Page 35 - JCTR-11-5

Journal of Clinical and

Translational Research

REVIEW ARTICLE
Alterations in vaginal and urinary microbiota

in menopause and associated pathologies: A
narrative review

Alfredo Ovalle *
1,2
1 Service of Obstetrics, Gynecology and Neonatology, San Borja Arriarán Clinical Hospital, Santiago,
Chile
2 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Chile, Santiago, Chile

Abstract

Background: In the premenopausal stage, the vaginal microbiota is characterized
by a high abundance of Lactobacillus, a key genus for preserving a healthy vaginal
environment. However, the estrogen decline associated with menopause modifies
this microbial community, leading to a reduction in Lactobacillus and promoting
the proliferation of anaerobic bacteria, thereby increasing the risk of dysbiosis,
as observed in bacterial vaginosis. Likewise, the urinary microbiota undergoes
alterations that heighten the susceptibility of postmenopausal women to urinary
*Corresponding author: tract infections. Hormonal changes also cause symptoms such as vaginal dryness,
Alfredo Ovalle
(alfredoovalle@gmail.com) irritation, and dyspareunia, resulting from urogenital atrophy, which affects not only
physical health but also emotional well-being and quality of life. Aim: The aim of the
Citation: Ovalle A. Alterations in
vaginal and urinary microbiota study was to describe the changes of the vaginal and urinary microbiota’s associated
in menopause and associated with estrogen deficiency in menopause, as well as their relationship with relevant
pathologies: A narrative review. clinical conditions, including pelvic floor diseases, genital infections, periodontal
stroke. J Clin Transl Res.
2025;11(5):29-49. disease, and gynecological cancers. Relevance for patients: Understanding these
doi: 10.36922/JCTR025150016 microbial changes is crucial for optimizing clinical management and improving
Received: April 10, 2025 the overall health of women in this stage of life, as these alterations represent an
emerging field of research with important diagnostic and therapeutic implications.
1st revised: August 04, 2025
2nd revised: August 15, 2025
Keywords: Vaginal microbiota; Urinary microbiota; Menopause; Associated pathologies
Accepted: August 18, 2025
Published online: September 10,
2025
1. Introduction
Copyright: © 2025 Author(s).
This is an open-access article Menopause marks the end of the female reproductive stage. It is accompanied by a
distributed under the terms of the
Creative Commons AttributionNon- decrease in estrogen levels, which not only affects women’s overall health but also alters
1
Commercial 4.0 International the composition and diversity of the lower genital tract microbiota. The development of
(CC BY-NC 4.0), which permits all molecular techniques has enabled a deeper understanding of the diversity and complexity
non-commercial use, distribution,
1,2
and reproduction in any medium, of this microbial community. In premenopausal women, the vaginal microbiota (VM)
provided the original work is is predominantly composed of beneficial bacteria, particularly from the Lactobacillus
properly cited. genus, which help prevent infections through the production of hydrogen peroxide and
1,3
Publisher’s Note: AccScience lactic acid, creating a protective acidic environment. After menopause, the decline
Publishing remains neutral with in estrogen levels alters the vaginal microbial community, leading to a decrease in
regard to jurisdictional claims in 4,5
published maps and institutional Lactobacillus abundance and promoting microbial imbalance with an overgrowth of
affiliations. anaerobic bacteria (dysbiosis). This shift increases the risk of infections such as bacterial

Volume 11 Issue 5 (2025) 29 doi: 10.36922/JCTR025150016