The cervicovaginal gut microbiota axis as a key determinant of systemic physiology

The gut and vaginal microbiomes are both essential to human health, yet they have largely been studied in isolation. Gut microbiota are central to host metabolism, immunity, and the gut-brain axis, while the vaginal microbiome, typically dominated by Lactobacillus species, protects against infection and shapes reproductive outcomes. Although dysbiosis at either site has been linked to systemic disease, the possibility that these communities are interrelated and that the vaginal microbiome could serve as a clinically accessible proxy for systemic microbial states remains underexplored. This represents a clear gap in the literature. In this review, we examine physiological connections between digestive and genitourinary systems, explore how endocrine and immune networks exert dual control across compartments, and analyze correlations between dysbiosis and disease states. We then consider emerging technologies for microbiome analysis and their clinical and translational implications, including the potential for vaginal microbiome profiling to function as a diagnostic surrogate for the gut and as a complementary biomarker platform for prediction of neurologic disease risk. By building a systems-level understanding of the joint immuno-microbial interactome, evaluating advances in computational and omics-based technologies, and situating these tools within emerging healthcare frameworks, we argue that the cervicovaginal-gut microbiota axis is a unique and understudied source for medical discovery.