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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Pelvic Inflammatory Disease (PID)
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.
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Divine Aleru
I am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
I am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
Overview
Pelvic Inflammatory Disease (PID) is a significant infection of the female upper reproductive tract, affecting the uterus, fallopian tubes, ovaries, and other surrounding pelvic structures. It is most commonly caused by sexually transmitted infections (STIs), particularly Chlamydia trachomatis and Neisseria gonorrhoeae. These infections ascend from the cervix or vagina into the upper genital tract, where they trigger an immune-inflammatory response.[1] This inflammation can lead to severe long-term complications, such as infertility, ectopic pregnancy, and chronic pelvic pain.[2] PID is considered a major cause of morbidity among women of reproductive age, with millions of cases occurring globally each year. The condition is most prevalent in women aged 15 to 25 and is often linked to sexual behaviors, such as multiple sexual partners or inconsistent condom use.[3][4] According to the National Health and Nutrition Examination Survey (NHANES) 2013–2014, the prevalence of a self-reported lifetime diagnosis of PID was 4.4% among sexually experienced women of reproductive age, translating to approximately 2.5 million prevalent PID cases in women aged 18 to 44 years nationwide in the United States.[5] This prevalence varied significantly depending on sexual health history and sexual behaviors, with PID rates differing across different racial and ethnic groups. Recent research has highlighted the importance of the microbiome in the development and progression of PID.[6] The vaginal microbiota, when balanced, plays a protective role in preventing infections. However, disruptions, or dysbiosis, where harmful bacteria overgrow, can increase the risk of PID. This connection between the microbiome and PID highlights a potential area for novel diagnostic and therapeutic interventions. [7]
Associated Conditions
PID is not only a significant reproductive health issue but is also associated with other severe conditions, especially those affecting a woman’s fertility. Infertility is one of the most concerning consequences of PID, as the inflammation and scarring of the fallopian tubes can prevent the passage of eggs from the ovaries to the uterus.[8] This condition can lead to tubal infertility, where the fallopian tubes are either blocked or impaired in their ability to function.[9][10] PID also increases the risk of ectopic pregnancies, which can be life-threatening if not treated promptly.[11][12]Chronic pelvic pain is a common long-term consequence, severely impacting a woman’s quality of life.[13][14] Emerging research has also drawn links between PID and endometriosis.[15] Studies have shown that women with a history of PID have a higher risk of developing ovarian cancer, especially in cases where the PID was chronic or recurrent.[16] The inflammatory environment caused by PID might contribute to carcinogenesis in the ovaries and fallopian tubes, as persistent inflammation can damage the epithelium of these organs, increasing the likelihood of malignant transformations.
Causes
PID is primarily caused by infections that ascend from the cervix and vagina into the upper genital tract. The most common pathogens implicated in PID are Chlamydia trachomatis and Neisseria gonorrhoeae, both of which are sexually transmitted infections (STIs).[17] These bacteria can trigger an immune response in the reproductive organs, leading to inflammation and, if untreated, long-term damage to the fallopian tubes, ovaries, and uterus. Other bacteria, including those associated with bacterial vaginosis (Peptostreptococcus and Bacteroides species) and enteric pathogens such as Escherichia coli, can also contribute to PID, especially in post-menopausal women or those with other underlying health conditions.[18][20] The pathogenesis of PID involves an immune-inflammatory response where the body attempts to fight off the infection, but in the process, it inadvertently damages the reproductive tissues, leading to scarring and adhesions that disrupt normal reproductive function.
