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Cited by 67Urinary Tract Infections ManagementReproductive tract infections researchUrinary Bladder and Prostate Research

Menopausal Changes in the Microbiome—A Review Focused on the Genitourinary Microbiome

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Park, Min Gu, Cho, Seok, Oh, Mi Mi·2023·Diagnostics
DOI 10.3390/diagnostics13061193PMC PMC10047399
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Abstract

A balanced interaction between the host and its microbiome is crucial to health. Research regarding the significance of the gut and vaginal microbiomes in female health is substantial. However, less data regarding the urinary microbiome are available. Interactions between the gut, vaginal, and urinary microbiomes are also currently being researched. Hormone-induced dysbiosis after menopause is believed to have effects on physical changes and health consequences. Postmenopausal changes in the gut microbiome are associated with increased short-chain fatty acids and hydrogen sulfide levels. Increased vaginal pH caused by reduced estrogen alters the vaginal microbiome, resulting in reduced levels of Lactobacillus. Such changes influence the vaginal structure and functions, contributing to the onset of genitourinary syndrome of menopause. A dysbiosis of the urinary microbiome is associated with urgency and urinary incontinence and also related to interstitial cystitis/bladder pain syndrome and neuropathic bladder. As these diseases commonly affect postmenopausal women, hormone-induced changes in the microbiome may play a role. Menopause increases the alpha diversity of the urinary microbiome and lowers the percentage of Lactobacillus in urine, and such changes precede recurrent cystitis. More research regarding the effects of changes in the urinary microbiome due to menopause on urinary tract diseases is needed.

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  • A dysbiotic state enriched with facultative anaerobic Gram-negative bacteria, such as Gardnerella vaginalis and E. coli, characterizes BV, and is strongly associated with increased UTI susceptibility and recurrence.

    “A dysbiotic state enriched with facultative anaerobic Gram-negative bacteria, such as Gardnerella vaginalis and E. coli , characterizes BV, and is strongly associated with increased UTI susceptibility and recurrence [9, 12].”

    From Vaginal microbiota and urinary tract infections in women: the protective role of vaginal lactobacilli in counteracting urinary tract infections occurrence and recurrence (2026) · cites this paper as [9]

    Section 4 links dysbiosis to recurrent cystitis, and Section 5 lists Gardnerella among bacteria in a non-Lactobacillus-dominant vaginal community. The review does not characterize BV as enriched with facultative anaerobic Gram-negative Gardnerella vaginalis and E. coli, or establish a strong association between that specified state and UTI susceptibility and recurrence. Section 4 instead describes BV-associated anaerobes separately from Gram-negative uropathobionts. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Prolonged use of antibiotics is associated with the emergence of antimicrobial resistance and disruption of the host microbiota, both of which may further predispose women to recurrent infections.

    “While effective in acute management, limitations of antibiotics are increasingly evident: their prolonged use is associated with the emergence of antimicrobial resistance and disruption of the host microbiota, both of which may further predispose women to recurrent infections [1-3, 9].”

    From Vaginal microbiota and urinary tract infections in women: the protective role of vaginal lactobacilli in counteracting urinary tract infections occurrence and recurrence (2026) · cites this paper as [9]

    Section 4 (page unavailable) links urinary dysbiosis to recurrent cystitis, supporting the claim that microbiota disruption may contribute to recurrent infection. It does not say that prolonged antibiotic use causes that disruption or antimicrobial resistance, or that antibiotic-associated changes increase recurrence. Its comparison of women with and without antibiotic prophylaxis reports no significant difference in bacterial numbers. (LLM, conf=0.79)

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Cited by

Sorted by citations

Authors
Park, M. G., Cho, S., & Oh, M. M.
Affiliations
  • Inje University Seoul Paik Hospital (KR)
  • Inje University Ilsan Paik Hospital (KR)
  • Korea University Guro Hospital (KR)
Corresponding author
Oh, Mi Mi
ORCID
Venue
Diagnostics
Publisher
MDPI AG
Published
2023-03-21
Volume
13
Issue
6
Pages
1193
ISSN
2075-4418 (ISSN-L)
DOI
10.3390/diagnostics13061193
PMC
PMC10047399
OpenAlex
W4353071140
Cited by
67
References
2
Citations by year
2026: 24 · 2025: 17 · 2024: 25 · 2023: 1
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Diagnostics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
Keywords
menopause, microbiome, gut microbiota, vaginal microbiota, urinary microbiome, dysbiosis, estrogen deficiency, Lactobacillus, short-chain fatty acids, hydrogen sulfide, vaginal pH, genitourinary syndrome of menopause, urinary incontinence, interstitial cystitis, neurogenic bladder, recurrent cystitis, microbial diversity

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