Age-Related Changes, Influencing Factors, and Crosstalk Between Vaginal and Gut Microbiota: A Cross-Sectional Comparative Study of Pre- and Postmenopausal Women.
Level 4 - case-series / case-control
Cross-sectional comparative study
PubMed 36374244 · doi:10.1089/jwh.2022.0114
What was done
A cross-sectional comparative study evaluated 35 premenopausal and 35 postmenopausal women (age range 27–76 years). Researchers measured gut and vaginal microbiota composition, vaginal pH, serum estradiol, follicle-stimulating hormone, and urinary equol concentrations to assess differences across menopausal status and evaluate correlations between microbial niches and hormonal markers.
What was found
Vaginal Lactobacillus species comprised ~71.98% of the vaginal microbiota in premenopausal women versus 10.08% in postmenopausal women, whereas nonoptimal species accounted for ~16.87% and 26.78%, respectively. Postmenopausal status was associated with significantly lower vaginal Lactobacillus and significantly higher vaginal microbial diversity and pH (p < 0.0001). Significant differences were observed in vaginal microbiota composition between groups, but noticeable differences were not observed in gut microbiota. Urinary equol production showed no significant correlation with vaginal microbiota, but correlated with gut microbiota composition in postmenopausal women only. In both cohorts, vaginal Lactobacillus abundance correlated inversely with microbial diversity and pH.
Why it matters
This study demonstrates that menopausal transition is accompanied by marked changes in the vaginal microenvironment—specifically a loss of Lactobacillus dominance and increased diversity—without equivalent broad compositional shifts in the gut microbiota.
Limits
The study is cross-sectional with a small sample size (n = 35 per group), preventing causal conclusions or longitudinal tracking of individual transitions. Confounders such as hormone therapy use, diet, sexual activity, and antimicrobial exposure were not detailed in the abstract.
Cited by
- contradicts Falling estrogen levels in women cause a reduction in gut microbial diversity.