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Gut and vaginal microbiomes on steroids: implications for women’s health

2021; Elsevier BV; Volume: 32; Issue: 8 Linguagem: Inglês

10.1016/j.tem.2021.04.014

1879-3061

Madeline Graham, William G. Herbert, Stephanie Song, Harshini Raman, Jade E. Zhu, Paulina E. Gonzalez, Marina Walther-António, Marc J. Tetel,

Gut microbiota and health

Sex steroids modulate the gut and vaginal microbiota, linking their composition and function. The estrobolome and the glycogen-estrogen hypothesis provide a potential pathway linking the gut and vaginal microbiomes through estrogen signaling. The gut and vaginal microbiomes are implicated in a wide range of disorders and disease states affecting women across their lifespan, including polycystic ovary syndrome (PCOS), unexplained infertility, obesity, and endometrial cancer. For example, PCOS is characterized by reduced richness and lower relative abundance of short-chain fatty acid (SCFA)-producing microbes in the gut microbiota, and increased alpha diversity and lower Lactobacillus spp. abundance in the vaginal microbiota. Mounting evidence suggests that steroids and gut microbiota acting via the gut–brain axis influence mental health changes that can occur throughout women's life phases, including depression, postpartum depression, and anxiety. This review discusses the interactions of steroids with the gut and vaginal microbiomes within each life phase of adult women and the implications for women's health. Each phase of a woman's life is characterized by distinct hormonal states which drive overall physiology of both host and commensal microbes. These host–microbiome interactions underlie disease pathology in disorders that affect women across their lifetime, including bacterial vaginosis, gestational diabetes, polycystic ovary syndrome (PCOS), anxiety, depression, and obesity. Although many associations between host health and microbiome composition are well defined, the mechanistic role of the microbiome in women's health outcomes is largely unknown. This review addresses potential mechanisms by which the microbiota influences women's health and highlights gaps in current knowledge. This review discusses the interactions of steroids with the gut and vaginal microbiomes within each life phase of adult women and the implications for women's health. Each phase of a woman's life is characterized by distinct hormonal states which drive overall physiology of both host and commensal microbes. These host–microbiome interactions underlie disease pathology in disorders that affect women across their lifetime, including bacterial vaginosis, gestational diabetes, polycystic ovary syndrome (PCOS), anxiety, depression, and obesity. Although many associations between host health and microbiome composition are well defined, the mechanistic role of the microbiome in women's health outcomes is largely unknown. This review addresses potential mechanisms by which the microbiota influences women's health and highlights gaps in current knowledge. a state of perturbed bacterial composition in the vagina, often leading to inflammation. a major ovarian estrogen steroid hormone. the onset of diabetes in pregnancy. commensal microbes in the gastrointestinal tract, whereas the gut microbiome constitutes all microbes and their associated gene products. the primary neuroendocrine pathway comprising the hypothalamus, anterior pituitary gland, and adrenal glands which regulates homeostasis and the stress response. a procedure in which an egg is fertilized by a sperm outside the body. a common hormonal disorder affecting women of reproductive age, causing elevated androgen levels, irregular menstrual cycles, and often small follicular cysts on the ovaries. the appearance of depressive symptoms after childbirth. a glycoprotein that binds estrogens and androgens and modulates their bioavailability. fatty acids with one to six carbons that are produced by bacterial fermentation of non-digestible dietary fibers, and that have a variety of physiological roles. diagnosis of infertility in the absence of any underlying conditions. commensal microbes in the vagina, whereas the vaginal microbiome consists of all microbes and their gene products.