Diagnosis
Diagnosing PID is primarily clinical, as it relies heavily on patient history and physical examination. Women with PID often present with lower abdominal or pelvic pain, vaginal discharge, dyspareunia (pain during intercourse), and symptoms of genital tract inflammation.[21] However, the variability in symptoms makes PID difficult to diagnose accurately, especially in cases where the infection is subclinical or presents with mild symptoms. Diagnosis is confirmed through clinical findings such as cervical motion tenderness, uterine tenderness, and adnexal tenderness, often accompanied by abnormal vaginal discharge. Laboratory tests, including nucleic acid amplification tests (NAAT) for Chlamydia trachomatis and Neisseria gonorrhoeae, are essential for confirming the infectious causes of PID.[22] In cases where the diagnosis is uncertain, or when complications such as tubo-ovarian abscess are suspected, imaging studies such as pelvic ultrasound may be used, or when complications are suspected, laparoscopy is considered a gold standard for confirming PID.[23][24] Advancements in diagnostic techniques are also exploring the potential of microbiome signatures and metabolomic profiles to detect PID, offering a non-invasive and more precise way to diagnose and monitor the disease.[25]
Primer
PID is a disease involving the female reproductive organs, immune system, and microbiome. Understanding the microbiome’s role in PID is important, as the gut and vaginal microbiota are deeply interconnected with immune functions and inflammation.[26] The immune-inflammatory response triggered by infections in the genital tract can have wide-reaching effects, potentially leading to long-term complications like infertility, endometriosis chronic pelvic pain, and an increased risk of ovarian cancer.[27] Studies increasingly focus on how manipulating the microbiome could provide novel treatment avenues for PID, including probiotics, fecal microbiota transplantation, vaginal microbiota transplantation, and other microbiome-targeted interventions. Understanding PID as a disease that goes beyond simple infection to involve immune system dysfunction and microbiome imbalance is vital for developing effective diagnostic and therapeutic strategies.
Metallomic Signature
Trace metals and minerals play a significant role in the pathophysiology and management of pelvic inflammatory disease. NHANES reveal a notable association between dietary intake of certain trace metals, for example, copper and magnesium, and PID risk. Low dietary copper intake correlates strongly with increased PID prevalence, suggesting that adequate copper levels may contribute to regulating inflammatory responses associated with PID.[28] Similarly, magnesium intake is inversely related to PID risk, potentially through its involvement in cellular processes like DNA synthesis, protein production, and modulation of systemic inflammation.[29] These minerals influence immune function and oxidative stress, which are critical in PID’s chronic inflammation and tissue damage.
Metabolomic Signatures
In PID, inflammatory responses triggered by ascending infections lead to oxidative stress and immune dysregulation, which are reflected in changes in metabolites such as amino acids, lipids, and bioactive small molecules. Key metabolites involved include arginine and ornithine, central to the arginine-proline metabolic pathway, that regulate nitric oxide synthesis, a critical mediator of inflammation and tissue injury in PID.[30] Elevated arginine levels correspond with increased nitric oxide synthase (NOS) activity, exacerbating oxidative damage and contributing to chronic inflammation.Lipid metabolites, including leukotrienes and arachidonic acid derivatives, also play significant roles in modulating inflammatory signaling, promoting vasodilation, leukocyte recruitment, and cytokine release within the pelvic tissues.[31] Disruptions in glutathione metabolism, a primary antioxidant defense, indicate heightened oxidative stress and compromised cellular detoxification during PID.
Microbiome Signature: Pelvic Inflammatory Disease (PID)
Interventions
We assess microbiome-targeted interventions (MBTIs) by analyzing their effect on the gut, vaginal and pelvic microbiota, clinical symptom resolution, and the modulation of bacterial pathogens responsible for PID. This method classifies interventions as validated, promising, or experimental based on the strength of scientific evidence linking changes in microbial composition to improved clinical outcomes, such as reduced inflammation, infection, and recurrence of PID. Focusing on restoring microbial balance, enhancing mucosal immunity, and inhibiting pathogenic overgrowth helps identify interventions that are most likely to improve patient outcomes and prevent long-term complications associated with PID.
