Divine Aleru, Microbiome Signatures Research Coordinator

Menopause drives profound shifts in the oral, gut, and vaginal microbiome, decreasing protective species and increasing disease risk. Understanding these hormone-microbe interactions is crucial for developing personalized interventions to improve women’s health during and after the menopausal transition.

This review details how menopause-driven hormonal changes alter the vaginal and gut microbiome, emphasizing the clinical implications for symptoms and therapies, and advocating for more inclusive, microbiome-informed interventions to support healthy aging in women.

This prospective study of 17,070 African American women found smoking most strongly predicts earlier menopause, while higher MI and oral contraceptive use are protective. Perceived racism showed suggestive but inconsistent associations with menopause timing, underscoring the need for further research on psychosocial stressors and reproductive aging.

Menopause alters the gut, vaginal, and urinary microbiomes, decreasing Lactobacillus and increasing microbial diversity. These changes contribute to SM, rUTI, and urinary symptoms. Hormone therapy and probiotics partially restore healthy microbiota, offering new avenues for genitourinary symptom management in postmenopausal women.

ICE guidance recommends diagnosing menopause in women over 45 clinically, not with lab tests, while SH measurement is reserved for suspected OI in women under 40, streamlining care and reducing unnecessary testing in clinical biochemistry laboratories.

Primary Ovarian Insufficiency (OI) is a medical condition in which a woman’s ovaries stop functioning normally before the age of 40. This leads to reduced estrogen production and irregular menstrual cycles, which may eventually result in infertility and early menopause-like symptoms. OI can occur due to various reasons, including genetic factors, autoimmune disorders, chemotherapy, or unknown causes. Though often misunderstood and misdiagnosed, OI can significantly impact a woman’s physical and emotional well-being. Early diagnosis and appropriate treatment, including hormone replacement therapy (RT) and fertility interventions, can help manage symptoms, improve quality of life, and in some cases, restore fertility.

Menopause impacts many aspects of health, including the gut microbiome, weight management, and hormone balance. Diet, probiotics, intermittent fasting, and RT offer effective management strategies.

A narrative review examining how dietary patterns, nutrients, and gut microbiota impact female fertility, highlighting the Mediterranean diet’s benefits, the risks of Western diets, key micronutrients, and the clinical importance of individualized nutritional care for women planning pregnancy or experiencing infertility.

What was studied?This original research investigated the long-term effects of dietary quercetin supplementation on female fertility and ovarian physiology in mice, with a specific focus on the role of the enzyme transglutaminase 2 (G2). Quercetin, a widely consumed flavonoid supplement, is known for its antioxidant properties, but its effects on female reproductive health remain poorly […]

What was reviewed?This review article examines current evidence on the use of medical-grade honey (GH) as a novel therapy for bacterial vaginosis (V), a prevalent condition among women of reproductive age characterized by a dysbiosis of the vaginal microbiome. V is associated with a reduction in protective, lactic acid-producing lactobacilli and an overgrowth of pathogenic […]

Honey exerts protective effects in reproductive health by modulating oxidative stress, supporting hormonal balance, and selectively inhibiting pathogens while preserving beneficial microbiota, making it a promising adjunct in fertility support, menopause symptom relief, and vulvovaginal candidiasis management.

This review summarizes evidence linking Mediterranean Diet adherence to improved RT outcomes, highlighting modest benefits for clinical pregnancy and live birth rates. Methodological heterogeneity and lack of CTs limit conclusions, underscoring the need for standardized research and mechanistic exploration.

This editorial reviews evidence on metformin for COS-related infertility, highlighting its benefits for ovulation induction, especially in women with longer fertility timelines, and advocating for individualized therapy over restrictive guidelines.

A randomized clinical trial found Nigella sativa plus black pepper significantly improved pregnancy rates and reproductive parameters versus letrozole plus tamoxifen in infertile women with COS, with comparable safety.

This review highlights how dietary patterns, micronutrients, genetics, and the microbiome interact to influence female infertility and RT outcomes, supporting the role of personalized nutrition and microbiome-targeted interventions in reproductive medicine.

