The Role of the Vaginal Microbiota in Reproductive Health: Mechanisms and Treatments

Abstract

This article systematically reviews the role of vaginal microbiota in reproductive health, exploring its mechanisms of action and available treatments for vaginal dysbiosis. The main objective is to provide a comprehensive overview of how vaginal microbiota influences gynecological health and emerging therapeutic innovations. The methodology followed the PRISMA guidelines, conducting searches in academic databases such as PubMed, Scopus, and Web of Science. Studies investigating vaginal microbiota, its mechanisms of action, disruptive factors, and treatments were selected. The main findings indicate that Lactobacillus spp., predominant in a healthy vaginal microbiota, produce lactic acid and hydrogen peroxide, maintaining a low pH that inhibits pathogens. Additionally, they produce bacteriocins and compete for nutrients and space, protecting against infections. Factors such as antibiotic use, inadequate hygiene practices, and hormonal changes can disrupt this balance, leading to dysbiosis. Treatments with probiotics and prebiotics have shown effectiveness in restoring microbial balance. Vaginal microbiota transplantation (VMT) emerges as a promising alternative. The personalization of treatments based on individual microbial profiles represents a crucial future direction. This article emphasizes the importance of personalized and holistic approaches in managing vaginal health.