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Menopause01:28

Menopause

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Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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Vagina01:26

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The vaginal canal is a tubular structure averaging about 10 cm in length that acts as the entryway to the female reproductive system and the passageway for menstrual flow and childbirth. The interior walls of the vagina exhibit concentric folds called rugae and are topped by an area known as the fornix, which connects with the protruding cervical portion of the uterus. This canal is comprised of an external fibrous layer, a muscular middle layer, and an inner lining with mucosal rugae, which...
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Hormonal Regulation of the Menstrual Cycle01:22

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The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
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Disorders of the Female Reproductive System01:24

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The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
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Surface Membrane Barriers01:18

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The skin and mucous membranes serve as the primary line of defense against pathogens by providing both physical and chemical protection. These barriers are essential in preventing the entry and establishment of microbes, thereby maintaining the integrity of the host.
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In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
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Menopause and the vaginal microbiome.

Alicia L Muhleisen1, Melissa M Herbst-Kralovetz2

  • 1Department of Obstetrics and Gynecology, Banner University Medical Center- Phoenix, Phoenix 85004, USA; Department of Basic Medical Sciences, University of Arizona, College of Medicine- Phoenix, Phoenix 85004, USA.

Maturitas
|July 25, 2016
PubMed
Summary

Menopause alters the vaginal microbiome, impacting women's health. Hormone therapy and probiotics show promise in restoring vaginal balance and alleviating symptoms, though more research is needed.

Keywords:
Anaerobic bacteriaBacterial vaginosisLactobacillus spp.ProbioticsSexual and vaginal healthVaginal drynessVaginal epitheliumVaginal microbiotaVulvovaginal atrophy

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Area of Science:

  • Gynecology
  • Microbiology
  • Reproductive Health

Background:

  • Vaginal homeostasis is maintained by bacteria; dysbiosis is linked to poor gynecologic health.
  • The vaginal microbiome significantly impacts postmenopausal women's vulvovaginal atrophy, dryness, sexual health, and quality of life.
  • Evolving molecular techniques have expanded understanding of vaginal bacterial community diversity.

Purpose of the Study:

  • To review changes in the menopausal vaginal microbiota.
  • To outline microbiome alterations linked to specific menopausal symptoms.
  • To define the impact of hormone replacement therapy (HRT) on the vaginal microbiome and menopausal symptoms.
  • To consider probiotics for restoring vaginal homeostasis post-menopause.

Main Methods:

  • Review of studies on Lactobacillus species and vaginal homeostasis.
  • Analysis of how vaginal microbiome structure changes with decreasing estrogen levels in postmenopausal women.
  • Description of microanatomical vaginal epithelium changes leading to menopausal symptoms.
  • Evaluation of HRT's direct influence on Lactobacillus dominance and symptom resolution.
  • Assessment of preliminary probiotic studies for modulating vaginal homeostasis.

Main Results:

  • Decreasing estrogen levels in menopause alter vaginal microbiome structure.
  • Microanatomical changes in the vaginal epithelium contribute to menopausal symptoms.
  • Hormone replacement therapy promotes Lactobacillus dominance and resolves vaginal symptoms.
  • Probiotic interventions show potential for restoring vaginal homeostasis.

Conclusions:

  • The vaginal microbiome undergoes significant changes during menopause, influenced by estrogen levels.
  • Hormone replacement therapy is effective in modulating the vaginal microbiome and alleviating menopausal symptoms.
  • Probiotics present a promising avenue for restoring vaginal homeostasis, but further clinical trials are necessary to confirm efficacy.