Intervention | Classification | Mechanism of Action | MBTI Status |
---|---|---|---|
Probiotics | Supplement | Lactobacillus species restore vaginal microbiota, inhibiting pathogen colonization, modulating vaginal pH, and enhancing mucosal immunity, thus reducing inflammation and susceptibility to PID-associated pathogens such as Chlamydia trachomatis and Neisseria gonorrhoeae.[32][33] | Validated |
Lactoferrin | Supplement | Lactoferrin exhibits prebiotic and antimicrobial activities, stimulating growth of beneficial vaginal microbiota while suppressing pathogens.[34] It modulates inflammation and strengthens mucosal immunity, effectively reducing PID severity and complications linked to microbial dysbiosis.[35] | Promising Candidate |
Vaginal Microbiota Transplantation (VMT) | Microbiota-based therapy | The transfer of healthy vaginal microbiota restores beneficial bacterial dominance, thereby re-establishing microbial homeostasis, preventing pathogen colonization, and mitigating inflammatory responses characteristic of PID.[36] | Experimental |
Fecal Microbiota Transplantation (FMT) | Microbiota-based therapy | Similar to VMT, the transfer of beneficial gut microbiota restores gut-vaginal microbial axis integrity, thereby reducing systemic inflammation, enhancing mucosal immunity, and indirectly ameliorating PID symptoms through modulation of intestinal flora and host immune responses.[37] | Experimental |
Metformin | Parmaceutical | Metformin modulates gut microbiota, improves mucosal barrier function, and reduces systemic inflammation via activation of AMP-activated protein kinase (AMPK), potentially decreasing inflammatory cytokines and oxidative stress markers involved in PID pathogenesis.[38][39] | Promising Candidate |
Bacteriophage Therapy | Biological Therapy | Bacteriophages provide a precise antibacterial effect without disrupting beneficial microbiota. This targeted approach prevents bacterial resistance, reduces inflammation, and restores microbial balance within the reproductive tract.[40] | Experimental |
Antimicrobial Peptides | Biological Therapy | The use of naturally derived or synthetic peptides that possess antimicrobial properties, targeting pathogenic bacteria associated with PID.[41] These peptides modulate vaginal microbiota composition, support mucosal immunity, reduce microbial colonization linked to PID pathogenesis.[42] | Promising Candidate |
Hyperbaric Oxygen Therapy (HBOT) | Physical Therapy | HBOT enhances oxygen delivery and reduces inflammation, promoting beneficial microbial growth and suppressing pathogenic anaerobic bacteria linked to PID.[43] | Under Investigation |
FAQs
How do microbiome-targeted interventions (MBTIs) differ from traditional antibiotic treatments in managing PID?
Traditional antibiotic treatments for PID focus on eradicating pathogens such as Chlamydia trachomatis and Neisseria gonorrhoeae, they often do so at the expense of the commensal (beneficial) microbiota. This non-selective approach can disrupt the vaginal and gut microbiomes, potentially leading to recurrent infections, antibiotic resistance, and poor long-term outcomes. In contrast, MBTIs aim to restore and maintain a healthy microbial balance, which plays a crucial role in immune regulation, mucosal barrier integrity, and pathogen resistance. Interventions such as probiotics, prebiotics like lactoferrin, and microbiota transplants (VMT and FMT) selectively support beneficial microbes while suppressing harmful ones. Emerging MBTIs like bacteriophage therapy and antimicrobial peptides offer pathogen-specific targeting without disturbing microbiome homeostasis. By correcting dysbiosis and modulating host immune responses, MBTIs provide a more sustainable, precision-based, and less disruptive alternative to conventional antibiotics.
What is the scientific rationale for using Vaginal Microbiota Transplantation (VMT) or Fecal Microbiota Transplantation (FMT) in PID?
The rationale behind using VMT and FMT in PID is grounded in the concept that both the vaginal and gut microbiomes play pivotal roles in reproductive tract immunity and inflammation. In many women with PID, especially those with recurrent or chronic cases, there is a documented imbalance in the vaginal microbiota—typically characterized by a depletion of Lactobacillus species and overgrowth of anaerobic pathogens. VMT involves transferring vaginal fluid from a healthy donor to restore Lactobacillus dominance, reestablishing pH balance, and reducing inflammation and pathogen colonization. On the other hand, FMT targets the gut-vaginal microbial axis. The gut microbiota communicates with the vaginal microbiome via hormonal, immune, and metabolic pathways. Disruption in the gut flora can contribute to systemic inflammation and weakened immune defenses, which in turn exacerbate PID. Restoring a healthy gut microbiome via FMT can indirectly improve vaginal immunity and reduce chronic pelvic inflammation. These strategies represent a systems-level, holistic approach to microbiome modulation in PID therapy.
Are microbiome-targeted interventions safe, and what challenges remain before they can be widely implemented in PID treatment?
