Menopausal Changes in the Microbiome-A Review Focused on the Genitourinary Microbiome

Area of Science:

• Microbiology
• Gynecology
• Urology

Background:

• A balanced host-microbiome interaction is vital for health.
• Gut and vaginal microbiomes are well-studied in women's health, but the urinary microbiome is less understood.
• Interactions between gut, vaginal, and urinary microbiomes are an emerging research area.

Purpose of the Study:

• To explore the impact of menopause-induced hormonal changes on the urinary microbiome.
• To investigate the association between urinary microbiome dysbiosis and genitourinary symptoms in postmenopausal women.
• To highlight the need for further research into the urinary microbiome's role in postmenopausal urinary tract diseases.

Main Methods:

• Review of existing literature on the gut, vaginal, and urinary microbiomes in relation to female health and menopause.
• Analysis of studies examining changes in microbial composition and diversity postmenopause.
• Correlation of observed microbiome shifts with specific genitourinary conditions.

Main Results:

• Menopause is associated with significant alterations in the urinary microbiome.
• Postmenopausal changes include increased alpha diversity and decreased levels of Lactobacillus in urine.
• Urinary microbiome dysbiosis is linked to conditions such as urgency, urinary incontinence, interstitial cystitis, and neuropathic bladder.

Conclusions:

• Hormone-induced changes during menopause significantly impact the urinary microbiome.
• Alterations in the urinary microbiome, particularly reduced Lactobacillus, may precede conditions like recurrent cystitis.
• Further research is essential to understand the role of the menopausal urinary microbiome in the development of urinary tract diseases.