scholarly journals Effect of Menopausal Hormone Therapy on the Vaginal Microbiota and Genitourinary Syndrome of Menopause in Chinese Menopausal Women

2020 ◽  
Vol 11 ◽  
Author(s):  
Lulu Geng ◽  
Wenjun Huang ◽  
Susu Jiang ◽  
Yanwei Zheng ◽  
Yibei Zhou ◽  
...  
Keyword(s):  
Microbial Diversity ◽  
Hormone Therapy ◽  
Anaerobic Bacteria ◽  
Vaginal Microbiota ◽  
Menopausal Hormone Therapy ◽  
Rrna Gene ◽  
Genitourinary Syndrome Of Menopause ◽  
Menopausal Women ◽  
Significant Difference ◽  
Genitourinary Syndrome

Genitourinary syndrome of menopause (GSM) is a chronic and progressive condition with a series of vulvovaginal, sexual, and lower urinary tract discomforts, mainly due to hypoestrogenism. Menopausal hormone therapy (MHT) has generally been considered as the most effective treatment for GSM. In addition, vaginal microbiota is of particular significance to gynecological and reproductive illnesses and potentially has some intimate connections with GSM. Consequently, we sought to evaluate how MHT impacts the composition and structure of vaginal microbiota while alleviating GSM in Chinese menopausal women aged 45–65 years, which has not been investigated previously. 16S rRNA gene sequencing was performed to analyze microbial diversity and composition using vaginal swabs obtained from 100 menopausal women, classified as MHT women who have been taking tibolone regularly (n = 50) and non-treated women who never received any treatment (n = 50). Vaginal Health Index Score (VHIS) and GSM symptoms inquiry were also performed. We found that the vaginal microbial diversity decreased and that the abundance of Lactobacillus increased to be the dominant proportion significantly in the MHT group, in considerable contrast to vaginal microbiota of the non-treated group, which significantly comprised several anaerobic bacteria, namely, Gardnerella, Prevotella, Escherichia-Shigella, Streptococcus, Atopobium, Aerococcus, Anaerotruncus, and Anaerococcus. In this study, women without any MHT had significantly more severe GSM symptoms than those receiving tibolone, especially with regard to vulvovaginal dryness and burning, as well as decreased libido (P < 0.01). However, there was no significant difference in the severity of urological symptoms between the groups (P > 0.05). Furthermore, Lactobacillus was demonstrated to be associated with VHIS positively (r = 0.626, P < 0.001) and with GSM negatively (r = −0.347, P < 0.001). We also identified Chlamydia (r = 0.277, P < 0.01) and Streptococcus (r = 0.270, P < 0.01) as having a prominent association with more serious GSM symptoms. Our study provided an elucidation that MHT could notably alleviate GSM and conspicuously reshape the composition of the vaginal microbiota, which is of extreme importance to clinical practice for the management of GSM.

scholarly journals Association of Vaginal Microbiota With the Genitourinary Syndrome of Menopause Across Reproductive Stages

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 171-171
Author(s):  
Michelle Shardell ◽  
Patti Gravitt ◽  
Jacques Ravel ◽  
Anne Burke ◽  
Rebecca Brotman
Keyword(s):  
Relative Abundance ◽  
Female Genital Tract ◽  
Signs And Symptoms ◽  
Vaginal Microbiota ◽  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Genitourinary Syndrome ◽  
Lactobacillus Spp

