Skip to main content

Advertisement

SpringerLink
Log in

Vaginal microbiome: normalcy vs dysbiosis

  • Mini-Review
  • Published:
Archives of Microbiology Aims and scope Submit manuscript

Abstract

It has been long understood that the vaginal microflora is crucial in maintaining a normal physiological environment for the host and its involvement is deemed indispensable for reproductive success. A global concept of normalcy vs. dysbiosis of vaginal microbiome is debatable as women of different races have a unique vaginal microflora with regional variations. Vaginal microflora is a dynamic microenvironment affected by gestational status, menstrual cycle, sexual activity, age, and contraceptive use. Normal vaginal flora is dominated by lactobacilli especially in women of European descent vs. African American women. These microbes confer the host vagina protection from potentially pathogenic microbes that may lead to urinary tract infections and sexually transmitted diseases. Changes in the vaginal microbiota including reduced lactobacilli abundance and increased facultative and anaerobic organism populations result in bacterial vaginosis, that predisposes the host to several conditions like low birth weight and increased risk of contracting bacterial infections. On the other hand, the vaginal microbiome is also reshaped during pregnancy, with less microbial diversity with a dominance of Lactobacillus species. However, an altered vaginal microbiota with low lactobacilli abundance especially during pregnancy may result in induction of excessive inflammation and pre-term labor. Since the vaginal microbiome plays an important role during embryo implantation, it is not surprising that bacterial vaginosis is more common in infertile women and associated with reduced rates of conception. Probiotic has great success in treating bacterial vaginosis and restoring the normal microbiome in recent. This report, reviewed the relationships between the vaginal microbiome and women’s reproductive health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Aagaard K, Riehle K, Ma J, Segata N, Mistretta TA, Coarfa C et al (2012) A metagenomic approach to characterization of the vaginal microbiome signature in pregnancy. PLoS ONE 7(6):e36466

    CAS  PubMed  PubMed Central  Google Scholar 

  • Anukam KC, Osazuwa EO, Ahonkhai I, Reid G (2006) Lactobacillus vaginal microbiota of women attending a reproductive health care service in Benin city Nigeria. Sex Transm Dis 33(1):59–62

    PubMed  Google Scholar 

  • Bahr PR (2007) Race and nutrition: an investigation of Black-White differences in health-related nutritional behaviours. Sociol Health Illn 29(6):831–856

    PubMed  Google Scholar 

  • Barbone F, Austin H, Louv WC, Alexander WJ (1990) A follow-up study of methods of contraception, sexual activity, and rates of trichomoniasis, candidiasis, and bacterial vaginosis. Am J Obstet Gynecol 163(2):510–514

    CAS  PubMed  Google Scholar 

  • Boris S, Barbés C (2000) Role played by lactobacilli in controlling the population of vaginal pathogens. Microbes Infect 2(5):543–546

    CAS  PubMed  Google Scholar 

  • Brotman RM, Shardell MD, Gajer P, Fadrosh D, Chang K, Silver MI et al (2014) Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause 21(5):450–458

    PubMed  PubMed Central  Google Scholar 

  • Casper RF (2009) Clinical manifestations and diagnosis of menopause. UpToDate, Waltham

    Google Scholar 

  • Chaban B, Links MG, Jayaprakash TP, Wagner EC, Bourque DK, Lohn Z et al (2014) Characterization of the vaginal microbiota of healthy Canadian women through the menstrual cycle. Microbiome 2:23

    PubMed  PubMed Central  Google Scholar 

  • Cribby S, Taylor M, Reid G (2008) Vaginal microbiota and the use of probiotics. Interdiscip Perspect Infect Dis. https://doi.org/10.1155/2008/256490

    Article  PubMed  Google Scholar 

  • David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE et al (2014) Diet rapidly and reproducibly alters the human gut microbiome. Nature 505(7484):559–563

