ArticleMenopause (New York, N.Y.)2014
Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy.
Article in Menopause (New York, N.Y.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 183 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Estrogen Impact on Overactive Bladder Syndrome: Female Pelvic Floor Microbiomes and Antimicrobial Peptides
Host Response to Pessaries in Microbial Communities of the Postmenopausal
Investigation of the Effect of the Female Urinary Microbiome on Incontinence
Defining the Vaginal Microbiome and the Vaginal pH of Menopausal Women With and Without Genitourinary Syndrome and With and Without Hormone Replacement Therapy
Investigation of the Effects of Local Estrogen Administration on Vaginal, Periurethral and Urinary Microbiota in Genitourinary Syndrome
Who cites it
183 citing papers in PubMed, 1 synthesis or guideline pooled it, 386 citations in OpenAlex.
- The Clinical Role of LASER for Vulvar and Vaginal Treatments in Gynecology and Female Urology: An ICS/ISSVD Best Practice Consensus Document.Journal of lower genital tract disease · 2019Pooled it
- Efficacy ofNutrients · 2024Trial
- Associations of vaginal microbiota with the onset, severity, and type of symptoms of genitourinary syndrome of menopause in women.Frontiers in cellular and infection microbiology · 2024Trial
- Association between postmenopausal vulvovaginal discomfort, vaginal microbiota, and mucosal inflammation.American journal of obstetrics and gynecology · 2021Trial
- Associations between improvement in genitourinary symptoms of menopause and changes in the vaginal ecosystem.Menopause (New York, N.Y.) · 2018Trial
- Vaginal microbiota and genitourinary menopausal symptoms: a cross-sectional analysis.Menopause (New York, N.Y.) · 2017Trial
- Methodology for a vaginal and urinary microbiome study in women with mixed urinary incontinence.International urogynecology journal · 2017Trial
- The cervicovaginal gut microbiota axis as a key determinant of systemic physiology.Gut microbes · 2026Review
- VISTA: a classifier for metagenomic subspecies and community state typing of the vaginal microbiome.Microbiology resource announcements · 2026Article
- Genitourinary microbiota in older women: a persistent knowledge gap that limits clinical and research progress.Infection and immunity · 2026Review
- Review
- Vaginal microbiomes and their pertinent social context: a microbial ecological review proffering AMR-STI acquisition and emergence.Biology of sex differences · 2026Review
- Dynamic, transition and variation of cervicovaginal microbiome and HPV infection and cervical dysplasia and cancer: a systematic review.Infectious agents and cancer · 2026Review
- Comparing Asymptomatic Versus Symptomatic Bacterial Vaginosis: Clinical Characteristics, Vaginal Microbiota, and Lactic Acid Profiles.Sexually transmitted diseases · 2026Article
- The Vaginal Microbiome and Recurrent and Chronic Urinary Tract Infection.International urogynecology journal · 2026Review
- Beyond the Barrier: Epithelial Cells as Immune Sentinels in the Female Genital Tract.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- Translating microbial dysbiosis into brain health interventions: a focus on the oral-gut-reproductive inflammatory pathways.Archives of microbiology · 2026Review
- Cervical Cytology and Age in HPV-Infected Women in North Macedonia: A Cross-Sectional Study.Acta medica academica · 2026Article
- The Gut Microbiota in Perimenopausal Anxiety: A Novel Therapeutic Pathway Through Diet.Nutrients · 2026Review
- Article
123 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Reprinted as
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe vaginal microbiota helps protect the female genital tract from disease. We sought to describe the composition of the vaginal microbiota in premenopausal, perimenopausal, and postmenopausal women and to explore the association between the microbiota and vulvovaginal atrophy (VVA).
methodsEighty-seven women (aged 35-60 y) were classified as premenopausal (n = 30), perimenopausal (n = 29), or postmenopausal (n = 28) according to Stages of Reproductive Aging Workshop guidelines. Midvaginal bacterial community composition was characterized by 16S ribosomal RNA gene analysis.
resultsBacterial communities clustered into six community state types (CSTs), of which four were dominated by Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, or Lactobacillus jensenii, and two (CST IV-A and CST IV-B) had low relative abundance of Lactobacillus. CST IV-A was characterized by Streptococcus and Prevotella, whereas CST IV-B was characterized by Atopobium. There were significant associations between menopause stage and CST (P = 0.004) and between VVA and CST (P = 0.002). Perimenopausal women were more likely to be classified as CST IV-A or L. gasseri CST, whereas postmenopausal women were often classified as CST IV-A. CSTs dominated by L. crispatus and L. iners were more prevalent in premenopausal women. Nineteen participants had signs of mild or moderate VVA. Compared with women with no VVA, the vaginal microbiota of women with mild or moderate atrophy had 25-fold greater odds of being classified as CST IV-A versus L. crispatus CST (adjusted odds ratio, 25.89; 95% credible interval, 2.98-406.79).
conclusionsA distinct bacterial community state (CST IV-A) with a low relative abundance of Lactobacillus is associated with VVA. Future studies recruiting a larger number of women are needed to replicate the findings. This study provides an impetus for future longitudinal studies designed to manage, modulate, and restore vaginal microbiota homeostasis, which would provide stronger evidence for a causal relationship with VVA and ultimately improve the treatment and prevention of atrophic vaginitis in menopause.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.