Abstract The genitourinary syndrome of menopause (GSM) is a collection of signs and symptoms related to estrogen decline that involves physical changes to the vulva, vagina, and lower urinary tract. GSM signs and symptoms may occur during any reproductive stage but are most common during menopause. Vaginal microbiota, particularly Lactobacillus spp., protect the female genital tract from multiple conditions; however, Lactobacillus spp. abundance declines during menopause. We aimed to determine the longitudinal association of vaginal microbiota with GSM signs and symptoms across reproductive stages. In a two-year cohort study comprising 750 women aged 35-60 years who contributed 2111 semiannual person-visits, low-Lactobacillus spp. vaginal microbiota communities were observed at 21.2% (169/798), 22.9% (137/597), and 49.7% (356/716) of person-visits among pre-, peri-, and post-menopausal women, respectively (p<.001). After covariate adjustment, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were associated with vulvovaginal atrophy relative to high-Lactobacillus spp. communities dominated by L. crispatus (OR[Odds Ratio]=3.04, 95% Confidence Interval[CI]=1.02-9.06) among post-menopausal, but not among peri- or pre-menopausal women. Also, post-menopausal women with low-Lactobacillus spp. communities reported decreased libido (OR=1.79, 95%CI=1.04-3.12) and vaginal dryness (OR=1.61, 95%CI=0.89-2.90) more frequently than their counterparts with high-Lactobacillus spp. communities, but not among peri- or pre-menopausal women (p for interaction<.05). Specifically, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were related to both decreased libido (OR=2.82, 95%CI=1.11-7.14) and vaginal dryness (OR=3.50, 95%CI=1.18-10.44) compared with high-Lactobacillus spp. communities dominated by L. gasseri/L. jensenii. Vaginal microbiota, particularly Lactobacillus spp., and menopause may synergistically influence GSM.

Association of Vaginal Microbiota with Signs and Symptoms of the Genitourinary Syndrome of Menopause across Reproductive Stages

2021 ◽  
Author(s):  
Michelle Shardell ◽  
Patti E Gravitt ◽  
Anne E Burke ◽  
Jacques Ravel ◽  
Rebecca M Brotman
Keyword(s):  
Postmenopausal Women ◽  
Female Genital Tract ◽  
Premenopausal Women ◽  
Signs And Symptoms ◽  
Amplicon Sequencing ◽  
Vaginal Microbiota ◽  
Gardnerella Vaginalis ◽  
Rrna Gene ◽  
Genitourinary Syndrome Of Menopause ◽  
Genitourinary Syndrome

Abstract The genitourinary syndrome of menopause (GSM) describes signs and symptoms resulting from effects of estrogen deficiency on the female genitourinary tract, including the vagina, labia, urethra, and bladder. Signs/symptoms associated with GSM may occur during any reproductive stage from multiple etiologies but are most common during menopause due to low estrogen. Vaginal microbiota, particularly Lactobacillus spp., are beneficial to the female genital tract; however, their abundance declines during menopause. We aimed to longitudinally assess vaginal microbiota characterized by 16S rRNA gene amplicon sequencing and GSM-associated endpoints across reproductive stages. In a two-year cohort study of 750 women aged 35-60 years at enrollment and 2,111 semiannual person-visits, low-Lactobacillus vaginal microbiota communities were observed at 21.2% (169/798), 22.9% (137/597), and 49.7% (356/716) of person-visits among pre-, peri-, and postmenopausal women, respectively (p<.001). Compared to communities that have high Gardnerella vaginalis relative abundance and diverse anaerobes, the following communities were associated with a lower covariate-adjusted odds of vaginal atrophy: L. crispatus-dominated communities among postmenopausal women (odds ratio[OR]=0.25; 95% confidence interval[CI], 0.08, 0.81), L. gasseri/L. jensenii (OR=0.21; 95%CI, 0.05, 0.94) and L. iners (OR=0.21; 95%CI, 0.05, 0.85) among perimenopausal women, and L. iners-dominated communities (OR=0.18; 95%CI, 0.04, 0.76) among premenopausal women. Postmenopausal women with L. gasseri/L. jensenii-dominated communities had the lowest odds of vaginal dryness (OR=0.36; 95%CI, 0.12, 1.06) and low libido (OR=0.28; 95%CI, 0.10, 0.74). Findings for urinary incontinence were inconsistent. Associations of vaginal microbiota with GSM signs/symptoms are most evident after menopause, suggesting an avenue for treatment and prevention.

scholarly journals Assessing the Concordance Between Urogenital and Vaginal Microbiota: Can Urine Specimens Be Used as a Proxy for Vaginal Samples?

