Vaginal microbiota (VM) (VM)

The vaginal microbiota is a complex biological community consisting of various microorganisms, predominantly bacteria, that inhabit the vaginal environment. In healthy individuals of reproductive age, the microbiota is typically dominated by Lactobacillus species, which play a critical role in maintaining vaginal health by producing lactic acid, lowering the pH to below 4.5, and secreting antimicrobial compounds [Ravel et al., 2011, PNAS]. This acidic environment serves as a primary defense mechanism against the colonization and overgrowth of pathogenic organisms, including those responsible for sexually transmitted infections and urinary tract infections [Coudray & Madhivanan, 2020, Eur J Obstet Gynecol Reprod Biol]. When the balance of this ecosystem is disrupted—a state known as dysbiosis—pathogenic anaerobic bacteria such as Gardnerella vaginalis and Atopobium vaginae proliferate, leading to bacterial vaginosis (BV) and increasing the risk of adverse pregnancy outcomes like preterm birth [Fettweis et al., 2019, Nature Medicine]. Therapeutic interventions target this community either through the use of broad-spectrum or targeted antibiotics to eliminate pathogens or through the administration of live biotherapeutic products (probiotics) to restore the dominance of beneficial Lactobacillus strains [Cohen et al., 2020, NEJM]. Understanding the dynamics of the vaginal microbiota is essential for developing precision medicine approaches to women's reproductive health and infectious disease management [Redelinghuys et al., 2020, Front Cell Infect Microbiol].

Other names

Vaginal microbiomeVaginal floraVaginal bacterial communityVaginal microflora

Antibiotics such as metronidazole and tinidazole act by being reduced within anaerobic bacteria to form reactive intermediates that disrupt DNA [StatPearls]. Clindamycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit [PubMed]. Live biotherapeutic products, such as Lactobacillus crispatus CTV-05, work through competitive exclusion, production of lactic acid to maintain a low pH, and secretion of hydrogen peroxide and bacteriocins to inhibit pathogenic growth [NEJM].