This review details how probiotics modulate the human microbiome to support fertility, addressing mechanisms, clinical evidence, and implications for male and female reproductive health, with particular focus on Lactobacillus species and their role in infertility treatment and prevention.

This review details how the reproductive tract microbiome impacts infertility and reproductive outcomes, highlighting the roles of specific microbial taxa, dysbiosis in disease, and potential microbiome-targeted therapies to improve RT success and pregnancy outcomes.

This review reveals how vaginal microbiota dysbiosis underpins diverse gynecological diseases, highlights characteristic microbial signatures, and evaluates interventions—especially probiotics and vaginal microbiota transplantation—as emerging strategies to restore health and reduce recurrence.

This review summarizes clinical and mechanistic evidence for complementary and alternative medicine in COS infertility, highlighting CM, acupuncture, nutrient supplementation, and lifestyle interventions as effective, safe adjunct therapies with potential microbiome-mediated benefits.

This study explores the relationship between co-exposure to phenols and phthalates and infertility risk in women of reproductive age, highlighting significant associations with PA and EHP metabolites.

This study identified 27 follicular fluid metabolites differentiating infertile from fertile women, developed a predictive Biomarker Score, and demonstrated strong correlations with VF outcomes, providing a basis for personalized infertility management.

What was studied?This original research article investigated the association between blood levels of lead and cadmium (two common environmental heavy metals) and self-reported infertility among women in the United States. The study leveraged data from the 2013–2014 and 2015–2016 cycles of the National Health and Nutrition Examination Survey (HANES), focusing on reproductive-aged women. The researchers […]

Environmental pollution—including heavy metals, air pollutants, and endocrine disruptors—negatively impacts female fertility through hormonal disruption, oxidative stress, and epigenetic changes. The review emphasizes the clinical need for exposure assessment and mitigation strategies to protect reproductive health.

Infertile women in Taiwan showed higher blood lead and arsenic levels than pregnant women, mainly linked to frequent Chinese herbal medicine use. Physical activity may help lower lead accumulation, highlighting the need to evaluate traditional medicine risks in women planning pregnancy.

This review synthesizes evidence linking lead, cadmium, and copper exposure to male and female infertility, detailing mechanisms of reproductive toxicity, epidemiological patterns, and the potential role of microbiome alterations as mediators and biomarkers of reproductive risk.

This cross-sectional study in American women found that higher urinary arsenic—and, to a lesser extent, cadmium—were associated with increased infertility risk, with lead exposure linked to infertility in older or overweight women, supporting the need for environmental exposure monitoring in reproductive health.

This review explores how metabolic risk factors—obesity, the female athlete triad, and oxidative stress—contribute to female infertility, highlighting associations with COS, endometriosis, and idiopathic infertility, and calling for improved metabolic assessment and molecular diagnostics in clinical practice.

This review synthesizes evidence on the multifactorial mechanisms underlying endometriosis-associated infertility, emphasizing inflammatory, hormonal, anatomical, and molecular drivers. It highlights advances in non-invasive diagnostics, individualized treatment, and the clinical promise of integrating molecular and microbiome signatures into care protocols for improved fertility outcomes.

This review details the multifactorial pathogenesis of endometriosis-associated infertility, emphasizing molecular, genetic, and inflammatory mechanisms, and evaluates current and emerging treatments, including VF and novel regenerative therapies.

This case report describes a young woman with premature ovarian insufficiency who, despite infertility and diagnostic confirmation of OI, experienced spontaneous conception. The case underscores the unpredictable nature of OI and the need for ongoing investigation into its etiologies, including possible microbiome links.

A large-scale Taiwanese study found that upper and lower genital tract infections, but not comorbidities or bacterial vaginosis, independently increased infertility risk. ID and lower genital tract inflammation showed the strongest associations, emphasizing the critical role of reproductive tract infections in female infertility.

A Nigerian study found only 10% of reproductive-age women recognized the link between ID and infertility, despite high education levels. The findings emphasize the need for improved public health campaigns and highlight the microbial etiology—chiefly Chlamydia trachomatis—behind ID-related infertility.

