Based on some recent insights, we know that ovarian hormones, diet and exercise can regulate vaginal microbial composition and stability and can impact vaginal and reproductive health.
Furthermore, it is hypothesized that dietary supplementation with probiotics in late pregnancy may have a positive impact on the vaginal microbiota.
Let's go into detail.
and gender-dominated aerobics Lactobacillus. However, the composition can be grouped into five main types of Community-State Types (CST).The activity of lactobacilli helps to maintain the balance of the vaginal microbiota; this role is fundamental for the health of the vagina, because it produces 80% of lactic acid (in addition to proteins, carbohydrates, glycoproteins, lipoteic acids and divalent cations) and because it constitutes a "natural barrier" from pathogens and stress chemist. It is also important for fertility and during pregnancy.
Many studies have also reported that around 20-30% of women suffer from a deficiency at any given time Lactobacillus in your vaginal microflora.
Some types of CST are more associated with poor reproductive outcomes and sexually transmitted diseases (STDs), while species dominated by Lactobacillus, particularly Lactobacillus crispatus, are more related to vaginal health.
Vaginal dysbiosis or dysbiosis (VD) or unhealthy microbiome is one of the most important risk factors for severe vaginal infections, preterm delivery and perinatal complications.
This condition is described for three main changes in the vaginal environment:
- a change in the composition of the vaginal microbiota from Lactobacillus spp. to facultative anaerobes;
- the production of amino compounds by the new bacterial microbiota;
- an increase in vaginal pH to more than 4.5.
Vaginal bacteriosis (BV) and infection with Human Papilloma Virus (HPV) are the most frequent discomfort of the lower reproductive tract in women, but vaginal yeast infections (such as candidiasis) and viruses, and urinary tract infections in general.
Since current BV cure rates vary between 50% and 80% after treatment with metronidazole, relapses being very common, more effective treatments are needed.
It follows that the consequences of the alteration of biological films, mainly borne by Gardnerella vaginalis (anaerobic and pathogenic potential that can cause severe damage to the vaginal mucosa), should be studied in more detail to achieve better treatment and prevention of recurrent infections.
and the availability of glycogen for the CST, with relative lowering of the pH (protective factor).
In pre-pubertal age, females have a more alkaline vaginal pH than fertile (estrogen-influenced) women, with colonization by diphtheroids (Corynebacterium spp. 78%), Staphylococcus epidermidis (73%) and from Mycoplasma spp.
In the fertile phase, on the other hand, especially in the secretory phase of estrogen and progesterone, the pH is lowered and prevail Lactobacillus spp. And Atopobium And Streptococcus spp. Even the use of hormonal contraceptives can alter the temporal dynamics of the vaginal microbiota and stabilize the population of Lactobacillus, depending on the hormonal content and the method of release.
On the other hand, the release of menstruation and sexual activity are correlated with the change in the vaginal microbial, destabilizing the concentration of Lactobacillus.
In postmenopausal women, the decrease in estrogen again causes an increase in pH, which facilitates the presence of enteric bacteria.
Ethnically, BV has long been associated with black, Afro-Arab, Gypsy and Tibetan ethnicities - depending on the state in which the studies are conducted.
Cigarette smoking has been linked with increased prevalence of BV in several epidemiological studies and, occasionally, in a dose-dependent manner.
Very recently, the role of stress on the female lower genital tract has been revised. For example, working with animal models, it has been reported that persistent exposure to psychosocial stress can lead to an alteration of the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes. This, in turn, drives a "cortisol-induced inhibition of glycogen deposition in the vagina, which results in a" disruption of epithelial maturation, crucial for maintaining vaginal homeostasis. Stress is therefore a risk factor for BV.
Too frequent use of harsh cleansers, douches, and absorbent tampons can increase the risk of BV.
vaginal are greater, also thanks to the reduction in the prevalence of BV and HPV in subjects who:
- follow a vegetarian diet;
- follow diets enriched in nutrients such as vitamins (A, C, D, E, folate), B-carotene and minerals such as iron, calcium and zinc;
- supplement with probiotics (see below).
Instead, they represent negative factors:
- diets deficient in these nutrients;
- diets enriched in carbohydrates and / or fats;
- obesity.
As the large intestine is known to function as an "extra-vaginal reservoir" for lactobacilli and other bacteria, its microbiological homeostasis plays a rather important role in vaginal homeostasis. This is why the intake of prebiotics and the functionality of the intestine itself are crucial to the maintenance of the vaginal flora.
It has also been shown that the vaginal microbiota is better in women who play sports regularly.
Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis"(Antonio Barrientos-Durán, Ana Fuentes-López, Adolfo de Salazar, Julio Plaza-Díaz, Federico García - Nutrients 2020).
