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The vaginal mucosal epithelium is a multilayered, stratified squamous epithelial tissue that lines the vaginal canal, providing mechanical strength and elasticity necessary for sexual intercourse and childbirth. It contains basal, parabasal, intermediate, and superficial cell layers, with superficial cells loaded with glycogen supporting an acidic milieu through microbiota metabolism. This barrier is non-keratinized but may show signs of parakeratinization mid-cycle. It is highly sensitive to hormonal (primarily estrogen) changes, which regulate its thickness, cell maturation, and immune function. Transverse epithelial folds and underlying smooth muscle contribute to the elasticity and functionality of the vaginal wall, while cellular junctions and secretions form a dynamic interface mediating host defense, local immunity, and microbial homeostasis.
Restoration of epithelial integrity and glycogen content by estrogen; Antimicrobial action via disruption of local microbiota or direct microbial killing; Reduction of local inflammation/immune modulation
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