This review details the polymicrobial pathogenesis of ID, its major microbial culprits—including both classical TIs and vaginal anaerobes—and underscores the high risk of infertility. Early diagnosis, broad-spectrum treatment, and awareness of microbiome shifts are key to reducing reproductive morbidity.

A comprehensive bibliometric analysis of global research trends in polycystic ovary syndrome (COS) and infertility reveals increasing publication rates, evolving research priorities, and key knowledge gaps, with growing emphasis on metabolic and inflammatory mechanisms relevant to microbiome research and clinical practice.

This review details the links between bacterial vaginosis, endometritis, pelvic inflammatory disease, and infertility, highlighting the role of vaginal and endometrial microbiota disruptions and their impact on reproductive outcomes and management strategies.

This study shows women with secondary infertility have persistently altered, less diverse vaginal microbiomes unresponsive to VF hormone stimulation. Increased Atopobium and decreased Lactobacillus may hinder VF success, suggesting microbiome-targeted interventions could benefit infertility care.

Microbiome dysbiosis and elevated miR-21-5p and miR-155-5p levels are strongly linked to unexplained infertility, suggesting their role as biomarkers. Correcting these microbiome imbalances could enhance fertility treatment success rates.

This study shows gut microbiota differences between fertile and infertile women, highlighting improved fertility outcomes with dietary fiber (HGG) supplementation that enhances beneficial gut bacteria, suggesting microbiome modulation as a viable strategy for improving reproductive success.

This study identified vaginal microbiota dysbiosis, marked by Lactobacillus iners dominance, in infertile women infected with Chlamydia trachomatis. Post-antibiotic recovery suggested microbiome restoration could enhance fertility outcomes, highlighting microbiota profiling as a diagnostic tool.

This review underscores the importance of genital tract microbiome composition in fertility, particularly Lactobacillus crispatus dominance, which is linked to better fertility outcomes. Dysbiosis and pathogens like Gardnerella are associated with infertility, suggesting microbiome profiling could be key in improving RT success.

This review connects genital microbiota dysbiosis to infertility, highlighting the role of Lactobacillus dominance in female fertility and microbial imbalances in seminal fluid affecting male fertility. It suggests personalized treatments targeting microbiome restoration could improve reproductive outcomes, especially in RT settings.

This study links the vaginal microbiome, particularly Lactobacillus crispatus dominance, to successful UI outcomes in idiopathic infertility. Dysbiosis, with an increase in Bifidobacterium, was associated with UI failure, suggesting the importance of vaginal microbiome evaluation in fertility treatments.

This study links endometrial microbiota composition to reproductive success in RT, showing that Lactobacillus dominance is associated with better outcomes, while dysbiosis with pathogens like Gardnerella and Klebsiella correlates with infertility. It suggests microbiota analysis as a tool for improving RT success.

This review summarizes the essential role of balanced reproductive microbiota, particularly Lactobacillus dominance, in fertility and VF success, linking microbial dysbiosis to infertility and poorer pregnancy outcomes, and highlighting microbiome evaluation as key to improving reproductive health management.

This study shows chronic endometritis significantly increases pregnancy complications in women with endometriosis-associated infertility. Placenta previa, gestational hypertension, and cesarean sections were notably higher, emphasizing the importance of diagnosing and managing E effectively for improved reproductive outcomes.

This study demonstrates a causal link between specific gut microbiota and infertility risks, identifying protective and harmful bacterial taxa in both men and women. It highlights the microbiome’s potential role in fertility management through targeted probiotics and lifestyle interventions.

The study confirmed causal links between specific gut microbiota and female reproductive tract inflammation and infertility. Notably, Lachnospiraceae and Ruminococcus increased inflammation risks, while Butyricicoccus provided protection. Faecalibacterium heightened infertility risk, suggesting new targets for microbiome-based diagnostics and interventions.

