Studying the etiology of age-related changes occurring in the female body, the researchers found significant changes in the vaginal microbiocenosis, which explain the pathogenesis of many problems associated with the sexual sphere of elderly women.
So, if in reproductive age in healthy women the level of acidity inside the vagina (pH) is 3.8-4.2, then during the hormonal involution this indicator increases to 5.4-6.8. That is, the causes of vaginal dysbiosis with menopause may consist in a more alkaline reaction of the mucous membranes and secretory fluids released by them. What is the reason for this?
Normally, the vaginal microbiota is almost 94% represented by various species of microanerophilic lactobacilli (Lactobacillus acidophilus, Lactobacillus cellobiosum, Lactobacillus fermentum, Lactobacillus plantarum, etc.). They produce lactic acid for a stably healthy pH, antibacterial hydrolase enzyme lysozyme, and also produce hydrogen peroxide, which protects the female reproductive tract from representatives of the so-called transitory microflora-epidermal staphylococci, streptococci, E. Coli, enterococci, bacteroides, fusobacteria present in the vagina , clostridia, gardnerell, etc.
In menstruation, the upper epithelial cells are subjected to excision and lysis, and in the process of lysis from the cytosol of the leaved cells, the polysaccharide glycogen is released. Under the influence of estrogens, it is metabolized into glucose, which lactobacilli is processed into lactic acid. It is clear that with a decrease in the level of estrogens, menstrual periods are absent during the menopause, and this factor disrupts the habitual life cycle of lactobacilli, causing dysbiosis of the vagina in menopause.
It should also be borne in mind that at the same time the vaginal mucosa under climax is undergoing atrophy, and cytological changes associated with estrogen deficiency lead to a significant reduction in the number of surface cells, a decrease in immunoglobulins (IgA) and globular glycoprotein lactoferrin, which provide humoral immunity.
Thus, the key causes of vaginal dysbiosis in menopause are related to the fact that under the conditions of cessation of hormonal stimulation of the vaginal tissues the glycogen content in cells of its mucosa decreases, the number of lactobacilli colony decreases and the mechanisms of local immune protection of the genital tract significantly weaken. First and foremost, the most important component of nonspecific protection of women from pathogens is the acid pH of the vagina.
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