    CAS  PubMed  Google Scholar 

  • DiGiulio DB, Callahan BJ, McMurdie PJ, Costello EK, Lyell DJ, Robaczewska A et al (2015) Temporal and spatial variation of the human microbiota during pregnancy. Proc Natl Acad Sci USA 112(35):11060–11065

    CAS  PubMed  PubMed Central  Google Scholar 

  • Dominguez-Bello MG, Costello EK, Contreras M, Magris M, Hidalgo G, Fierer N et al (2010) Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 107(26):11971–11975

    PubMed  PubMed Central  Google Scholar 

  • Drell T, Lillsaar T, Tummeleht L, Simm J, Aaspõllu A, Väin E et al (2013) Characterization of the vaginal micro-and mycobiome in asymptomatic reproductive-age Estonian women. PLoS ONE 8(1):e54379

    CAS  PubMed  PubMed Central  Google Scholar 

  • Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M et al (2005) Diversity of the human intestinal microbial flora. Science 308(5728):1635–1638

    PubMed  PubMed Central  Google Scholar 

  • Falagas ME, Betsi GI, Athanasiou S (2006) Probiotics for prevention of recurrent vulvovaginal candidiasis: a review. J Antimicrob Chemother 58(2):266–272

    CAS  PubMed  Google Scholar 

  • Farage MA, Miller KW, Sobel JD (2010) Dynamics of the vaginal ecosystem—hormonal Influences. Infect Dis: Res Treat. https://doi.org/10.4137/IDRT.S3903

    Article  Google Scholar 

  • Fettweis JM, Brooks JP, Serrano MG, Sheth NU, Girerd PH, Edwards DJ et al (2014) Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiology 160(Pt 10):2272–2282

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gajer P, Brotman RM, Bai G, Sakamoto J, Schütte UM, Zhong X et al (2012) Temporal dynamics of the human vaginal microbiota. Sci Transl Med. https://doi.org/10.1126/scitranslmed.3003605

    Article  PubMed  PubMed Central  Google Scholar 

  • Georgijević A, Cjukić-Ivancević S, Bujko M (2000) Bacterial vaginosis. Epidemiology and risk factors. Srp Arh Celok Lek 128(1–2):29–33

    PubMed  Google Scholar 

  • Goldin BR, Adlercreutz H, Gorbach SL, Warram JH, Dwyer JT, Swenson L et al (1982) Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med 307(25):1542–1547

    CAS  PubMed  Google Scholar 

  • Goldin BR, Woods MN, Spiegelman DL, Longcope C, Morrill-LaBrode A, Dwyer JT et al (1994) The effect of dietary fat and fiber on serum estrogen concentrations in premenopausal women under controlled dietary conditions. Cancer 74(3 Suppl):1125–1131

    CAS  PubMed  Google Scholar 

  • Guarner F, Schaafsma GJ (1998) Probiotics. Int J Food Microbiol 39(3):237–238

    CAS  PubMed  Google Scholar 

  • Harwich MD, Serrano MG, Fettweis JM, Alves JM, Reimers MA, Buck GA et al (2012) Genomic sequence analysis and characterization of sneathia amnii sp. nov. BMC Genomics. https://doi.org/10.1186/1471-2164-13-S8-S4

    Article  PubMed  PubMed Central  Google Scholar 

  • Hernández-Rodríguez C, Romero-González R, Albani-Campanario M, Figueroa-Damián R, Meraz-Cruz N, Hernández-Guerrero C (2011) Vaginal microbiota of healthy pregnant Mexican women is constituted by four Lactobacillus species and several vaginosis-associated bacteria. Infect Dis Obstet Gynecol. https://doi.org/10.1155/2011/851485

    Article  PubMed  PubMed Central  Google Scholar 

  • Hilakivi-Clarke L, Cho E, Cabanes A, DeAssis S, Olivo S, Helferich W et al (2002) Dietary modulation of pregnancy estrogen levels and breast cancer risk among female rat offspring. Clin Cancer Res 8(11):3601–3610

