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Karahalis L.Yu., Ponomareva Yu.S.

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Karahalis L.Yu., Ponomareva Yu.S. The state of the vaginal microbiota during the perimenopausal period.

Questions of practical colposcopy. Genital infections. 2022; (1): 66–69.

DOI 10.46393/27826392_2022_1_66


The state of the vaginal microbiota in women during the transition to menopause depends not only on hormonal levels, but also on the presence of lactobacilli, which determine the types of conditions (TS). Until now, it remains unknown how TC changes in perimenopause, how they are related to the indices of vaginal health (IVH) and maturation of the vaginal epithelium (VEM), pH of vaginal discharge (VD).

Objective: To determine the types of vaginal microbiota conditions in perimenopause and their impact on the vaginal epithelial maturation index and vaginal health index.

Material and methods. To determine the state of vaginal microbiocenosis, Femoflor®16 was used; lactobacilli strains were determined by mass spectrometry. Based on the data obtained, the TC was established in the groups, the IVI, ISEV were calculated, and the pH of the VO was determined. Statistical analysis was carried out in the environment of the Statistica 10 package (Tibco, USA) and Microsoft Excel 2016. In all criteria, the generally accepted level of statistical significance was used: p = 0.05.

Results. Patients (n = 109) according to STRAW+10 were divided into three groups: the first group - early transition to menopause (n = 34), the second - late transition to menopause (n = 39), the third group - early postmenopause (n = 36 ). There was a significant difference in the pH levels of VO, ISEV and IVZ between groups (p = 0.000). The increase in VO pH, which varied between groups, correlated with a decrease in estrogen levels during the perimenopausal transition. The level of ISEV below the normative indicators (norm above 65%) was registered in the second and third groups. The severity of atrophic changes was characterized by the level of IVZ: there were significant differences between the first and second (p = 0.000) and first and third (p = 0.000) groups. The groups differed in the level of lactobacilli (in the first group - 106, in the second and third - 103); in the third group there were no strains of L. crispatus and L. gasseri. This determined the TC: in the first group it was TC I, TC II, TC III; in the second - TC I, TC II, TC III, TC IVA, TC IVB, in the third - TC III, TC IVA, TC IVB. A high degree of correlation was determined between the stages of perimenopause and the pH of VO (R = 0.837) and ISEW (R = -0.839); moderate – between the stages of perimenopause and IVD (R = -0.605), as well as the number of patients with the L. crispatus strain (R = -0.349) and the L. gasseri strain (R = -0.429).

Conclusions. Types of vaginal microbiota conditions are supported by lactobacilli. The level of lactobacilli, along with age-related estrogen deficiency, affects the pH of VO, ISEV, IVZ, which have a high degree of correlation with the stages of perimenopause. The use of lactobacilli preparations from early menopause requires further study, and during late menopause and early postmenopause is necessary to maintain vaginal health.

Journal “Issues of practical colposcopy. Genital infections" No. 1_2022
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