The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic Parameters

The vaginal microbiota, a critical determinant of women’s health, is influenced by hormonal and metabolic parameters across the lifespan. While <i>Lactobacillus</i> species are beneficial markers of vaginal health, microbial composition undergoes pronounced alterations after menopause. T...

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Main Authors: Yi-Chun Chen, Yi-Fen Chiang, Ko-Chieh Huang, Kai-Lee Wang, Yun-Ju Huang, Tzong-Ming Shieh, Mohamed Ali, Shih-Min Hsia
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/13/6/1317
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author Yi-Chun Chen
Yi-Fen Chiang
Ko-Chieh Huang
Kai-Lee Wang
Yun-Ju Huang
Tzong-Ming Shieh
Mohamed Ali
Shih-Min Hsia
author_facet Yi-Chun Chen
Yi-Fen Chiang
Ko-Chieh Huang
Kai-Lee Wang
Yun-Ju Huang
Tzong-Ming Shieh
Mohamed Ali
Shih-Min Hsia
author_sort Yi-Chun Chen
collection DOAJ
description The vaginal microbiota, a critical determinant of women’s health, is influenced by hormonal and metabolic parameters across the lifespan. While <i>Lactobacillus</i> species are beneficial markers of vaginal health, microbial composition undergoes pronounced alterations after menopause. This study aimed to elucidate the associations between vaginal microbiota composition, vaginal pH, menopausal status, and metabolic parameters in Asian women. Vaginal secretion samples were collected from 40 women (20 premenopausal, 20 postmenopausal). Full-length 16S rRNA gene sequencing was used to characterize the microbiota, categorized into Community State Types (CSTs): CST-I + II (<i>Lactobacillus crispatus</i>/<i>gasseri</i>, protective), CST-III (<i>Lactobacillus iners</i>, neutral), and CST-IV (anaerobic bacteria, harmful). Vaginal pH and clinical data were assessed in relation to microbial profiles. CST distribution differed significantly by menopausal status and vaginal pH. Harmful-type CST-IV was more prevalent in postmenopausal women (70% vs. 40%, <i>p</i> < 0.05), while CST-III was dominant in premenopausal women (45% vs. 5%). CST-IV was associated with elevated pH (median 6.00, <i>p</i> = 0.026) and increased abundance of anaerobes including <i>Bacteroides</i>, <i>Fusobacterium</i>, <i>Porphyromonas</i>, <i>Prevotella</i>, and <i>Streptococcus</i>. Oral antibiotic use reduced both beneficial and harmful CSTs, shifting toward neutral CST-III (75%, <i>p</i> = 0.048). Use of sodium–glucose cotransporter-2 (SGLT2) inhibitors in postmenopausal women was associated with a higher prevalence of protective CST-I + II (57.14% vs. 8.33%, <i>p</i> < 0.05), though no significant impact on pathogen presence was observed. This study highlights the dynamic interplay between menopausal status, metabolic interventions, and vaginal microbiota composition. Findings may inform targeted strategies to maintain vaginal health in aging populations.
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spelling doaj-art-b91c7ca14c72441991ea8409503d767b2025-08-20T02:21:04ZengMDPI AGMicroorganisms2076-26072025-06-01136131710.3390/microorganisms13061317The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic ParametersYi-Chun Chen0Yi-Fen Chiang1Ko-Chieh Huang2Kai-Lee Wang3Yun-Ju Huang4Tzong-Ming Shieh5Mohamed Ali6Shih-Min Hsia7School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, TaiwanSchool of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, TaiwanSchool of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, TaiwanSchool of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, TaiwanDepartment of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan City 710301, TaiwanSchool of Dentistry, College of Dentistry, China Medical University, Taichung 404333, TaiwanDepartment of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USASchool of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, TaiwanThe vaginal microbiota, a critical determinant of women’s health, is influenced by hormonal and metabolic parameters across the lifespan. While <i>Lactobacillus</i> species are beneficial markers of vaginal health, microbial composition undergoes pronounced alterations after menopause. This study aimed to elucidate the associations between vaginal microbiota composition, vaginal pH, menopausal status, and metabolic parameters in Asian women. Vaginal secretion samples were collected from 40 women (20 premenopausal, 20 postmenopausal). Full-length 16S rRNA gene sequencing was used to characterize the microbiota, categorized into Community State Types (CSTs): CST-I + II (<i>Lactobacillus crispatus</i>/<i>gasseri</i>, protective), CST-III (<i>Lactobacillus iners</i>, neutral), and CST-IV (anaerobic bacteria, harmful). Vaginal pH and clinical data were assessed in relation to microbial profiles. CST distribution differed significantly by menopausal status and vaginal pH. Harmful-type CST-IV was more prevalent in postmenopausal women (70% vs. 40%, <i>p</i> < 0.05), while CST-III was dominant in premenopausal women (45% vs. 5%). CST-IV was associated with elevated pH (median 6.00, <i>p</i> = 0.026) and increased abundance of anaerobes including <i>Bacteroides</i>, <i>Fusobacterium</i>, <i>Porphyromonas</i>, <i>Prevotella</i>, and <i>Streptococcus</i>. Oral antibiotic use reduced both beneficial and harmful CSTs, shifting toward neutral CST-III (75%, <i>p</i> = 0.048). Use of sodium–glucose cotransporter-2 (SGLT2) inhibitors in postmenopausal women was associated with a higher prevalence of protective CST-I + II (57.14% vs. 8.33%, <i>p</i> < 0.05), though no significant impact on pathogen presence was observed. This study highlights the dynamic interplay between menopausal status, metabolic interventions, and vaginal microbiota composition. Findings may inform targeted strategies to maintain vaginal health in aging populations.https://www.mdpi.com/2076-2607/13/6/1317vaginal microbiotamenopausevaginal pHcommunity state types (CSTs)16S rRNA sequencingmetabolic parameters
spellingShingle Yi-Chun Chen
Yi-Fen Chiang
Ko-Chieh Huang
Kai-Lee Wang
Yun-Ju Huang
Tzong-Ming Shieh
Mohamed Ali
Shih-Min Hsia
The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic Parameters
Microorganisms
vaginal microbiota
menopause
vaginal pH
community state types (CSTs)
16S rRNA sequencing
metabolic parameters
title The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic Parameters
title_full The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic Parameters
title_fullStr The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic Parameters
title_full_unstemmed The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic Parameters
title_short The Vaginal Microbiome: Associations with Vaginal pH, Menopause and Metabolic Parameters
title_sort vaginal microbiome associations with vaginal ph menopause and metabolic parameters
topic vaginal microbiota
menopause
vaginal pH
community state types (CSTs)
16S rRNA sequencing
metabolic parameters
url https://www.mdpi.com/2076-2607/13/6/1317
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