    CAS  PubMed  Google Scholar 

  • Hillier SL, Krohn MA, Nugent RP, Gibbs RS (1992) Characteristics of three vaginal flora patterns assessed by gram stain among pregnant women. Vaginal infections and prematurity study group. Am J Obstet Gynecol 166(3):938–944

    CAS  PubMed  Google Scholar 

  • Hillier SL, Krohn MA, Rabe LK, Klebanoff SJ, Eschenbach DA (1993) The normal vaginal flora, H2O2-producing lactobacilli, and bacterial vaginosis in pregnant women. Clin Infect Dis 16(Suppl 4):S273–S281

    PubMed  Google Scholar 

  • Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH et al (1995) Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The vaginal infections and prematurity study group. N Engl J Med 333(26):1737–1742

    CAS  PubMed  Google Scholar 

  • Holzman C, Leventhal JM, Qiu H, Jones NM, Wang J, Group BS (2001) Factors linked to bacterial vaginosis in nonpregnant women. Am J Public Health 91(10):1664–1670

    CAS  PubMed  PubMed Central  Google Scholar 

  • Hotel ACP, Cordoba A (2001) Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. Prevention 5(1):1–10

    Google Scholar 

  • Huang Y, Merkatz RB, Hillier SL, Roberts K, Blithe DL, Sitruk-Ware R et al (2015) effects of a one year reusable contraceptive vaginal ring on vaginal microflora and the risk of vaginal infection: an open-label prospective evaluation. PLoS ONE 10(8):e0134460

    PubMed  PubMed Central  Google Scholar 

  • Hummelen R, Macklaim JM, Bisanz JE, Hammond JA, McMillan A, Vongsa R et al (2011) Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness. PLoS ONE 6(11):e26602

    CAS  PubMed  PubMed Central  Google Scholar 

  • Hyman RW, Fukushima M, Jiang H, Fung E, Rand L, Johnson B et al (2014) Diversity of the vaginal microbiome correlates with preterm birth. Reprod Sci 21(1):32–40

    PubMed  PubMed Central  Google Scholar 

  • Jakobsson T, Forsum U (2007) Lactobacillus iners: a marker of changes in the vaginal flora? J Clin Microbiol 45(9):3145

    PubMed  PubMed Central  Google Scholar 

  • Jespers V, Menten J, Smet H, Poradosú S, Abdellati S, Verhelst R et al (2012) Quantification of bacterial species of the vaginal microbiome in different groups of women, using nucleic acid amplification tests. BMC Microbiol 12:83

    PubMed  PubMed Central  Google Scholar 

  • Karaoǧlu AŞ, Aydin F, Kiliç SS, Kilic A (2003) Antimicrobial activity and characteristics of bacteriocins produced by vaginal lactobacilli. Turk J Med Sci 33(1):7–13

    Google Scholar 

  • Koumans EH, Sternberg M, Bruce C, McQuillan G, Kendrick J, Sutton M et al (2007) The prevalence of bacterial vaginosis in the United States, 2001–2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis 34(11):864–869

    PubMed  Google Scholar 

  • Lamont RF, Sobel JD, Akins RA, Hassan SS, Chaiworapongsa T, Kusanovic JP et al (2011) The vaginal microbiome: new information about genital tract flora using molecular based techniques. BJOG 118(5):533–549

    CAS  PubMed  PubMed Central  Google Scholar 

  • Li K, Bihan M, Methé BA (2013) Analyses of the stability and core taxonomic memberships of the human microbiome. PLoS ONE 8(5):e63139

    CAS  PubMed  PubMed Central  Google Scholar 

  • Ling Z, Kong J, Liu F, Zhu H, Chen X, Wang Y et al (2010) Molecular analysis of the diversity of vaginal microbiota associated with bacterial vaginosis. BMC Genomics 11:488

    PubMed  PubMed Central  Google Scholar 

  • MacIntyre DA, Chandiramani M, Lee YS, Kindinger L, Smith A, Angelopoulos N et al (2015) The vaginal microbiome during pregnancy and the postpartum period in a European population. Sci Rep 5:8988

