Vaginal microbiota and genitourinary menopausal symptoms: a cross-sectional analysis. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Mitchell, Caroline M.; Srinivasan, Sujatha; Zhan, Xiang; Wu, Michael C.; Reed, Susan D.; Guthrie, Katherine A.; LaCroix, Andrea Z.; Fiedler, Tina; Munch, Matthew; Liu, Congzhou; Hoffman, Noah G.; Blair, Ian A.; Newton, Katherine; Freeman, Ellen W.; Joffe, Hadine; Cohen, Lee; Fredricks, David N.
• Is Part Of: Menopause. Volume 24:Issue 10(2017)
• Publication Date: 2017-10
• Subjects: Genitourinary symptoms of menopause -- Menopause -- Vaginal glycogen -- Vaginal microbiota; Menopause -- Periodicals; 618.175005
• DOI: 10.1097/GME.0000000000000904
• Languages: English
• ISSNs: 1072-3714

Abstract

Abstract: Objective: To examine associations between the composition of the vaginal microbiota and genitourinary menopausal symptoms, serum estrogen, and vaginal glycogen. Methods: For this cross-sectional study, 88 women aged 40 to 62 years, enrolled in a hot flash treatment trial, provided vaginal swabs and a blood sample at enrollment. Bacterial communities were characterized using 16S rRNA PCR and deep sequencing targeting the V3-V4 region. Quantities of Lactobacillus crispatus and Lactobacillus iners were measured using qPCR. Self-reported genitourinary symptoms included: presence and severity of individual symptoms and identification of most bothersome symptom. Glycogen was measured fluorometrically in swab eluate. Serum estradiol (E2 ) and estrone (E1 ) were measured by liquid chromatography/mass spectrometry. Associations between bacteria, symptoms, glycogen, and serum estrogens were tested by linear regression or Wilcoxon signed-rank test, adjusted for multiple comparisons. Comparisons between groups used Kruskall-Wallis or Fisher's exact test. Results: Of the 88 women, 33 (38%) had a majority of Lactobacillus species, whereas 58 (66%) had any Lactobacillus detected. Over half (53%) reported at least one vulvovaginal symptom (most commonly dryness), but symptoms were not associated with the presence of Lactobacillus species. Women with Lactobacillus -dominant communities had higher unconjugated serum estrone, but no difference in vaginal glycogen levels, compared with those with non- Lactobacillus -dominant communities. Higher serum E2 and E1 were not associated with either higher vaginal glycogen or detection of individual genera. Conclusions: Presence of Lactobacillus -dominant vaginal microbiota was not associated with fewer vulvovaginal symptoms. Serum estrone was higher in women with Lactobacillus dominance, but vaginal-free glycogen was not associated with composition of the vaginal microbiota.