibiting the colonization of pathogenic organisms (Ravel et al., 2011, PNAS). This microbial community serves as a primary defense mechanism against infections such as bacterial vaginosis, vulvovaginal candidiasis, and sexually transmitted diseases (Borges et al., 2014, Arch Gynecol Obstet). Dysbiosis, characterized by a decrease in Lactobacilli and an increase in anaerobic diversity, is associated with adverse outcomes including preterm birth and increased susceptibility to viral infections like HIV (Petrova et al., 2015, Trends Microbiol). Therapeutic targeting of the vaginal microbiota involves the use of antibiotics to eliminate pathogens or live biotherapeutic products (LBPs) to restore beneficial bacteria (Cohen et al., 2020, NEJM). Recent advancements include vaginal microbiota transplantation (VMT) for recalcitrant cases of dysbiosis, highlighting the microbiota's role as a complex, living therapeutic target (Lev-Sagie et al., 2019, Nat Med).

Other names

Vaginal microbiomeVaginal floraVaginal microfloraVaginal microbial community

Restoration of microbial homeostasis through competitive exclusion of pathogens, production of antimicrobial metabolites such as lactic acid and hydrogen peroxide, and modulation of the local mucosal immune environment (Borges et al., 2014, Arch Gynecol Obstet; Cohen et al., 2020, NEJM).