    CAS  PubMed  PubMed Central  Google Scholar 

  • Mania-Pramanik J, Kerkar SC, Salvi VS (2009) Bacterial vaginosis: a cause of infertility? Int J STD AIDS 20(11):778–781

    CAS  PubMed  Google Scholar 

  • Martín V, Maldonado A, Fernández L, Rodríguez JM, Connor RI (2010) Inhibition of human immunodeficiency virus type 1 by lactic acid bacteria from human breastmilk. Breastfeed Med 5(4):153–158

    PubMed  PubMed Central  Google Scholar 

  • Martínez-Peña MD, Castro-Escarpulli G, Aguilera-Arreola MG (2013) Lactobacillus species isolated from vaginal secretions of healthy and bacterial vaginosis-intermediate Mexican women: a prospective study. BMC Infect Dis 13:189

    PubMed  PubMed Central  Google Scholar 

  • Miller EA, Beasley DE, Dunn RR, Archie EA (2016) Lactobacilli dominance and vaginal pH: why is the human vaginal microbiome unique? Front Microbiol 7:1936

    PubMed  PubMed Central  Google Scholar 

  • Mirmonsef P, Hotton AL, Gilbert D, Burgad D, Landay A, Weber KM et al (2014) Free glycogen in vaginal fluids is associated with Lactobacillus colonization and low vaginal pH. PLoS ONE 9(7):e102467

    PubMed  PubMed Central  Google Scholar 

  • Moi H (1990) Prevalence of bacterial vaginosis and its association with genital infections, inflammation, and contraceptive methods in women attending sexually transmitted disease and primary health clinics. Int J STD AIDS 1(2):86–94

    CAS  PubMed  Google Scholar 

  • Nasioudis D, Beghini J, Bongiovanni AM, Giraldo PC, Linhares IM, Witkin SS (2015) α-Amylase in vaginal fluid: association with conditions favorable to dominance of Lactobacillus. Reprod Sci 22(11):1393–1398

    CAS  PubMed  Google Scholar 

  • Neggers YH, Nansel TR, Andrews WW, Schwebke JR, Yu KF, Goldenberg RL et al (2007) Dietary intake of selected nutrients affects bacterial vaginosis in women. J Nutr 137(9):2128–2133

    CAS  PubMed  Google Scholar 

  • Ness RB, Hillier S, Richter HE, Soper DE, Stamm C, Bass DC et al (2003) Can known risk factors explain racial differences in the occurrence of bacterial vaginosis? J Natl Med Assoc 95(3):201–212

    PubMed  PubMed Central  Google Scholar 

  • Oakley BB, Fiedler TL, Marrazzo JM, Fredricks DN (2008) Diversity of human vaginal bacterial communities and associations with clinically defined bacterial vaginosis. Appl Environ Microbiol 74(15):4898–4909

    CAS  PubMed  PubMed Central  Google Scholar 

  • O’Hanlon DE, Moench TR, Cone RA (2013) Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota. PLoS ONE 8(11):e80074

    CAS  PubMed  PubMed Central  Google Scholar 

  • Organization WHO (2012) Born too soon: the global action report on preterm birth. World Health Organization, Geneva. http://www.who.int/pmnch/media/news/2012/201204_borntoosoon-report.pdf

  • Panda S, Guarner F, Manichanh C (2014) Structure and functions of the gut microbiome. Endocr Metab Immune Disord Drug Targets 14(4):290–299

    CAS  PubMed  Google Scholar 

  • Pendharkar S, Magopane T, Larsson PG, de Bruyn G, Gray GE, Hammarström L et al (2013) Identification and characterisation of vaginal lactobacilli from South African women. BMC Infect Dis 13:43

