Modern concept about the vaginal biocenosis of adolescent girls and its changes
https://doi.org/10.29413/ABS.2025-10.1.2
Abstract
The main representative of the vaginal biocenosis of adolescent girls after menarche and during the reproductive period of life is obligate-anaerobic lactobacilli. Qualitative and quantitative changes in the composition of the vaginal biocenosis occur under the influence of various exogenous and endogenous factors and can contribute to the development of the vulvar and vaginal inflammatory diseases.
The aim of the review. To analyze modern literary data on the peculiarities of the vaginal biocenosis of adolescent girls, its formation in the age aspect, changes under the influence of adverse factors and in the presence of comorbid diseases. Two hundred fifty foreign and Russian literature sources indexed in RSCI, PubMed, Scopus, SSCI were analyzed, mainly from 2014 to 2024. Sixty-nine sources were used for the article, 23 of them published in the last 5 years.
Results. Most studies emphasize the fact that it is necessary to carefully examine adolescent girls with identified risk factors for violations of vaginal biocenosis, including comorbid diseases.
About the Authors
M. Yu. Akhmetova
Irkutsk State Medical University;
Scientific Centre for Family Health and Human Reproduction Problems
Russian Federation
Russian Federation
Marina Yu. Akhmetova – Teaching Assistant at the Department of Obstetrics and Gynecology with a Course of Pediatric and Adolescent Gynecology, Krasnogo Vosstaniya str. 16, Irkutsk 664003;
applicant, Timiryazeva str. 16, Irkutsk 664003
V. V. Florensov
Irkutsk State Medical University
Russian Federation
Russian Federation
Vladimir V. Florensov – Dr. Sc. (Med.), Professor, Head of the Department of Obstetrics and Gynecology with a Course of Pediatric and Adolescent Gynecology,
Krasnogo Vosstaniya str. 16, Irkutsk 664003
O. Ya. Leshchenko
Scientific Centre for Family Health and Human Reproduction Problems
Russian Federation
Russian Federation
Olga Ya. Leshchenko – Dr. Sc. (Med.), Chief Research Officer at the Department of Medical Technologies,
Timiryazeva str. 16, Irkutsk 664003
O. E. Baryaeva
Irkutsk State Medical University
Russian Federation
Russian Federation
Olga E. Baryaeva – Cand. Sc. (Med.), Associate Professor at the Department of Obstetrics and Gynecology with a Course of Pediatric and Adolescent Gynecology,
Krasnogo Vosstaniya str. 16, Irkutsk 664003
L. I. Kolesnikova
Scientific Centre for Family Health and Human Reproduction Problems
Russian Federation
Russian Federation
Lyubov I. Kolesnikova – Dr. Sc. (Med.), Professor, Member of the RAS, Scientific Advisor,
Timiryazeva str. 16, Irkutsk 664003
References
1. Medzhidova MK, Zaydiyeva ZS, Veresova AA. Vaginal microbiocenosis and factors affecting its status. Medical Council. 2013; 5: 118-125. (In Russ.). doi: 10.21518/2079-701X-2013-3-2-118-125
2. Uvarova EV, Aryukh AV, Kazakova AV. The ratio of aerobic and anaerobic vaginal microflora in different periods of sexual development. Modern Problems of Science and Education. 2017; 1: 124. (In Russ.).
3. Gurkin YuA, Rukhlyada NN. Gynecology of childhood and adolescence: A guide for physycians. Moscow: MIA; 2019. (In Russ.).
4. Uvarova EV, Kazakova AV, Ovchinnikova AO. Comparative analysis of vaginal microflora in females in the neutral and prepubertal periods. Pediatric and Adolescent Reproductive Health. 2016; 5: 39-44. (In Russ.).
5. Kazakova AV, Uvarova EV, Limareva LV. Inflammatory diseases ofthe vulva and vagina in girls: Prognosis and prevention. Cheboksary: Sreda; 2020. (In Russ.). doi: 10.31483/a-117
6. Sanfilippo JS, Lara-Torre E, Gomez-Lobo V (eds.). Sanfilippo’s textbook of pediatric and adolescent gynecology; 2nded. CRC Press; 2019. doi: 10.1201/9781315147659
7. Isayeva AS, Letarov AV, Ilyina EN, Borovskaya AD, Muravyeva VV, Ankirskaya AS. Species identification of vaginal lactobacilli isolated in reproductive-age women. Obstetrics and Gynecology. 2012; 3: 60-64. (In Russ.).