Probiotics offer a promising microbiome-targeted intervention (BTI) for managing pelvic inflammatory disease (ID). By restoring beneficial Lactobacillus species and reducing inflammation, they directly counteract the microbial imbalances and immune dysregulation characteristic of ID. This article explores the therapeutic mechanisms of probiotics, their clinical validation, and how they reinforce the accuracy of ID’s microbiome signature as both a diagnostic and therapeutic tool.

Bacteriophage therapy presents a promising alternative to antibiotics for bacterial sexually transmitted infections, particularly against antibiotic-resistant strains like N. gonorrhoeae, through targeted bacterial destruction and minimal off-target effects, though significant clinical research and optimization remain essential for widespread application.

Vaginal microbiota transplantation (MT) successfully treats bacterial vaginosis by restoring Lactobacillus dominance, lowering vaginal pH, and inhibiting pathogens through nutritional competition, antimicrobial production, and enhanced epithelial adhesion, promising broad clinical applications for reproductive health.

Metformin emerges as a promising non-hormonal therapy for endometriosis, showing potent anti-inflammatory, anti-angiogenic, and fertility-enhancing effects, with significant symptom relief in limited clinical testing.

Metformin shows potential in treating endometriosis through anti-inflammatory, anti-angiogenic, anti-proliferative effects, and modulation of the gut microbiome. It could be a safe, effective alternative or adjunctive therapy, particularly in patients contraindicated for hormonal therapies or seeking fertility.

The study found a potent inhibitory effect against Chlamydia trachomatis infection using Lactobacillus brevis combined with lactoferrin, notably reducing bacterial adhesion, invasion, and inflammation. This indicates significant therapeutic potential in preventing chronic complications from genital infections.

Lactoferrin demonstrates significant antimicrobial and prebiotic activity in the female reproductive tract, promoting beneficial bacteria and suppressing pathogens, suggesting therapeutic potential for vaginal microbiota balance.

This review explores the impact of microbiome imbalances on infertility, with insights into microbial diagnostics and potential treatments to improve fertility outcomes.

This review investigates the potential of Complementary and Alternative Medicine (AM) in managing Pelvic Inflammatory Disease (ID). Therapies like Chinese Herbal Medicine and acupuncture show promise in improving symptoms and reducing inflammation, making them valuable adjuncts to conventional treatments.

This review highlights the crucial interactions between gut microbiota and microRNAs in pelvic inflammatory disease, revealing novel diagnostic markers and therapeutic targets.

Women with pelvic inflammatory disease have a higher risk of endometrial cancer, especially older and hypertensive women, highlighting the need for vigilant care.

Higher dietary copper intake significantly lowers the risk of pelvic inflammatory disease in S. women, highlighting copper’s role in inflammation and reproductive health.

Higher dietary magnesium intake significantly reduces pelvic inflammatory disease risk in S. women, especially older adults, highlighting magnesium’s role in inflammation and reproductive health.

Kangfuxiaoyan suppository effectively treats chronic pelvic inflammatory disease by regulating key inflammatory and metabolic pathways, significantly reducing inflammation. Integrated metabolomics and network pharmacology clarify its therapeutic mechanisms, highlighting specific active ingredients and metabolic biomarkers for potential clinical use.

This study shows volatile oil from Prunella vulgaris effectively reduces pelvic inflammation by correcting metabolic disruptions in a rat ID model, highlighting key inflammatory metabolites as biomarkers and suggesting therapeutic potential for herbal treatments in ID management.

This study identifies key differences in the vaginal microbiome of women with ID, emphasizing a significant reduction in Lactobacillus and an increase in polymicrobial infections. The findings underscore the importance of microbiome management in diagnosing and treating ID.

This study identifies microbial differences in women with ID based on UD use, highlighting a higher presence of anaerobic bacteria in UD users and an increased risk of ID complications. These findings emphasize the need for careful monitoring of UD users and further research into the microbiome’s role in ID development.

This study identifies key bacterial pathogens associated with pelvic inflammatory disease (ID) in Abuja, Nigeria, highlighting the effectiveness of Cefotaxime in treatment. The research also stresses the role of socio-demographic factors in ID prevalence and calls for targeted health interventions.

