Age-related aspects of vaginal microbiocenosis and the prevalence of opportunistic mycoplasmas in gynecologically healthy women
AbstractThe vaginal microbiome, changing throughout life from the neonatal period to postmenopause, largely determines the quality of life of a woman. In newborn girls, the vaginal microbiome is mainly dependent on the presence of transplacental estrogens and is similar to the maternal microbiome. The vaginal microbiome of girls is poor and, as puberty approaches, it begins to be enriched with lactobacilli. The basis of the vaginal microbiome of women of reproductive age is lactobacilli. In women undergoing the menopausal transition or menopause, changes in the composition of the vaginal microflora are associated with depletion of lactoflora. Lactobacilli may not completely disappear from the vaginal biotope, however, how often and in what proportion they are present in women of different age groups is not clear. Conditionally pathogenic genital mycoplasmas (mollicutes) often colonize the urogenital tract of women who do not present any complaints, but their detection may cause concern for patients and doctors.
The aim of the study was to determine the age aspects of vaginal microbiocenosis, the species composition of lactobacilli and the prevalence of opportunistic mycoplasmas in gynecologically healthy women undergoing periodic preventive examinations by a gynecologist.
Material and methods. 203 women aged 18–78 years who visited a gynecologist for periodic preventive examinations were examined. All patients were divided into 3 age groups: group 1 – up to 45 years (reproductive age) – 101 women; group 2 – 46–52 years (menopausal transition period) – 31 women; group 3 – over 53 years old (menopause) – 71 women. All patients underwent molecular biological studies.
Results. In 99% of gynecologically healthy non-pregnant women under the age of 45, lactobacilli are present in the vaginal biotope, while the predominantly lactobacillary type of microbiocenosis was detected in 66.3% of cases. Lactobacilli were found in most women in older age groups, but their concentration and species diversity were less than in women of reproductive age. Lactobacillus iners is the most common species of lactobacilli in the study population. The dominance of Lactobacillus crispatus was more often determined in women of reproductive age. Colonization with genital mycoplasmas was: Ureaplasma parvum in 26% of women, Ureaplasma urealyticum in 2% and Mycoplasma hominis in 4.4%. Ureaplasma was found in women of all age groups. Ureaplasma parvum was more common in women of reproductive age, and Mycoplasma hominis was found only in women of reproductive age, and in clinically significant quantities in patients with severe vaginal dysbiosis. G. vaginalis was more often found in postmenopausal women. The vaginal microbiome in postmenopausal women is characterized by greater diversity and lower concentration of microorganisms.
Conclusion. The prevalence of opportunistic mycoplasmas depends on the age and sexual activity of women. Ureaplasma is not associated with disorders of the vaginal microbiocenosis. A high bacterial load of Mycoplasma hominis is associated with dysbiotic disorders of the vaginal biotope in women of reproductive age. An increase in the species diversity of vaginal microbiome during menopausal transition and postmenopause is associated with a decrease in estrogen levels.
Keywords: vaginal microbiome; vaginal lactobacilli; reproductive age; menopausal transition; postmenopause; opportunistic genital mycoplasmas
Funding. The work was carried out within the framework of the initiative theme.
Conflict of interest. The authors declare no conflict of interest.
Contribution. Concept and design of the study – Savicheva A.M.; taking an anamnesis, clinical examination and obtaining test material – Vorobyova N.E., Shirshova N.Yu.; performing laboratory tests – Budilovskaya O.V., Krysanova A.A., Khusnutdinova T.A., Shalepo K.V.; collection and processing of material, statistical data processing, text writing – Budilovskaya O.V., Cheberya A.S., Cheberya A.R., Vasilyeva S.K.; editing – Savicheva A.M., Shirshova N.Yu. All the authors made a significant contribution to the research and preparation of the article, read and approved the final version before publication.
Approval of the Ethics Committee. The study was approved by the local Ethics Committee of the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott, Protocol No. 130 dated 11/14/2023.
For citation: Budilovskaya O.V., Cheberya A.S., Cheberya A.R., Vasilyeva S.K., Vorobyova N.E., Shirshova N.Yu., Khusnutdinova T.A., Krysanova A.A., Shalepo K.V., Savicheva A.M. Age-related aspects of vaginal microbiocenosis and the prevalence of opportunistic mycoplasmas in gynecologically healthy women. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2024; 12 (2): 21–9. DOI: https://doi.org/10.33029/2303-9698-2024-12-2-21-29 (in Russian)
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