The role of microbiota in the management of genitourinary syndrome of menopause

Abstract

It is estimated that the 25–50% of women who are reaching menopause every year report symptoms related to the genitourinary syndrome of menopause (GSM). The symptoms are not due simply to lack of estrogen. One possible contributing cause of symptoms is the vaginal microbiota. The vaginal microbiota is a dynamic entity and plays a critical role in the pathogenic interplay of postmenopausal changes. Treatment of this syndrome depends on the severity and type of the symptoms and on the preferences and expectations of women. As there are many treatment options, therapy should be individualized. While new evidence on the role of Lactobacilli in premenopause is emerging, the role of Lactobacilli is still unclear in GSM and the impact of microbiota on vaginal health remains conflictual. However, some reports show promising data on the effect of probiotic therapy in menopause. In the literature there are few studies and small population samples on the role of an exclusive therapy with Lactobacilli and further data will be mandatory. Studies involving large numbers of patients and different intervention periods will be necessary to obtain evidence of the preventive and curative role of vaginal probiotics.

摘要

据估计, 每年有25-50%的绝经期女性出现绝经泌尿生殖系统综合征(GSM)相关症状。这些症状并不仅仅因为缺乏雌激素。阴道菌群改变也可能是引起该症状的原因之一。阴道微生物群是一个动态变化的群体, 在绝经后女性身体变化中起着关键作用。治疗取决于症状的严重程度和类型以及女性的偏好和期望。有许多治疗选择, 需要治疗个体化。虽然近些年出现了关于乳杆菌在绝经前作用的证据, 但乳杆菌在GSM中的作用仍不清楚, 微生物群对阴道健康的影响仍然存在争议。然而, 一些研究报道了益生菌治疗绝经症状有效数据。在文献中, 关于乳酸菌治疗的GSM的研究很少并且都是小群体样本, 需要进一步研究。为了获得阴道益生菌预防和治疗作用的证据, 有必要进行大样本和不同干预方式的研究。

Keywords:

• Genitourinary syndrome of menopause
• menopause
• microbiota
• Lactobacilli
• vulvovaginal atrophy
• management
• therapy

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Source of funding

Nil.