This study identifies key socio-demographic factors associated with ID in women of reproductive age, highlighting the need for better education, healthcare access, and early intervention. It underscores the importance of targeting high-risk groups, including young, uneducated, and economically disadvantaged women, for improved reproductive health outcomes.

This meta-analysis reveals a significant association between pelvic inflammatory disease (ID) and an increased risk of ovarian cancer. The link is particularly strong among Asian women, with implications for early detection and prevention strategies, especially for borderline ovarian tumors.

This nationwide study from Taiwan demonstrates that women with a history of pelvic inflammatory disease (ID) are at a significantly higher risk of developing ovarian cancer. The study highlights the importance of monitoring and early screening for ovarian cancer in women with ID, particularly those aged 40 and above.

This review highlights how vaginal microbiota imbalance, particularly bacterial vaginosis, significantly increases the risk of pelvic inflammatory disease. Advanced molecular methods have identified diverse microbes linked to ID, emphasizing the importance of microbiome health in preventing serious reproductive infections.

This study identified a declining trend in emergency department diagnoses of ID among North Carolina women from 2008-2017. Persistent disparities emerged among young, low-income, and publicly insured women, underscoring the need for improved screening, reporting, and public health interventions to reduce ID’s serious reproductive consequences.

Family practice perspectives highlight challenges diagnosing ID, advocating enhanced clinical suspicion, multi-antibiotic treatment adherence, and regular screening for asymptomatic infections to minimize severe reproductive complications such as infertility and ectopic pregnancies.

This review highlights ID’s diagnostic challenges, microbiological associations, and evidence-based treatment guidelines. It emphasizes routine screening for chlamydia to reduce disease incidence, focusing clinicians on adopting comprehensive strategies aligned with current DC recommendations to effectively manage and prevent ID and its severe reproductive complications.

This study highlights significant gaps in gynecologists’ knowledge regarding Pelvic Inflammatory Disease (ID). Misdiagnosis, inadequate treatment duration, and poor adherence to guidelines were noted. Enhanced training and culturally adapted guidelines are urgently recommended to address misconceptions and improve patient outcomes.

Pelvic Inflammatory Disease (ID) is a complex interplay between pathogens, immune responses, and microbial communities. As research continues to uncover the microbiome’s role in reproductive health, microbiome-targeted interventions (BTIs) such as probiotics, prebiotics, and transplants are redefining how we prevent and treat ID. This page dives deep into these innovations, offering a glimpse into the future of personalized, biologically informed women’s healthcare.

This systematic review explores the impact of diet and nutritional supplementation on perinatal depression (PD), highlighting protective effects from healthy dietary patterns, omega-3s, and micronutrients like Vitamin D and selenium, but emphasizes the need for further research.

This review explores the clinical, psychological, and pharmacological treatment options for postpartum depression (PD), focusing on antidepressants, therapy, and alternative treatments like omega-3s and exercise, highlighting the importance of early intervention and individualized care for new mothers.

This study explores how 919 syrup, a Chinese herbal remedy, alleviates postpartum depression (PD) by modulating the gut microbiome and hippocampal ABA metabolism, offering a novel treatment approach.

This study demonstrates that Lactobacillus rhamnosus N001 reduces symptoms of postpartum depression and anxiety, providing a potential non-pharmaceutical treatment for new mothers.

This review investigates the relationship between gut microbiota and perinatal depression, highlighting how nutrition and probiotics may help regulate mood disorders during pregnancy and postpartum.

This study identifies gut microbiota and blood metabolites causally associated with postpartum depression, revealing potential biomarkers and therapeutic targets for PD.

What was reviewed?The review was a protocol for a systematic review and meta-analysis aimed at evaluating the effectiveness of iron supplementation in treating postpartum depression (PD). The review seeks to analyze randomized controlled trials (CTs) to gather evidence on the benefits of iron supplementation for PD, as iron deficiency has been associated with increased risks […]

The study explored the impact of iron deficiency anemia on postpartum cognitive and emotional health. Iron supplementation significantly improved depression, stress, and cognitive performance in anemic mothers, with potential implications for maternal and infant health.

