Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Gynecology and Physiopathology of Human Reproduction Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Surgical and Medical Sciences, S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti, 9, Bologna 40138, Italy.
Maturitas. 2022 May;159:7-14. doi: 10.1016/j.maturitas.2021.12.007. Epub 2021 Dec 18.
Vulvo-vaginal atrophy (VVA) is a highly prevalent chronic condition affecting the lives of postmenopausal women. Ospemifene and systemic hormone therapy (HT) improve vaginal health. This study aims to characterize the vaginal metabolic profile of women with VVA at baseline and after ospemifene and systemic HT.
Sixty postmenopausal women, 32 of whom were affected by VVA, were consecutively enrolled. The vaginal metabolic profile of women with and without VVA at baseline and after three months of ospemifene or HT treatment was assessed.
The following parameters were evaluated: (i) the Vaginal Health Index; (ii) the Vaginal Maturation Index; and (iii) vaginal metabolic profile, by means of H NMR spectroscopy.
The vaginal metabolome of postmenopausal women with VVA was different from that of postmenopausal women without VVA, including a more profound decrease in the levels of lactate and several amino acids, typically found in eubiosis, together with an enrichment of molecules derived from anaerobes and gut microbes. After 3 months, ospemifene and HT had modified the vaginal metabolome of the women with VVA, specifically by increasing the levels of beneficial molecules (e.g., lactate, leucine, glycine) and reducing those involved in dysbiosis (e.g., formate). HT improved the vaginal metabolome to a lesser extent.
The vaginal metabolic profile of postmenopausal women with VVA differs from that of postmenopausal women without VVA. Our preliminary data show that both ospemifene and HT treatment increase the levels of molecules beneficial for vaginal health and reduce the levels of those involved in dysbiosis. HT improves the vaginal metabolic profile to a lower extent than ospemifene over the course of three months.
外阴阴道萎缩（VVA）是一种高发的慢性疾病，影响绝经后女性的生活。Ospemifene 和全身激素治疗（HT）可改善阴道健康。本研究旨在描述基线时和接受 ospemifene 或全身 HT 治疗 3 个月后 VVA 女性的阴道代谢特征。
连续纳入 60 名绝经后女性，其中 32 名患有 VVA。评估基线时和接受 ospemifene 或 HT 治疗 3 个月后 VVA 和非 VVA 女性的阴道代谢特征。
（i）阴道健康指数；（ii）阴道成熟指数；（iii）通过 H NMR 光谱评估阴道代谢谱。
患有 VVA 的绝经后女性的阴道代谢组与不患有 VVA 的绝经后女性不同，包括乳酸和几种氨基酸水平显著降低，这些氨基酸通常存在于正常菌群中，同时富含来自厌氧菌和肠道微生物的分子。治疗 3 个月后，ospemifene 和 HT 改变了患有 VVA 的女性的阴道代谢组，具体表现为增加有益分子（如乳酸、亮氨酸、甘氨酸）的水平和减少与失调相关的分子（如甲酸盐）的水平。HT 的改善程度较小。
患有 VVA 的绝经后女性的阴道代谢组与不患有 VVA 的绝经后女性不同。我们的初步数据表明，ospemifene 和 HT 治疗均可增加有益于阴道健康的分子水平，并降低与失调相关的分子水平。在 3 个月的疗程中，HT 对阴道代谢组的改善程度低于 ospemifene。
