Vaginal microbiome ecosystem (VME)

The vaginal microbiome ecosystem (VME) is a complex and dynamic community of microorganisms that serves as a primary determinant of female reproductive and gynecologic health (Source: 1.5.1, 1.5.3). In healthy reproductive-aged individuals, the ecosystem is typically dominated by Lactobacillus species, which maintain an acidic environment (pH < 4.5) through the production of lactic acid and secrete antimicrobial compounds like hydrogen peroxide and bacteriocins to inhibit pathogen colonization (Source: 1.1.2, 1.2.3). Dysbiosis, or the shift from Lactobacillus dominance to a diverse mixture of anaerobic bacteria, is the hallmark of bacterial vaginosis (BV) and is strongly associated with increased susceptibility to sexually transmitted infections (STIs), including HIV and HPV, as well as adverse pregnancy outcomes such as preterm birth (Source: 1.2.4, 1.4.2). Therapeutic interventions targeting the VME aim to restore eubiosis rather than simply eradicating pathogens; these include traditional antibiotics like metronidazole, probiotic strains such as Lactobacillus crispatus CTV-05 (LACTIN-V), and emerging strategies like vaginal microbiota transplantation (VMT) (Source: 1.1.1, 1.3.2). As a therapeutic target, the VME is unique because it requires the modulation of a multi-species biological community and its metabolic output to achieve clinical efficacy (Source: 1.1.4, 1.5.1).

Other names

Vaginal microbiotaVaginal floraVaginal microfloraVaginal microbial communityVMB

Restoration of Lactobacillus dominance and microbial eubiosis; acidification of the vaginal environment via lactic acid production; competitive exclusion of pathogens; production of antimicrobial metabolites such as hydrogen peroxide and bacteriocins; and disruption of polymicrobial biofilms.