Dysbiosis of the vaginal microbiome

Dysbiosis of the vaginal microbiome refers to an imbalance in the natural bacterial community. Specifically, a disruption to the normal dominance of beneficial bacteria like lactobacilli, where a highly diverse state of opportunistic anaerobic and aerobic microbes takes hold instead. Opportunistic bacteria likely translocate from the gut or they may come from a partner.

In a dysbiotic vaginal microbiome, microbial diversity is accompanied with increased mucosal inflammation and immune cell activation within the vaginal tract. In some cases, dysbiosis can be symptomatic, and present with symptoms such as discharge, burning and an unusual odour.

Aerobic Vaginitis (AV) and Vulvovaginal Candidiasis (VVC) tend to present with symptoms in women, but Bacterial Vaginosis (BV) can be asymptomatic in up to 50% of women. Dysbiosis, characterised by loss of lactobacillus dominance and increased microbial diversity, has been linked to an increased risk of:

• Genital tract diseases such as AV, BV and Vulvovaginal Candidiasis (VVC) (vaginal and vulval thrush)
  
• Urinary tract infections (UTIs) and related urinary symptoms
  
• Sexually Transmitted Infections (STIs)
  
• Pelvic Inflammatory Disease (PID)
  
• Human Papilloma Virus (HPV) persistence and cervical cancer
  
• Poorer fertility outcomes (infertility, miscarriage, pre-term birth and newborn infection)
  
• Possible progression of inflammatory condition Endometriosis
  Toxic shock syndrome