    PubMed  PubMed Central  Google Scholar 

  • Perry GH, Dominy NJ, Claw KG, Lee AS, Fiegler H, Redon R et al (2007) Diet and the evolution of human amylase gene copy number variation. Nat Genet 39(10):1256–1260

    CAS  PubMed  PubMed Central  Google Scholar 

  • Petricevic L, Domig KJ, Nierscher FJ, Sandhofer MJ, Fidesser M, Krondorfer I et al (2014) Characterisation of the vaginal Lactobacillus microbiota associated with preterm delivery. Sci Rep 4:5136

    CAS  PubMed  PubMed Central  Google Scholar 

  • Petrova MI, van den Broek M, Balzarini J, Vanderleyden J, Lebeer S (2013) Vaginal microbiota and its role in HIV transmission and infection. FEMS Microbiol Rev 37(5):762–792

    CAS  PubMed  Google Scholar 

  • Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SS, McCulle SL et al (2011) Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci USA 108(Suppl 1):4680–4687

    CAS  PubMed  Google Scholar 

  • Reid G, Beuerman D, Heinemann C, Bruce AW (2001) Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunol Med Microbiol 32(1):37–41

    CAS  PubMed  Google Scholar 

  • Romero R, Hassan SS, Gajer P, Tarca AL, Fadrosh DW, Nikita L et al (2014a) The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women. Microbiome 2(1):4

    PubMed  PubMed Central  Google Scholar 

  • Romero R, Hassan SS, Gajer P, Tarca AL, Fadrosh DW, Bieda J et al (2014b) The vaginal microbiota of pregnant women who subsequently have spontaneous preterm labor and delivery and those with a normal delivery at term. Microbiome 2:18

    PubMed  PubMed Central  Google Scholar 

  • Saunders S, Bocking A, Challis J, Reid G (2007) Effect of Lactobacillus challenge on gardnerella vaginalis biofilms. Colloids Surf B Biointerfaces 55(2):138–142

    CAS  PubMed  Google Scholar 

  • Sha BE, Chen HY, Wang QJ, Zariffard MR, Cohen MH, Spear GT (2005) Utility of Amsel criteria, Nugent score, and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis, and Lactobacillus spp. for diagnosis of bacterial vaginosis in human immunodeficiency virus-infected women. J Clin Microbiol 43(9):4607–4612

    PubMed  PubMed Central  Google Scholar 

  • Sirota I, Zarek SM, Segars JH (2014) Potential influence of the microbiome on infertility and assisted reproductive technology. Semin Reprod Med 32(1):35–42

    PubMed  PubMed Central  Google Scholar 

  • Smart S, Singal A, Mindel A (2004) Social and sexual risk factors for bacterial vaginosis. Sex Transm Infect 80(1):58–62

    CAS  PubMed  PubMed Central  Google Scholar 

  • Sobel JD (1999) Is There a protective role for vaginal flora? Curr Infect Dis Rep 1(4):379–383

    CAS  PubMed  Google Scholar 

  • Spandorfer SD, Neuer A, Giraldo PC, Rosenwaks Z, Witkin SS (2001) Relationship of abnormal vaginal flora, proinflammatory cytokines and idiopathic infertility in women undergoing IVF. J Reprod Med 46(9):806–810

    CAS  PubMed  Google Scholar 

  • Spear GT, French AL, Gilbert D, Zariffard MR, Mirmonsef P, Sullivan TH et al (2014) Human α-amylase present in lower-genital-tract mucosal fluid processes glycogen to support vaginal colonization by Lactobacillus. J Infect Dis 210(7):1019–1028

    CAS  PubMed  PubMed Central  Google Scholar 

  • Thoma ME, Klebanoff MA, Rovner AJ, Nansel TR, Neggers Y, Andrews WW et al (2011) Bacterial vaginosis is associated with variation in dietary indices. J Nutr 141(9):1698–1704