2021 ◽  
Vol 11 ◽  
Author(s):  
Sarah E. Brown ◽  
Courtney K. Robinson ◽  
Michelle D. Shardell ◽  
Johanna B. Holm ◽  
Jacques Ravel ◽  
...  
Keyword(s):  
Vaginal Microbiota ◽  
Reproductive Age ◽  
Urine Samples ◽  
Kappa Statistics ◽  
Rrna Gene ◽  
State Type ◽  
Menopausal Women ◽  
Significant Difference ◽  
Post Menopausal ◽  
Tract Infections

BackgroundThe vaginal microbiota play a key role in defense against reproductive tract infections; however, many population-based women’s health studies do not collect vaginal samples. Molecular examinations of urine samples have revealed common vaginal bacteria. We sought to assess the extent that community state type assignments of archived random-catch and clean-catch urine samples agreed with the paired vaginal samples in both reproductive-age and peri/post-menopausal women.ResultsUsing archived samples, we evaluated the microbiota concordance among women in three studies: two with paired mid-vaginal/random-catch urine (N=91 reproductive-age participants and N=13 peri/post-menopausal participants), and one with paired mid-vaginal/clean-catch urine (N=99 reproductive-age participants). Microbiota composition was characterized by sequencing amplicons of the 16S rRNA gene V3-V4 regions and assigned to community state types. Similarity of paired samples was gauged using agreement of community state types and Yue-Clayton θ indices. Analysis of Composition of Microbiomes II indicated which taxa were differently relatively abundant in paired vaginal and urine samples. In reproductive-age women, random-catch and clean-catch urines were 89.0% and 86.9% concordant on five community state types with paired mid-vaginal swabs, and Kappa statistics indicated almost perfect agreement (κrandom-catch=.85, κclean-catch=.81, p<0.0001). A small number of pairs of samples were discordant (23/190, 12%), and discordant pairs tended to be between samples classified to L. iners-dominated and/or low-Lactobacillus states. Concordance and agreement remained similar when dichotomizing the microbiota to Lactobacillus-dominated versus low-Lactobacillus microbiota, as well as when evaluating separately the three subtypes of the low-Lactobacillus community state type IV. Median similarity of paired urine/vaginal samples was high (θrandom-catch=.85, θclean-catch=.88), and a comparison of the random-catch and clean-catch similarity scores showed no significant difference (p=.80). Concordance and similarity were lower for peri/post-menopausal women, but agreement remained substantial (76.9% concordant, κrandom-catch= 0.64, θrandom-catch=.62). Taxonomic-level analysis confirmed these findings.ConclusionsRandom-catch and clean-catch urine samples showed substantial agreement on bacterial composition to paired mid-vaginal samples, indicating that the genitourinary microbiota may be a reliable proxy for assessing the overall composition of the vaginal microbiota via community state types. This data suggests that urine samples can, with proper interpretation, be utilized as a surrogate for developing preliminary data and hypothesis-generating studies.

THE PROBLEM OF OSTEOPOROSIS IN MENOPAUSAL WOMEN AND POSSIBLE SOLUTIONS

2021 ◽  
Vol 2 (1) ◽  
pp. 15-17
Author(s):  
Maiorova M.O.
Keyword(s):  
Hormone Therapy ◽  
Bone Tissue ◽  
Calcium Metabolism ◽  
Management Strategy ◽  
Menopausal Hormone Therapy ◽  
Effective Management ◽  
Treatment Of Osteoporosis ◽  
Menopausal Women ◽  
Prevention And Treatment

41 women with osteoporosis were examined. The age of the examined people ranged from 50 to 60 years. All the women were postmenopausal. As a result of the study, it was found that the most effective management strategy for such patients is a combination of menopausal hormone therapy and non-hormonal drugs that affect calcium metabolism in bone tissue, improve its metabolism and reduce resorption. If there are contraindications to MGT, prevention and treatment of osteoporosis should also be carried out using the appointment of non-hormonal drugs. In this case, the use of ipriflavone is effective.

scholarly journals The nasopharyngeal, ruminal, and vaginal microbiota and the core taxa shared across these microbiomes in virgin yearling heifers exposed to divergent in utero nutrition during their first trimester of gestation and in pregnant beef heifers in response to mineral supplementation

