Exploring Associations between the Vaginal Microbiome and Health Behaviors, Sociodemographic Factors, and Vaginal Symptoms in Postmenopausal Women Open Access
Daniel, Gaea (Summer 2019)
Abstract
Background:Postmenopausal women are more likely to have greater bacterial diversity and less protective Lactobacillus(L. spp.) within their vaginal microbiome than premenopausal women due to decreased estrogen levels. It is unclear whether health behaviors and sociodemographic factors affect the vaginal microbiomes of postmenopausal women and if vaginal symptoms are related to unhealthy changes in the vaginal microbiome.
Purpose:To characterize the vaginal microbiomes of postmenopausal women, and to assess associations between the vaginal microbiome of these women and their health behaviors, sociodemographic factors, and vaginal symptoms.
Methods:A secondary analysis of an ongoing study of postmenopausal women was conducted. Twenty-one participants with physician-collected vaginal swabs and self-reported responses to questionnaires about their health behaviors, sociodemographic factors, and vaginal symptoms were available for analysis. Alpha and beta diversity were used to assess microbial diversity within and between samples. The Wilcoxon and Kruskal-Wallis rank sum tests, relative abundances, Bray-Curtis and Jaccard distances, PERMANOVA, and Linear Decomposition Model were used to evaluate associations between the vaginal microbiome and health behaviors, sociodemographic factors, and vaginal symptoms.
Results:Alpha diversity was significantly higher for participants who used antibiotics (p<0.05) and trended towards significance for participants who used oral probiotics (p=0.16). Four vaginal microbiome samples had a relative abundance of L. spp. ≥90%. Relative abundance of other genera was negligible in these samples.
Conclusion:Use of antibiotics is associated with increase diversity in the vaginal microbiome, and oral probiotic use may potentially be associated with decreased diversity. The association between L. spp.-dominance and health promoting and disruptive behaviors warrants further study. A larger sample size is needed to confirm associations. Both researchers and clinicians should thoroughly assess health promoting and health disruptive behaviors when evaluating the vaginal microbiome and gynecological health.
Table of Contents
Article One: A Framework for Studying the Vaginal Microbiome
Introduction ……………………………………………………………………………….1
Sociodemographic Factors and the Vaginal Microbiome……………………...………….2
Health Behaviors and the Vaginal Microbiome………………………………….………..4
Discussion………………………………………………………………………………....8
References………………………………………………………………………..………10
Article Two: Exploring the Vaginal Microbiome and Intravaginal Practices in Postmenopausal Women
Introduction ……………………………………………………………..……………….17
Methods……………………………………………………………………………….….20
Results……………………………………………………………………………..……..24
Discussion………………………………………………………………………….…….25
References…………………………………………………………………………..……33
Article Three: The Vaginal Microbiome in Postmenopausal Women: Associations with Health Behaviors Sociodemographic Factors, and Vaginal Symptoms
Introduction ………………………………….………………………….……………….40
Methods……………………………………….………………………………………….46
Results……………………………………………….……………………………….…..49
Discussion……………………………………………………………………….……….50
References…………………………………………….………………………….………55
List of Tables and Figures…………………………………….………………………………….63
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