Department of Obstetrics and Gynecology, University of Maryland School of Medicine, Baltimore, MD.
Menopause. 2024 Jun 1;31(6):537-545. doi: 10.1097/GME.0000000000002358.
Menopause is often accompanied by lowered Lactobacillus spp. relative abundance and increased abundance of diverse anaerobic/aerobic bacteria in the vaginal microbiota due in part to declines in estrogen. These microbiota are associated with urogenital symptoms and infections. In premenopause, vaginal microbiota can fluctuate rapidly, particularly with menstrual cycles and sexual activity; however, the longitudinal dynamics of vaginal microbiota are understudied in peri- and postmenopause. We described vaginal community stability across reproductive stages.
Pre- (n = 83), peri- (n = 8), and postmenopausal (n = 11) participants provided twice-weekly mid-vaginal samples (total, 1,556; average, 15 per participant) over 8 weeks in an observational study. Composition of the vaginal microbiota was characterized by 16S rRNA gene amplicon sequencing, and a community state type (CST) was assigned to each sample. Clustering of longitudinal CST profiles, CST transition rates, duration of low-Lactobacillus/high bacterial diversity CSTs, and other metrics of bacterial community dynamics were assessed across reproductive stages.
The proportion of participants with longitudinal CST profiles characterized by low-Lactobacillus CSTs was similar among pre- (38.6%), peri- (37.5%), and postmenopausal (36.4%) participants (P = 0.69). CST transition rates between consecutive samples were 21.1%, 16.7%, and 14.6% for pre-, peri-, and postmenopausal participants, respectively (P = 0.49). Low-Lactobacillus CST tended to persist for at least 4 weeks, irrespective of reproductive stage.
Findings from this small yet frequently sampled cohort revealed vaginal bacterial fluctuations over 8 weeks that were similar across reproductive stages. Larger and longer-term studies based on these preliminary data could provide insights into the influence of microbiota dynamics on urogenital outcomes during menopause.
由于雌激素水平下降，绝经后阴道微生物群中的乳酸杆菌相对丰度降低，多种厌氧/需氧细菌丰度增加，这在一定程度上导致了绝经。这些微生物群与泌尿生殖症状和感染有关。在绝经前，阴道微生物群可能会迅速波动，特别是在月经周期和性行为期间；然而，绝经前后阴道微生物群的纵向动态变化研究较少。我们描述了整个生殖阶段阴道群落的稳定性。
在一项观察性研究中，共 83 名绝经前、8 名绝经中和 11 名绝经后参与者在 8 周内每周两次提供阴道中段样本（共 1556 个；每个参与者平均 15 个）。通过 16S rRNA 基因扩增子测序来描述阴道微生物群的组成，并为每个样本分配一个社区状态类型（CST）。评估了生殖阶段之间纵向 CST 图谱聚类、CST 转换率、低乳酸杆菌/高细菌多样性 CST 持续时间和其他细菌群落动态指标。
具有低乳酸杆菌 CST 特征的纵向 CST 图谱的参与者比例在绝经前（38.6%）、绝经中和绝经后（37.5%和 36.4%）参与者中相似（P=0.69）。绝经前、绝经中和绝经后参与者连续样本之间的 CST 转换率分别为 21.1%、16.7%和 14.6%（P=0.49）。低乳酸杆菌 CST 倾向于持续至少 4 周，与生殖阶段无关。
这项小样本但经常采样的队列研究发现，8 周内阴道细菌波动在生殖阶段相似。基于这些初步数据的更大和更长时间的研究可以深入了解微生物群动态对绝经期间泌尿生殖结局的影响。
