Vaginal microbiota #22
By Prof. Satu. Pekkala
Research Fellow of the Academy of Finland,
Faculty of Sport and Health Sciences, University of Jyväskylä, Finland, Finland
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Created
19 February 2025
Updated
09 April 2025
Menopause: Unbalanced vaginal microbiota may promote inflammation
During the premenopause (the period before menstruation ceases for good), the drop in estrogen levels leads to a reduction in the glycogen content of the mucosal cells, glycogen being the preferred food of Lactobacillus. Less well nourished, Lactobacillus become less abundant and lose their dominant position in the flora, which can lead to imbalances in the vaginal microbiota. The reduction in sex hormones is also associated with a harmful increase in microbial diversity.
Several studies have shown that the loss of Lactobacillus dominance and the increase in bacterial diversity are associated with inflammation of the vaginal mucosa. Inflammation increases the risk of infection, particularly with sexually transmitted infections (STIs),
and of precancerous cervical lesions. While the link between changes in the vaginal microbiota and inflammation has been shown in premenopausal women, no study has yet been carried out to determine whether it persists in the postmenopausal period.
To document this, a team of US researchers used data from 119 postmenopausal women (average age 61) who had taken part in a clinical trial comparing the effects of estrogen or a moisturizing cream on the vaginal flora. They analyzed both bacterial populations and markers of inflammation (cytokines) in the volunteers’ vaginal fluids to determine whether these two parameters were linked. They found that the women whose vaginal microbiota was the most diverse, or the most depleted in Lactobacillus, had the highest levels of cytokines. These two characteristics of the vaginal microbiota are therefore associated with inflammation, as in premenopausal women.
These results are interesting since they suggest that may one day it be possible, by modulating the vaginal microbiota of postmenopausal women, to limit inflammation of the vaginal mucosa, and thus act preventively to preserve their health.
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