8. Batyrova ZK, Uvarova EV, Latypova NKh. Vaginal mucosa microbiocenosis features in girls with vulvovaginitis in case of the use of molecular-genetic diagnostics methods. Pediatric and Adolescent Reproductive Health. 2014; 4: 42-48. (In Russ.).
9. Hickey RJ, Zhou X, Settles ML, Erb J, Malone K, Hansmann MA, et al. Vaginal microbiota of adolescent girls prior to the onset of menarche resemble those of reproductive-age women. mBio. 2015;6(2):e00097-15. doi: 10.1128/mBio.00097-15
10. Thoma ME, Gray RH, Kiwanuka N, Aluma S, Wang MC, Sewankambo N, et al. Longitudinal changes in vaginal microbiota composition assessed by gram stain among never sexually active pre- and postmenarcheal adolescents in Rakai, Uganda. J Pediatr Adolesc Gynecol. 2011; 24(1): 42-47. doi: 10.1016/j.jpag.2010.07.002
11. Toktar LR, Mikhaleva LM, Lee KI, Pak VE, Midiber KYu, Samsonova IA, et al. Recurrent vaginitis as a major predictor of obstetric perineal injury: Searching for evidence. Obstetrics and gynecology: News. Opinions. Training. 2023; S: 74-84. (In Russ.). doi: 10.33029/2303-9698-2023-11-suppl-74-84
12. Chapanova VD, Yangeldina AF, Mitrofanova NN. Vaginal microflora in normal and pathological conditions. Vestnik of Penza State University. 2024; 1(45): 21-27. (In Russ.).
13. Kungurtseva EA, Leschenko OYa, Danusevich IN, Popkova SM, Shabanova NM, Nemchenko UM, et al. Vaginal microecology in women with the non-specific genital inflammatory diseases and reproductive function disorders. Acta biomedica scientifica. 2013; 2(2): 197-201. (In Russ.)].
14. Sevil S, Kevser O, Aleattin U. An evaluation of the relationship between genital hygiene practices, genital infection. Gynecol Obstet. 2013; 3(6): 187. doi: 10.4172/2161-0932.1000187
15. DeMaria AL, Flores M, Hirth JM, Berenson AB. Complications related to pubic hair removal. Am J Obstet Gynecol. 2014; 210(6): 528.e1-5. doi: 10.1016/j.ajog.2014.01.036
16. Madan RP, Carpenter C, Fiedler T, Kalyoussef S, McAndrew TC, Viswanathan S, et al. Altered biomarkers of mucosal immunity and reduced vaginal Lactobacillus concentrations in sexually active female adolescents. PLoS One. 2012; 7(7): e40415. doi: 10.1371/journal.pone.0040415
17. Rychkova LV, Astakhova TA, Bugun OV, Khramova EE. Reproductive health and reproductive behavior of adolescent girls in Tofalaria. Human Ecology. 2023; 5: 352-361. (In Russ.). doi: 10.17816/humeco109241
18. Adilova GR. Modern ways to control the reproductive health of adolescent girls. Economy and Society. 2024; 1(116): 715-718. (In Russ.).
19. Linhares IM, Summers PR, Larsen B. Contemporary perspectives on vaginal pH and lactobacilli. Am J Obstet Gynecol. 2011; 204: 120.e1-120.e5. doi: 10.1016/j.ajog.2010.07.010
20. Bunnell RE, Dahlberg L, Rolfs R, Ransom R, Gershman K, Farshy C, et al. High prevalence and incidence of sexually transmitted diseases in urban adolescent females despite moderate risk behaviors. J Infect Dis. 1999; 180(5): 1624-1631. doi: 10.1086/315080
21. Adıbelli D, Kilinc N, Akpak YK, Kılıç D. Genital hygiene behaviors and associated factors in women living in rural areas of Turkey. El Mednifico Journal. 2014; (2): 210-214.
22. Tegegne TK, Sisay MM. Menstrual hygiene management and school absenteeism among female adolescent students in Northeast Ethiopia. BMC Public Health. 2014; 14: 1118. doi: 10.1186/1471-2458-14-1118
23. Kazakova AV, Spiridonova NV. Knowledge and skills of intimate hygiene according to the survey data in girls of the younger age group. Pediatric and Adolescent Reproductive Health. 2017; 4(5): 85-90. (In Russ.).
