The Vaginal Microbiome: II. Vaginal Dysbiotic Conditions.

Area of Science:

• Gynecology
• Microbiology
• Reproductive Health

Background:

• The vaginal microbiome (VMB) plays a critical role in women's health.
• Lactobacillus-dominant microbiota are considered optimal for vaginal health.
• Dysbiosis refers to an imbalance in the VMB, often characterized by lactobacilli depletion.

Purpose of the Study:

• To review recent findings on the vaginal bacterial microbiota.
• To focus on conditions of vaginal dysbiosis relevant to clinicians.
• To summarize understanding of bacterial vaginosis (BV) and related disorders.

Main Methods:

• PubMed database search using terms: "vaginal microbiome," "dysbiosis," "bacterial vaginosis," "cytolytic vaginosis," "desquamative inflammatory vaginitis," and "aerobic vaginitis."
• Review of full article texts.
• Screening of reference lists for additional relevant studies.

Main Results:

• Vaginal dysbiosis is typically characterized by a depletion of lactobacilli.
• Bacterial vaginosis (BV) is the most common dysbiotic condition, a polymicrobial disorder causing vaginal discharge.
• Other reviewed conditions include desquamative inflammatory vaginitis, aerobic vaginitis, and the controversial cytolytic vaginosis.

Conclusions:

• Bacterial vaginosis (BV) exhibits complex microbiology with potential impacts from Gardnerella heterogeneity and bacterial biofilms.
• The etiology and persistence of BV may involve bacterial biofilms.
• The absence of lactobacilli does not always correlate with an overgrowth of anaerobic bacteria.