Oral probiotics and vaginal microbiome in post-menopause women: an opinion for the improvement of natural therapies in gynecology

The vaginal microbiota represents an intricate and multifaceted biome that directly modulates female health. It refers to the community of microorganisms, including bacteria, fungi, and viruses, which reside in the vagina 1 . This complex ecosystem plays a crucial role in female health and a potential role in reproductive fitness. The vaginal microbiome’s composition varies among individuals and can be influenced by numerous factors such as age, racial factors, hormonal changes, sexual activity, and the use of contra-ceptives or antibiotics. In many healthy individuals, the vaginal microbiome is often dominated by bacteria from the Lactobacillus genus. These bacteria produce lactic acid, helping to maintain a low pH in the vagina and thus providing a natural defense against the colonization of pathogenic microbes. However, an imbalance or dysbiosis in the vaginal microbiome can lead to various health issues such as bacterial vaginosis, yeast infections, or increased susceptibility to sexually transmitted infections 2 . Disruptions in this microbiome, particularly during the menopausal transition, are caused especially by the lack of estrogen and can lead to an array of deleterious conditions such as atrophic vaginitis, recurrent urinary tract