24. Brusch JL, Bronze MS. Prevention of urinary tract infections in women. Medscape. 2017. URL: https://emedicine.medscape.com/article/1958794-overview [date of access: 28.10.2024].
25. Voropaeva NM, Nemchenko UM, Grigorova EV, Khramova EE, Ivanova EI, Bugun OV, et al. Microecological features of the vaginal biotope in teenage girls with menstrual disorders. Pediatric and Adolescent Reproductive Health. 2018; 1: 37-44. (In Russ.).
26. Platonova AG, Kozlovskaya NA. The vaginal biotope in adolescent girls with menstrual disorders. Pediatric and Adolescent Reproductive Health. 2020; 2(16): 53-60. (In Russ.)]. doi: 10.33029/1816-2134-2020-16-1-53-60
27. Kamalova KA, Yashuk AG. Combined oral contraceptive pills and vaginal health. Bashkortostan Medical Journal. 2016; 3(63): 71-74. (In Russ.).
28. Baeten JM, Nyange PM, Richardson BA, Lavreys L, Chohan B, Martin HL Jr, et al. Hormonal contraception and risk of sexually transmitted disease acquisition: Results from a prospective study. Am J Obstet Gynecol. 2001; 185(2): 380-385. doi: 10.1067/mob.2001.115862
29. Batashki I, Markova D, Milchev N, Uchikova E, Gŭrova A. Effect of oral contraceptives on vaginal flora. Akush Ginekol (Sofiia). 2006; 45(3): 49-51.
30. Gupta K, Hillier S, Hooton T. Effects of contraceptive method on the vaginal microbial flora: A prospective evaluation. J Infect Dis. 2000; 181: 595-601. doi: 10.1086/315267
31. Kolesnikova LI, Kungurtseva EA, Darenskaya MA, Ivanova EI, Leshchenko OYa, Mikhalevich IM, et al. Identifying pathogenetically important indicators of microbiome in chronic endometritis in women with reproductive disorders. Pathogenesis. 2018; 16(3): 66-71. (In Russ.). doi: 10.25557/2310-0435.2018.03.68-73
32. Popkova SM, Rakova EB, Khramova EE, Danusevich IN, Shabanova NM, Serdyuk LV, et al. Microecological combinations of vaginal and intestinal biotopes in women with lower female reproductive tract inflammantory diseases and in adolescents girls with ovarian dysfunction. Siberian Scientific Medical Journal. 2013; 4(33): 77-84. (In Russ.).
33. Molchanov OL, Kira EF. Vaginal microecosystem. Features of normal functioning. Obstetrics and Gynecology of St. Petersburg. 2018; 1: 65-68. (In Russ.).
34. Romanitsa AI, Nemchenko UM, Pogodina AV, Grigorova EV, Belkova NL, Voropaeva NM, et al. Associations of clinical manifestations of functional intestinal disorders with characteristics of the microbiota of the colon in adolescents: A pilot study. Acta biomedica scientifica. 2021; 2(6): 73-81. (In Russ.). doi: 10.29413/ABS.2021-6.6-2.8
35. Mikhailenko EL, Gorelov AV, Ardatskaya MD, Usenko DV, Murzina OB. Microecological disorders of the gastrointestinal tract and reproductive system in acute intestinal infections in children. Gastroenterology of St. Petersburg. 2009; 2(3): 17-19. (In Russ.).
36. Fujimura KE, Sitarik AR, Havstad S, Lin DL, Levan S, Fadrosh D, et al. Neonatal gut microbiota associates with childhood multisensitized atopy and T cell differentiation. Nat Med. 2016; 22: 1187-1191. doi: 10.1038/nm.4176
37. Karlsson CL, Molin G, Cilio CM, Ahrné S. The pioneer gut microbiota in human neonates vaginally born at term – A pilot study. Pediatr Res. 2011; 70(3): 282-286. doi: 10.1203/PDR.0b013e318225f765
38. Trace SE, Baker JH, Penas-Lledo E, Bulik CM. The genetics of eating disorders. Annu Rev Clin Psychol. 2013; 9: 589-620. doi: 10.1146/annurev-clinpsy-050212-185546
39. Solovyova AV. Violations of vaginal biocenosis in women of reproductive age. Status Praesens. Gynecology, Obstetrics, Infertile Marriage. 2017; 2(38): 61-66. (In Russ.).
