Vagina is generally denigrated organ that is meant for only a channel for sperm entry, vaginal discharge during menstruation, and delivering babies. However, now studies indicate that this organ greatly affects the health of future generations as long-term features of a fetus are programmed in the womb itself. During a woman’s lifespan, the microbiome undergoes striking changes that correspond with age, hormonal status, and lifestyle changes. In childhood, the internal lining of the vagina is thin, and small rod shaped bacteria that do not require oxygen for growth (anaerobes) preponderate in the vagina. With the beginning of puberty and the estrogenic cycle, the vaginal lining thickens and starts secreting glucose. These changes considerably influence the microbiome for the germs that ferment glucose producing acidic environment in the vagina. The adult human vagina is an exceptional organ that has reduced bacterial diversity in a healthy status. Most bacteria found in the vagina are lactic acid bacteria and specifically belonging to the Lactobacillus group of bacteria[in Latin Lacto is milk and bacillus means slender rod shaped]. The required nutrients for microbiome are derived from secretions of the vaginal lining. The vaginal mucosal lining is a physical barrier that provides protection against infections through the cooperation between mucosal cells, the immune system and colonizing microbiome. Today, we know that vaginal health depends a lot on the constitution of its microbiome and some salient features of research facts are as follows:
- Vaginal Lactobacillus has important health-promoting effects on the reproductive fitness of women. The reproductive microbiome associated with male and female tissues is possibly involved in human reproduction. It is likely that intervention in the microbiome can be done to improve fertility, conception, healthy pregnancy, microbial seeding of the infant, and to prevent preterm birth.
- Establishment of the microbiome of the neonate mainly occurs during the delivery and depends on its type i.e. Vaginal or Caesarean delivery. The inoculum may be largely derived either from the mother’s vaginal and faecal microbiota (in a conventional vaginal birth)
- There is increasing evidence that the intrauterine environment including its microbiome has a vital role in mediating the effects of maternal stress during pregnancy on nervous system development of fetus.
- Bacterial infections of the vagina called ‘vaginosis’ is the most frequently occurring abnormal vaginal condition in women with vaginal discharge and malodor that primarily happens due to disruption of normal vaginal microbiome.
- A healthy state of vaginal microbiome is maintained by both commensal and disease-causing bugs termed as pathogens. Lactobacillus can form small colonies that adhere to the vaginal lining thereby creating a physical barrier against harmful bacteria. Lactobacillus is a known stimulator of host defense mechanisms and it also works against a variety of vaginal pathogens causing urinary tract infections and sexually transmitted diseases such as gonorrhea, and Chlamydia. The use of Lactobacillus is regarded as an alternative for the prevention and treatment of vaginal Candida infections.
- Increased inflammation of vagina due to dreadful germs is associated with increased HIV threats. Women with a healthy state of microbiome accommodate Lactobacillus as a dominant bacterium that is also reported to have less probability of acquiring viral pathogens including HIV. However, those having dysbiosis in the vaginal microbiome are especially dominated by anaerobic bacteria have a greater risk of acquiring viral pathogens.
- A study involving women practicing cervical cap and diaphragm–spermicide based birth control methods were associated with an increase in anaerobic microbiome leading to vaginal dysbiosis.
Dr. Milind S. Patole & Nitin Bayal
Dr. Milind Patole is Scientist ‘G’ at the National Centre for Cell Science, Pune. Nitin Bayal is Ph.D. scholar at National Centre for Cell Science, Pune
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