Vaginal microecology

Vaginal microecology refers to the complex and dynamic biological system of the female lower genital tract, which includes the vaginal microbiota, host endocrine environment, local immune defenses, and anatomical structures [2, 14]. A healthy microecological state is typically characterized by low microbial diversity and the dominance of Lactobacillus species, such as L. crispatus, which maintain an acidic environment (pH <4.5) through the production of lactic acid and various antimicrobial compounds [6, 17, 24]. Disruption of this balance, known as dysbiosis, leads to the overgrowth of anaerobic pathogens like Gardnerella vaginalis and Atopobium vaginae, resulting in conditions such as bacterial vaginosis (BV) and increased susceptibility to human papillomavirus (HPV) and other sexually transmitted infections [3, 15, 23]. From a therapeutic perspective, vaginal microecology is treated as a target for restoration using antimicrobial agents to eradicate pathogens and probiotics or vaginal microbiota transplants (VMT) to re-establish beneficial commensal communities [1, 4, 7, 10]. Modern interventions aim to move beyond simple infection management toward precision medicine strategies that stabilize the vaginal ecosystem to prevent reproductive complications and cervical malignancies [1, 10, 16].

Other names

Vaginal microbiomeVaginal microbiotaVaginal ecosystemVaginal biocenosisVaginal floraCervicovaginal microecology

Restoration of the vaginal microecology is achieved through the reduction of pathogenic microbial loads using targeted antimicrobials and the replenishment of commensal Lactobacillus species, which acidify the microenvironment and provide competitive inhibition against pathogen colonization [16, 17, 24].