2021 ◽  
Author(s):  
Samat Amat ◽  
Devin B Holman ◽  
Kaycie Schmidt ◽  
Ana Clara B Menezes ◽  
Friederike Baumgaertner ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
First Trimester ◽  
Nervous System Development ◽  
Vaginal Microbiota ◽  
Rrna Gene ◽  
Beef Heifers ◽  
Mineral Supplement ◽  
Alpha And Beta Diversity ◽  
Significant Difference

Emerging evidence has indicated that microbial transmission from the bovine dam to her fetus may take place before birth, and that the maternal microbiota during pregnancy modulates programming of fetal metabolic and nervous system development, highlighting the potential and extended role of the maternal microbiome in calf health and development. In the present study, we characterized the nasopharyngeal, ruminal and vaginal microbiota from two cohorts of beef heifers managed at the same location: 1) virgin yearling heifers (9 months old) born from dams received gestational diets which resulted in low (LG, n = 22) or medium (MG, n = 23) weight gain during the first 84 days of gestation; and 2) pregnant replacement heifers that received a vitamin and mineral supplement (VTM, n = 17) or not (Control, n = 15) during the first 6 months of gestation. Nasopharyngeal and vaginal swabs as well as ruminal fluid were collected from both cohorts and the microbiota of each sample was assessed using 16S rRNA gene sequencing. In addition to the comparison between treatment groups within each cohort, the similarity of the microbiota of the three sample types were evaluated, and shared taxa amongst these communities were identified. The bacterial genera present in the rumen and vagina that can influence methanogenic archaeal genera were predicted using a stepwise-selected generalized linear mixed model. No significant difference was observed in the alpha and beta diversity in any of the nasopharyngeal, ruminal and vaginal microbiota between LG and MG offspring virgin heifers, or between the control and VTM pregnant heifers (p > 0.05). Subtle compositional changes in the vaginal microbiota in yearling heifers, and in the nasopharyngeal and ruminal microbiota of pregnant heifers were detected in response to treatments. Forty-one archaeal and bacterial OTUs were shared by over 60% of all samples from both virgin and pregnant heifers. Two taxa within the Methanobrevibacter genus were identified as core taxa and this genus was more relatively abundant in pregnant heifers compared to virgin heifers. Among the 25 top genera, Prevotella and Prevotella UCG-003 (negative) and Christensenellaceae R-7 group (positive) were predicted to have a significant effect on ruminal Methanobrevibacter spp. The results of this study indicate that there is little impact of divergent gestational nutrition during the first trimester on the calf microbiome at 9 months postnatal, and that VTM supplementation during pregnancy may not alter the maternal microbiome. This study provides evidence that there are several microbial taxa, including methanogenic archaea, that are shared across the respiratory, gastrointestinal, and reproductive tracts, suggesting the need for a holistic evaluation of the bovine microbiota when considering potential maternal sources for seeding calves with pioneer microbiota.

scholarly journals Identification of Vaginal Microbial Communities Associated with Extreme Cervical Shortening in Pregnant Women

2020 ◽  
Vol 9 (11) ◽  
pp. 3621
Author(s):  
Monica Di Paola ◽  
Viola Seravalli ◽  
Sara Paccosi ◽  
Carlotta Linari ◽  
Astrid Parenti ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Microbial Communities ◽  
Inflammatory Responses ◽  
Critical Role ◽  
Anaerobic Bacteria ◽  
Vaginal Microbiota ◽  
Rrna Gene ◽  
Spontaneous Preterm Birth ◽  
Short Cervix ◽  
Lactobacillus Spp

