A role for the endometrial microbiome in dysfunctional menstrual bleeding

Area of Science:

• Gynecological microbiology
• Human microbiome research

Background:

• The female upper genital tract's microbial composition is not fully understood.
• Dysfunctional uterine bleeding, including menorrhagia and dysmenorrhea, affects many women.

Purpose of the Study:

• To characterize the microbial communities in the endometrial cavity and endocervix.
• To investigate differences in microbial profiles related to menorrhagia and dysmenorrhea.

Main Methods:

• Collected paired endocervical and endometrial biopsy samples.
• Utilized two-step next-generation sequencing of the 16S rRNA gene (V5-V8 regions).
• Analyzed microbial DNA to profile community composition.

Main Results:

• Endocervix and endometrium share a minor microbial community but harbor distinct populations (p=0.024).
• Distinct microbial profiles were observed between women with menorrhagia and dysmenorrhea (p=0.017).
• Lactobacillus spp. were abundant in 50% of cohorts; Prevotella, Fusobacterium, and Jonquetella were prevalent in nulliparous women.

Conclusions:

• The female upper genital tract is not sterile.
• Microbial community profiling reveals significant differences between the endocervix and endometrium.
• Distinct endometrial microbial profiles correlate with menorrhagia and dysmenorrhea, potentially offering insights into pathology and management.