Introduction
Il microbiota vaginal is fundamental to the health of the apparatus genital female, for the maintenance of reproductive function and for the good course of the pregnancy.
However, the regolazione of these microorganisms - in terms of strains and population density - DON'T it is still quite clear.
Based on some recent insights, we know that ovarian hormones, diet and exercise can regular vaginal composition and microbial stability and may have a impact on health vaginal and reproductive.
Furthermore, it is assumed that thefood supplement evaluation with Probiotics during pregnancy may have a positive impact on the vaginal microbiota.
Let's go into detail.
Importance of the Physiological Flora
Physiological flora for fertility and pregnancy
It is hypothesized that the vaginal microbiota is formed mainly by the advent of dal microbes right (last intestinal tract).
The vaginal microbiota of healthy women consists of a large variety of bacterial genera and species anaerobici e aerobian dominated by the genus Lactobacillus. However, the composition can be grouped into five main types of Community-State Types (CST).
The activity of lactobacilli helps to maintain theequilibrium of vaginal microbiota; this role is fundamental for the health of the vagina, because it produces 80% of thelactic acid (in addition to proteins, carbohydrates, glycoproteins, lipoteic acids and divalent cations) and because it constitutes a "natural barrier" from pathogens and chemical stress. It is also important for the fertility and during the pregnancy.
Many studies have also reported that approx 20-30% of women suffer, at least once, from a lack of Lactobacillus in their vaginal microflora.
Some types of CST are mostly associated a poor results reproductive e diseases a sexual transmission (STDs), while species dominated by Lactobacillus, particularly Lactobacillus crispatus, are more related to vaginal health.
Il dysmicrobism o vaginal dysbiosis (VD) o microbiota disease It is one of factors di risk most important for severe vaginal infections, childbirth preterm and perinatal complications.
This condition is described for three main changes in the vaginal environment:
- a change in the composition of the vaginal microbiota from Lactobacillus spp. to facultative anaerobes;
- the production of amino compounds by the new bacterial microbiota;
- an increase in vaginal pH to more than 4,5.
La vaginal bacteriosis (BV) el'infection Human Papilloma Virus (HPV) are the most frequent discomforts of the lower reproductive tract in women, but vaginal infections from yeast (such as candidiasis) and viruses, and urinary tract infections in general.
As current BV cure rates vary between 50% and 80% after treatment with metronidazoloAs relapses are very common, more effective treatments are needed.
It follows that the consequences of the'alteration biological films, mainly caused by Gardnerella vaginalis (anaerobic and potentially pathogenic which can cause serious damage to the vaginal mucosa), should be studied in more detail to obtain better treatment and prevention of recurrent infections.
Non Dietary Factors
Non-dietary factors affecting the vaginal microbiota
Various factors can affect the vaginal microbiota of women; below we will analyze the diet-independent ones.
First of all theage, because it is related to the presence of estrogen and to the availability of glycogen for the CST, with relative lowering of pH (protective factor).
In age pre-adolescent, females have a pH vaginal more alkaline compared to fertile women (affected by estrogen), with colonization by diphtheria (Corynebacterium spp. 78%), Staphylococcus epidermidis (73%) and Mycoplasma spp.
In the fertile phase, on the other hand, especially in the phase secretory of estrogen and progesterone, the pH is lowered and Lactobacillus spp. and Atopobium and Streptococcus spp. Also the use of hormonal contraceptives can alter la temporal dynamics of the vaginal microbiota e stabilize the Lactobacillus population, depending on the hormone content and method of delivery.
On the other hand, the release of period el 'sexual activity are related to the change in vaginal microbial, destabilizing la concentration in Lactobacillus.
In women in Postmenopausal, the decrease in estrogen again causes an increase in pH, which facilitates the presence of enteric bacteria.
From the point of view ethnic, BV has long been associated with ethnicity black, afro-arabic, gypsy e Tibetan - depending on the state in which the studies are conducted.
Il cigarette smoke has been related to theincrease the prevalence of BV in several epidemiological studies and, occasionally, in a dose-dependent manner.
Very recently, the role of the stress on the female lower genital tract. For example, working with animal models, it has been reported that persistent exposure to psychosocial stress can lead to an alteration of the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes. This, in turn, drives a cortisol-induced inhibition of glycogen deposition in the vagina, which results in a 'interruption area of epithelial maturation, crucial for maintaining vaginal homeostasis. Stress is therefore a risk factor for BV.
Use too frequent harsh cleansers, douches, and absorbent tampons can increase the risk of BV.
Dietary Factors
Dietary factors that improve or worsen the vaginal microbiota
La quality of the microbiota and the welfare vaginal are greater, also thanks to the reduction the prevalence of BV and HPV in individuals who:
- follow a diet Vegetarian food;
- follow diets enriched in nutrients such as Vitamins (A, C, D, E, folate), B-carotene e minerals like iron, calcium and zinc;
- integrate evaluation with Probiotics (look down).
Instead they represent negative factors:
- diets lacking di these nutrients;
- diets enriched in carbohydrates and / or grassi;
- l'obesity.
It being known that thelarge intestine functions from "tank extra-vaginal"for lactobacilli and other bacteria, its microbiological homeostasis plays a rather important role in vaginal homeostasis. This is why the intake of probiotics and the functionality of the intestine itself are crucial to the maintenance of the vaginal flora.
It has also been shown that the vaginal microbiota is top in women who practice sport regularly.
References
- Daily Vaginal Microbiota Fluctuations Associated with Natural Hormonal Cycle, Contraceptives, Diet, and Exercise - Stephanie D. Song, Kalpana D. Acharya, Jade E. Zhu, Christen M. Deveney, Marina R. S. Walther-Antonio, Marc J. Tetel, and Nicholas Chia.
- Dietary supplementation with probiotics during late pregnancy: outcome on vaginal microbiota and cytokine secretion - Beatrice Vil tuo Paese, Federica Cruciani, Maria Elisabetta Baldassarre, Teresa Capursi, Enzo Spisni, Maria Chiara Valerii, Marco Candela, Silvia Turroni & Patrizia Brigidi - BMC Microbiology.
- Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis "(Antonio Barrientos-Durán, Ana Fuentes-López, Adolfo de Salazar, Julio Plaza-DÃaz, Federico GarcÃa - Nutrients 2020).
