Host, microbial, and environmental drivers of vaginal microbiota composition
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(Published version)
Date
2026
Authors
Young, R.B.
Correia, G.D.S.
MacIntyre, D.A.
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Fertility and Sterility, 2026; 125(4):1-10
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Remy B. Young, Gonçalo D.S. Correia, David A. MacIntyre
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Abstract
The human vagina harbours a microbial community that differs markedly in compositional structure from all mammals, including closely related primates. Lactobacilli are the most abundant vaginal species, and their dominance in this niche are associated with protection against adverse health outcomes including preterm birth, sexually transmitted infections and bacterial vaginosis. However, the vaginal environment can also support compositions of diverse anaerobic bacteria, which have been linked to poor reproductive health outcomes. Here, we review current knowledge on host and microbial determinants that influence microbial community structure within the vaginal niche, emphasising the interplay between host physiology, immune and metabolic interactions as well as lifestyle factors. This integrated understanding provides a foundation for linking vaginal microbiome compositions to clinically relevant phenotypes and highlights mechanisms that could be exploited to promote improved reproductive health.
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Copyright ©2026 Published by Elsevier Inc. on behalf of the American Society for Reproductive Medicine. This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (https://creativecommons.org/licenses/by/4.0/)