Abstract
The ovulatory cycle has a significant influence on the microbial composition, according to the action of estrogen and progesterone on the stratified squamous epithelium, due to an increase in epithelial thickness, glycogen deposition, and influence on local immunology. The 16S rRNA gene amplification and pyrosequencing study demonstrated that healthy women have community state types (CST), classified as; type “L,” with a predominance of Lactobacillus crispatus, type II, with a predominance of Lactobacillus gasseri, type III, where Lactobacillus iners predominates, and type V with a predominance of Lactobacillus jensenii. Type IV does not identify lactobacilli but a heterogeneous population of bacteria. There seems to be a relationship between increased vaginal bacterial diversity and poverty of lactobacilli with the complaining of vaginal dryness. With menopause, there appears to be a reduction in lactobacilli associated with higher serum levels of follicle-stimulating hormone (FSH) and lower estrogen levels. The evaluation of Gram-stained vaginal smears in postmenopause women must take into account the clinical-laboratory correlation. We should observe two meanly possibilities, atrophy with few bacterial morphotypes, without inflammatory, infiltrate (atrophy without inflammation), and atrophy with evident inflammatory infiltrate (atrophy with inflammation or atrophic vaginitis). The relationship between the microbiome and postmenopausal vulvovaginal symptoms seems to be related to the bacterial vaginal population. However, more robust studies are needed to confirm this impression.
Highlights
Human beings are considered holobionts, a set of host organisms with stable and transient symbiotic microbiota
Vaginal dysbiosis is an imbalance in this microenvironment associated with complications such as pelvic inflammatory disease, increased risk of infection of the human immunodeficiency virus (HIV), human papillomavirus (HPV), in addition to poor repercussions on pregnancy
The vaginal microbiota can be dominated by species of lactobacilli, and eventually, by a polymicrobial flora without lactobacilli
Summary
Nayara Santos de Oliveira 1, Ana Beatriz Feijão de Lima 2, Juliana Carvalho Regino de Brito 1, Ayane Cristine Alves Sarmento 3, Ana Katherine Silveira Gonçalves 3,4 and José Eleutério Jr. 5*. Specialty section: This article was submitted to Gynecology, a section of the journal Frontiers in Reproductive Health. The 16S rRNA gene amplification and pyrosequencing study demonstrated that healthy women have community state types (CST), classified as; type “L,” with a predominance of Lactobacillus crispatus, type II, with a predominance of Lactobacillus gasseri, type III, where Lactobacillus iners predominates, and type V with a predominance of Lactobacillus jensenii. There seems to be a relationship between increased vaginal bacterial diversity and poverty of lactobacilli with the complaining of vaginal dryness. The evaluation of Gram-stained vaginal smears in postmenopause women must take into account the clinical-laboratory correlation. The relationship between the microbiome and postmenopausal vulvovaginal symptoms seems to be related to the bacterial vaginal population. More robust studies are needed to confirm this impression
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