This study highlights the role of gestational iron supplementation in alleviating depressive-like behavior in postpartum rats, showing improvements in neuronal health and mood regulation. It suggests that addressing maternal iron deficiency may be a promising strategy for managing postpartum depression.

What was reviewed?This study is a systematic review and meta-analysis that investigates the association between anemia (both postpartum anemia and anemia during pregnancy) and postpartum depression (PD). The review aims to provide a comprehensive assessment by synthesizing findings from multiple studies to evaluate whether anemia increases the risk of developing PD in women.Who was reviewed?The […]

This study demonstrates that low serum zinc levels correlate with increased severity of postpartum depression, suggesting the potential benefits of zinc supplementation in postpartum care.

Postpartum zinc supplementation shows promise in reducing postpartum depression risk and improving maternal zinc levels, though it may cause transient hematological changes when combined with iron.

This review links prenatal chemical exposures to perinatal depression and anxiety through microbiome disruption and neuroinflammation. Environmental chemicals alter the gut-brain axis, emphasizing the need for integrative, preventative maternal mental health strategies.

This study demonstrates significant associations between prenatal traffic-related air pollution exposure and postpartum depressive and anxiety symptoms, highlighting increased vulnerability among women with hypertensive pregnancy disorders. Findings support integrating environmental health assessments into postpartum mental health strategies.

This review highlights how gut microbiota disruptions contribute to postpartum depression via hormonal, inflammatory, and neurochemical pathways. It supports microbial modulation as a novel, noninvasive treatment strategy.

This review explores how deficiencies or imbalances in zinc, magnesium, iron, and copper contribute to postpartum depression. It supports trace element supplementation as a nonpharmacologic treatment strategy and calls for further research to solidify clinical protocols and explore microbiome interactions.

This study identifies significant barriers preventing women from seeking help for postpartum depression, notably stigma and socio-cultural factors. Active help-seeking behaviors significantly increase diagnosis rates, highlighting the importance of mental health education and stigma-reduction efforts, especially among Pacific Islander women and those with intended pregnancies.

This review emphasizes peripartum depression as distinct from general depression, featuring pronounced anxiety, psychomotor symptoms, and obsessive thoughts, urging expanded diagnostic criteria to cover the full peripartum year and specific maternal symptomatology, crucial for improved diagnosis and tailored intervention.

This review explores women’s experiences with psychological treatments for postpartum depression, emphasizing the importance of personalized care, supportive relationships, and social support systems. It highlights the positive outcomes of treatments like BT and home visits, while stressing the need for flexibility and empathy in treatment delivery.

This review examines how cultural factors influence postpartum depression, identifying both protective and harmful cultural practices. It emphasizes the need for culturally sensitive care and highlights the role of social support systems in mitigating depressive symptoms.

This umbrella review synthesizes research on postpartum depression risk factors, highlighting prenatal depression and current abuse as the strongest predictors. It emphasizes the need for targeted screening and early intervention to improve maternal health and outcomes for both mothers and their children.

This review analyzes the risk factors for postpartum depression (PD), highlighting key predictors such as a history of depression, lack of support, gestational diabetes, and birth complications. It calls for early screening and targeted interventions to address PD and mitigate its long-term effects on mothers and children.

This comprehensive review of postpartum depression (PD) explores its pathophysiology, risk factors, and treatment options. It emphasizes the need for early diagnosis, multidisciplinary care, and further research into the neurobiological causes of PD to improve prevention and treatment strategies.

This review examines the prevalence and risk factors of postpartum depression in Vietnam, highlighting significant socio-economic, cultural, and personal contributors. It calls for early screening and more comprehensive support for mothers, especially in rural areas.

This systematic review examines postpartum depression in Arab countries, revealing varying prevalence rates and highlighting socio-economic, marital, and health-related factors as major risk predictors. It advocates for routine screening and culturally sensitive interventions to address PD effectively.

This review explores the prevalence of postpartum depression (PD) among African mothers, highlighting significant variation across countries and the need for culturally validated diagnostic tools to improve screening and treatment in postpartum care.