ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1569667
This article is part of the Research TopicAdvances in Vaginal Microbiome and Metabolite Research: Genetics, Evolution, and Clinical PerspectivesView all 9 articles
Age-Related Vaginal Microecology and Infection Epidemiology Among Premenopausal and Postmenopausal Gynecologic Outpatients: A Cross-Sectional Study
Provisionally accepted
Wenyu Lin1
Liying Wang1
Binhua Dong1
Yuhang Zhang2Yan Zhan1,2
Liang Wang1Jun Shen1Yanfang Lu1Meijin Zheng1*
Pengming Sun1*- 1Fujian Maternity and Child Health Hospital, Fuzhou, China
- 2State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, China
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Background: Postmenopausal estrogen deficiency disrupts vaginal microecological balance. This cross-sectional study investigates the epidemiology of vaginal infections and alterations in microbiota composition, enzymes, and metabolites among premenopausal and postmenopausal gynecologic outpatients.The study analyzed the vaginal microecology data from 27,346 women who underwent examinations at Fujian Maternity and Child Health Hospital between 2018 and 2023. Parameters including vaginal cleanliness, bacterial density, and diversity were systematically evaluated. Additionally, a total of 20 participants (10 premenopausal and 10 postmenopausal women) were enrolled for nontargeted LC-MS metabolomic analysis through stratified random sampling.The population comprised 22,525 (82.4%) premenopausal women (18 -44 years), 3,456 (12.6%) transitioning women (45 -55 years), and 1,365 (5.0%) postmenopausal women ( ＞ 55 years). In mixed infections, BV + VVC co-infections predominated (1264/2766, 45.7%). Postmenopausal women showed significantly higher BV prevalence (22.8% vs. 17.9%, P < 0.001) and AV (24.8% vs. 4.6%, P < 0.001), but lower rates of VVC (1.2% vs. 8.2%, P < 0.001). In postmenopausal women, BV-associated biomarkers (including clue cells and sialidase activity) and inflammatory markers (such as pus cells and leukocyte esterase activity) were concurrently elevated. Metabolomic analysis identified elevated chenodeoxycholic acid glycine conjugate levels alongside reduced Ophosphothreonine, morpholine, and diethanolamine.Age significantly influences vaginal microecology, altering infection epidemiology, microbiota, enzymes, and metabolites. Accounting for these age-related estrogen changes in clinical interventions is critical for effective management.
Keywords: Vaginal microecology, Vaginal Infection, Menopause, microbiota, Metabolites
Received: 01 Feb 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Lin, Wang, Dong, Zhang, Zhan, Wang, Shen, Lu, Zheng and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Meijin Zheng, Fujian Maternity and Child Health Hospital, Fuzhou, China
Pengming Sun, Fujian Maternity and Child Health Hospital, Fuzhou, China
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