    CAS  PubMed  PubMed Central  Google Scholar 

  • Tohill BC, Heilig CM, Klein RS, Rompalo A, Cu-Uvin S, Piwoz EG et al (2007) Nutritional biomarkers associated with gynecological conditions among US women with or at risk of HIV infection. Am J Clin Nutr 85(5):1327–1334

    CAS  PubMed  Google Scholar 

  • Ursell LK, Metcalf JL, Parfrey LW, Knight R (2012) Defining the human microbiome. Nutr Rev 70(Suppl 1):S38-44

    PubMed  Google Scholar 

  • van de Wijgert JH, Borgdorff H, Verhelst R, Crucitti T, Francis S, Verstraelen H et al (2014) The vaginal microbiota: what have we learned after a decade of molecular characterization? PLoS ONE 9(8):e105998

    PubMed  PubMed Central  Google Scholar 

  • van Oostrum N, De Sutter P, Meys J, Verstraelen H (2013) Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis. Hum Reprod 28(7):1809–1815

    PubMed  Google Scholar 

  • Vandenbergh PA (1993) Lactic acid bacteria, their metabolic products and interference with microbial growth. FEMS Microbiol Rev 12(1–3):221–237

    CAS  Google Scholar 

  • Verstraelen H, Verhelst R, Claeys G, De Backer E, Temmerman M, Vaneechoutte M (2009) Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora. BMC Microbiol. https://doi.org/10.1186/1471-2180-9-116

    Article  PubMed  PubMed Central  Google Scholar 

  • Willson RJ, Goforth ML (1942) Effect of an excess of ingested carbohydrate upon the glycogen content of vaginal epithelium. J Clin Endocrinol Metab 2(4):223–225

    CAS  Google Scholar 

  • Wright VC, Chang J, Jeng G, Macaluso M, (CDC) CfDCaP (2008) Assisted reproductive technology surveillance–United States 2005. MMWR Surveill Summ 57(5):1–23

    PubMed  Google Scholar 

  • Xiao BB, Liao QP (2012) Analysis of diversity of vaginal microbiota in healthy Chinese women by using DNA-fingerprinting. Beijing Da Xue Xue Bao Yi Xue Ban 44(2):281–287

    CAS  PubMed  Google Scholar 

  • Zhou X, Brown CJ, Abdo Z, Davis CC, Hansmann MA, Joyce P et al (2007) Differences in the composition of vaginal microbial communities found in healthy Caucasian and black women. ISME J 1(2):121–133

    CAS  PubMed  Google Scholar 

  • Żukiewicz-Sobczak W, Wróblewska P, Adamczuk P, Silny W (2014) Probiotic lactic acid bacteria and their potential in the prevention and treatment of allergic diseases. Cent Eur J Immunol 39(1):104–108

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Biosciences, COMSATS University, Islamabad, Pakistan

    Viqar Sayeed Saraf, Sohail Aslam Sheikh, Aftab Ahmad & Sundus Javed

  2. Microbiome Analysis Center, George Mason University, Science and Technology Campus, Manassas, VA, USA

    Patrick M. Gillevet

  3. Kohsar University Murree, Murree, KPK, Pakistan

    Habib Bokhari

Authors
  1. Viqar Sayeed Saraf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sohail Aslam Sheikh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aftab Ahmad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patrick M. Gillevet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Habib Bokhari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sundus Javed
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SAS and VSS performed the literature review and compiled the initial draft. Both authors contributed equally. HB and PMG contributed to critical review, editing, and approved the final draft. SJ and AA contributed to writing, editing, and prepared the graphic art.

Corresponding authors

Correspondence to Habib Bokhari or Sundus Javed.

Additional information

Communicated by Erko Stackebrandt.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Viqar Sayeed Saraf and Sohail Aslam Sheikh contributed equally.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saraf, V.S., Sheikh, S.A., Ahmad, A. et al. Vaginal microbiome: normalcy vs dysbiosis. Arch Microbiol 203, 3793–3802 (2021). https://doi.org/10.1007/s00203-021-02414-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00203-021-02414-3

Keywords

Search

Navigation