40. Tovstanskaya VA, Alatorskikh AE, Parsai Faranak. Evaluation of the vaginal microflora in women with bacterial vaginosis after treatment in order to determine its effectiveness. Woman Health. 2016; 1(107):154-159. (In Russ.).
41. Chilova RA, Proklova GF, Goncharenko NV. Differential diagnosis and treatment for bacterial vaginosis. Russian Journal of Woman and Child Health. 2020; 3(1): 39-43. (In Russ.). doi: 10.32364/2618-8430-2020-3-1-39-43
42. Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature. 2012; 486(7402): 207-214. doi: 10.1038/nature11234
43. Macklaim JM, Fernandes AD, Di Bella JM, Hammond JA, Reid G, Gloor GB. Comparative meta-RNA-seq of the vaginal microbiota and differential expression by Lactobacillus iners in health and dysbiosis. Microbiome. 2013; 1(1): 12. doi: 10.1186/2049-2618-1-12
44. Budilovskaya OV, Shipitsyna EV, Gerasimova EN, Safronova MM, Savicheva AM. Species diversity of vaginal lactobacilli in norm and in dysbiotic states. Journal of Obstetrics and Women’s Diseases. 2017; 2: 24-32. (In Russ.).
45. Jespers V, van de Wijgert J, Cools P, Verhelst R, Verstraelen H, Delany-Moretlwe S, et al. The significance of Lactobacillus crispatus and L. vaginalis for vaginal health and the negative effect of recent sex: A cross-sectional descriptive study across groups of African women. BMC Infect Dis. 2015; 15: 115. doi: 10.1186/s12879-015-0825-z
46. Voroshilina ES, Zornikov DL, Plotko EE. Normal vaginal microbiota: Patient’s subjective evaluation, physical examination and laboratory tests. Bulletin of RSMU. 2017; 2: 42-46. (In Russ.).
47. Kushkarova AA. Features of the course of vulvovaginitis in girls and adolescent girls living in an ecologically unfavorable region. Global Science and Innovations 2018: Materials of the International Scientific Conference (Jaeger, Hungary, February 28, 2018). 2018; 547-553. (In Russ.).
48. Gabidullina RI, Bagirli RR, Sharapova AM, Galimyanova EI. Effects of combined oral contraceptives on vaginal microbiota. Practical Medicine. 2018; 6: 106-110. (In Russ.). doi: 10.32000/2072-1757-2018-16-6-106-110
49. Selikhova MS, Kostenko TI, Smolyaninov AA. Rational therapy for vaginal infections is a gynecologist’s choice. Russian Journal of Woman and Child Health. 2022; 1(5): 41-45. (In Russ.). doi: 10.32364/2618-8430- 2022-5-1-41-45
50. Voropaeva NM, Belkova NL, Nemchenko JM, Grigorova EV, Danusevich IN. Microorganisms associated with bacterial vaginosis: Diversity and clinical and diagnostic significance. Acta biomedica scientifica. 2021; 6(3): 17-30. (In Russ.). doi: 10.29413/ABS. 2021-6.3.2
51. Kungurtseva EA, Kolesnikova LI, Darenskaya MA, Ivanova EI, Tunik TV, Nemchenko UM, et al. Pathogenic potential of the microbiota of various biotopes of women with reproductive disorders and chronic endometritis. Journal Infectology. 2018; S2-1: 67. (In Russ.).