The vaginal microbiota plays a critical role in pregnancy. Bacteria from Lactobacillus spp. are thought to maintain immune homeostasis and modulate the inflammatory responses against pathogens implicated in cervical shortening, one of the risk factors for spontaneous preterm birth. We studied vaginal microbiota in 46 pregnant women of predominantly Caucasian ethnicity diagnosed with short cervix (<25 mm), and identified microbial communities associated with extreme cervical shortening (≤10 mm). Vaginal microbiota was defined by 16S rRNA gene sequencing and clustered into community state types (CSTs), based on dominance or depletion of Lactobacillus spp. No correlation between CSTs distribution and maternal age or gestational age was revealed. CST-IV, dominated by aerobic and anaerobic bacteria different than Lactobacilli, was associated with extreme cervical shortening (odds ratio (OR) = 15.0, 95% confidence interval (CI) = 1.56–14.21; p = 0.019). CST-III (L. iners-dominated) was also associated with extreme cervical shortening (OR = 6.4, 95% CI = 1.32–31.03; p = 0.02). Gestational diabetes mellitus (GDM) was diagnosed in 10/46 women. Bacterial richness was significantly higher in women experiencing this metabolic disorder, but no association with cervical shortening was revealed by statistical analysis. Our study confirms that Lactobacillus-depleted microbiota is significantly associated with an extremely short cervix in women of predominantly Caucasian ethnicity, and also suggests an association between L. iners-dominated microbiota (CST III) and cervical shortening.

Use of menopausal hormone therapy in the correction of cognitive impairment in menopausal women

2018 ◽  
Vol 12_2018 ◽  
pp. 157-162 ◽  
Author(s):  
Gasparyan S.A. Gasparyan ◽  
Drosova L.D. Drosova ◽  
Karpov S.M. Karpov ◽  
Khripunova A.A. Khripunova ◽  
Keyword(s):  
Cognitive Impairment ◽  
Hormone Therapy ◽  
Menopausal Hormone Therapy ◽  
Menopausal Women

scholarly journals The Nasopharyngeal, Ruminal, and Vaginal Microbiota and the Core Taxa Shared across These Microbiomes in Virgin Yearling Heifers Exposed to Divergent In Utero Nutrition during Their First Trimester of Gestation and in Pregnant Beef Heifers in Response to Mineral Supplementation

2021 ◽  
Vol 9 (10) ◽  
pp. 2011
Author(s):  
Samat Amat ◽  
Devin B. Holman ◽  
Kaycie Schmidt ◽  
Ana Clara B. Menezes ◽  
Friederike Baumgaertner ◽  
...  
Keyword(s):  
Reproductive Tract ◽  
Average Daily Gain ◽  
Methanogenic Archaea ◽  
16S Rrna Gene Sequencing ◽  
First Trimester ◽  
Vaginal Microbiota ◽  
Rrna Gene ◽  
Beef Heifers ◽  
Β Diversity ◽  
Significant Difference

In the present study, we evaluated whether the nasopharyngeal, ruminal, and vaginal microbiota would diverge (1) in virgin yearling beef heifers (9 months old) due to the maternal restricted gain during the first trimester of gestation; and (2) in pregnant beef heifers in response to the vitamin and mineral (VTM) supplementation during the first 6 months of pregnancy. As a secondary objective, using the microbiota data obtained from these two cohorts of beef heifers managed at the same location and sampled at the same time, we performed a holistic assessment of the microbial ecology residing within the respiratory, gastrointestinal, and reproductive tract of cattle. Our 16S rRNA gene sequencing results revealed that both α and β-diversity of the nasopharyngeal, ruminal and vaginal microbiota did not differ between virgin heifers raised from dams exposed to either a low gain (targeted average daily gain of 0.28 kg/d, n = 22) or a moderate gain treatment (0.79 kg/d, n = 23) during the first 84 days of gestation. Only in the vaginal microbiota were there relatively abundant genera that were affected by maternal rate of gain during early gestation. Whilst there was no significant difference in community structure and diversity in any of the three microbiota between pregnant heifers received no VTM (n = 15) and VTM supplemented (n = 17) diets, the VTM supplementation resulted in subtle compositional alterations in the nasopharyngeal and ruminal microbiota. Although the nasopharyngeal, ruminal, and vaginal microbiota were clearly distinct, a total of 41 OTUs, including methanogenic archaea, were identified as core taxa shared across the respiratory, gastrointestinal, and reproductive tracts of both virgin and pregnant heifers.

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