52. Leshchenko OYa. Chronic endometritis and reproductive disorders: Versions and contraversions (review). Bulletin of Siberian Medicine. 2020; 3(19): 166-176. (In Russ.). doi: 10.20538/1682-0363-2020-3-166-176
53. Naboka YL, Kogan MI, Gudima IA, Mitusova EV, Dzhalagoniya KT, Ivanov SN. Is there a relationship between the urine, vagina, and gut microbiota in patients with an infection of the upper urinary tract? Urology Herald. 2019; 1(7): 38-45. (In Russ.). doi: 10.21886/2308-6424-2019-7-1-38-45
54. Meštrović T, Matijašić M, Perić M, Čipčić Paljetak H, Barešić A, Verbanac D. The role of gut, vaginal, and urinary microbiome in urinary tract infections: From bench to bedside. Diagnostics. 2021; 11(1): 7. doi: 10.3390/diagnostics11010007
55. Zaitsev AV, Apolikhina IA, Khodyreva LA, Bernikov AN, Kupriyanov YuA, Stroganov RV, et al. Role of abnormal vaginal microbiota in the pathogenesis of recurrent lower urinary tract infection: A modern view of the problem. Obstetrics and Gynecology. 2021; 5: 40-46. (In Russ.). doi: 10.18565/aig.2021.5.40-46
56. Kulchavenya EV, Breusoff AA. Recurrent cystitis and bacterial vaginosis: How to avoid polypharmacy. Gynecology. 2020; 4(22): 17-21. (In Russ.). doi: 10.26442/20795696.2020.4.200275
57. Jackson EC. Urinary tract infections in children: Knowledge updates and a salute to the future. Pediatr Rev. 2015; 36(4): 153-166. doi: 10.1542/pir.36-4-153
58. Kosova IV, Barsegian VA, Sinyakova LA, Lukianov IV, Kolbasov DN. Vaginal dysbiosis as a factor contributing to the development of recurrent lower urinary tract infections. Urology Herald. 2023; 1: 34-41. (In Russ.). doi: 10.21886/2308-6424- 2023-11-1-34-41
59. Derevyanko TI, Pridchin SV, Ryzhkova EV. Anti-inflammatory therapy of lower urinary tract infection in patients with distal urethral diseases. Experimental and Clinical Urology. 2021; 2(14): 100-104. (In Russ.). doi: 10.29188/2222-8543-2021-14-2-100-104
60. Godovalov AP, Karpunina NS, Karpunina TI. Microbiota of the intestine and vagina of women with secondary infertility and diseases of the gastrointestinal tract. Experimental and Clinical Gastroenterology. 2016; 6(130): 109-113. (In Russ.).
61. Thursby E, Juge N. Introduction to the human gut microbiota. BiochemJ. 2017; 474(11): 1823-1836. doi: 10.1042/BCJ20160510
62. Veselova EN, Aslanov АM, Chebotareva YuYu, Alekseev EE, Kovtunenko SB. Тhe problem of comorbidity in diseases of the gastrointestinal tract in women: solutions. South Russian Journal of Therapeutic Practice. 2023; 1(4): 40-45. (In Russ.). doi: 10.21886/2712-8156-2023-4-1-40-45
63. Tolstova AS, Morozov MV, Rodin OV, Fazilov NA, Kokh AA, Bezzhonova AA. Polycystic ovary syndrome and their relationship with gut and vaginal microbiota (literature review). Modern Science: Actual Problems of Theory and Practice. Series: Natural and Technical Sciences. 2021; 5: 206-214. (In Russ.). doi: 10.37882/2223-2966.2021.05.29
64. Suturina L, Belkova N, Igumnov I, Lazareva L, Danusevich I, Nadeliaeva I, et al. Polycystic ovary syndrome and gut microbiota: Phenotype matters. Life. 2023; 13(1): 7. doi: 10.3390/life13010007
65. Shin NR, Whon TW, Bae JW. Proteobacteria: Microbial signature of dysbiosis in gut microbiota. Trends Biotechnol. 2015; 33(9): 496-503. doi: 10.1016/j.tibtech.2015.06.011
66. Laschke MW, Menger MD. The gut microbiota: A puppet master in the pathogenesis of endometriosis? Am J Obstet Gynecol 2016; 215(1): 68.e1-68.e4. doi: 10.1016/j.ajog.2016.02.036
67. Savilov ED, Markova YA, Nemchenko UM, Noskova OA, Chemezova NN, Kungurtseva EA, et al. Ability to biofilm formation in infectious agents isolated from patients of a large general children’s hospital. Pacific Medical Journal. 2020; 1: 32-35. (In Russ.). doi: 10.34215/1609-1175-2020-1-32-35
68. Gorbachinsky I, Sherertz R, Russell G, Krane L, Hodges S. Altered perineal microbiome is associated with vulvovaginitis and urinary tract infection in preadolescent girls. Ther Adv Urol. 2014; 6: 224-229.
69. Shoghiradze LD, Suvorova AA. Intestinal microbiocenosis in girls with abnormal uterine bleeding. Obstetrics and Gynecology of St. Petersburg. 2019; 1: 57-61. (In Russ.).
Review
For citations:
Akhmetova M.Yu., Florensov V.V., Leshchenko O.Ya., Baryaeva O.E., Kolesnikova L.I. Modern concept about the vaginal biocenosis of adolescent girls and its changes. Acta Biomedica Scientifica. 2025;10(1):12-24. (In Russ.) https://doi.org/10.29413/ABS.2025-10.1.2
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