Most microbiome-targeted interventions show promising safety profiles, especially well-characterized probiotics and prebiotics like lactoferrin, which have been extensively studied in reproductive and gastrointestinal health. However, the safety of newer MBTIs such as VMT, FMT, and bacteriophage therapy, requires further validation in large-scale clinical trials. Risks include potential transmission of pathogens (especially in transplants), immune reactions, and variability in donor microbiota. Personalized response to MBTIs can vary depending on the host’s existing microbial composition, genetic background, and environmental exposures. Another challenge is the lack of standardized protocols for donor screening, microbiota preparation, and administration, particularly for VMT. Regulatory frameworks also lag behind scientific progress, slowing the adoption of these therapies in clinical practice. Despite these hurdles, advancements in microbiome science, precision diagnostics, and regulatory policy are steadily paving the way for MBTIs to become a core component of PID management.
Research Feed
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) increases the risk of acquiring HIV by up to 60% in women due to the disruption of the protective vaginal microbiome and the resulting inflammation that facilitates the virus’s entry.
Did you know?
Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Did you know?
Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Did you know?
Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Did you know?
Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Did you know?
Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Gut microbiota predict endometriosis better than vaginal microbiota.
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Gut microbiota predict endometriosis better than vaginal microbiota.
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Despite common perceptions, male factors alone are responsible for about 30% of all infertility cases and contribute to another 20% when combined with female factors. This highlights the importance of evaluating both partners in infertility assessments.
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Bacterial vaginosis (BV) is the most common vaginal disorder linked to an increased risk of PID and that restoring Lactobacillus-dominant flora reduces this risk?
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Chronic Pelvic Pain (CPP) is persistent pain in the pelvic region lasting six months or longer, often multifactorial, impacting physical and emotional well-being, and associated with various medical conditions.
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Chronic Pelvic Pain (CPP) is persistent pain in the pelvic region lasting six months or longer, often multifactorial, impacting physical and emotional well-being, and associated with various medical conditions.
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
Bacterial vaginosis (BV) is caused by an imbalance in the vaginal microbiota, where the typically dominant Lactobacillus species are significantly reduced, leading to an overgrowth of anaerobic and facultative bacteria.
Probiotics are live microorganisms that offer significant health benefits when administered in adequate amounts. They primarily work by modulating the gut microbiome, supporting a balanced microbial ecosystem. Probiotics have been shown to improve gut health, modulate immune responses, and even influence metabolic and mental health disorders. With growing evidence supporting their therapeutic potential, probiotics are increasingly recognized for their role in treating conditions like irritable bowel syndrome (IBS), antibiotic-associated diarrhea (AAD), and even mental health conditions like depression and anxiety through their impact on the gut-brain axis.
Fecal Microbiota Transplantation (FMT) involves transferring fecal bacteria from a healthy donor to a patient to restore microbiome balance.
Vaginal Microbiome Transplant (VMT) involves transferring healthy vaginal flora from a donor to a recipient to treat conditions like recurrent bacterial vaginosis. It aims to restore balance in the vaginal microbiome, potentially offering a non-pharmacological treatment option for persistent gynecological disorders.
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.
Probiotics are live microorganisms that offer significant health benefits when administered in adequate amounts. They primarily work by modulating the gut microbiome, supporting a balanced microbial ecosystem. Probiotics have been shown to improve gut health, modulate immune responses, and even influence metabolic and mental health disorders. With growing evidence supporting their therapeutic potential, probiotics are increasingly recognized for their role in treating conditions like irritable bowel syndrome (IBS), antibiotic-associated diarrhea (AAD), and even mental health conditions like depression and anxiety through their impact on the gut-brain axis.
Probiotics offer a promising microbiome-targeted intervention (MBTI) for managing pelvic inflammatory disease (PID). By restoring beneficial Lactobacillus species and reducing inflammation, they directly counteract the microbial imbalances and immune dysregulation characteristic of PID. This article explores the therapeutic mechanisms of probiotics, their clinical validation, and how they reinforce the accuracy of PID’s microbiome signature as both a diagnostic and therapeutic tool.
Lactoferrin (LF) is a naturally occurring iron-binding glycoprotein classified as a postbiotic with immunomodulatory, antimicrobial, and prebiotic-like properties.
Vaginal Microbiome Transplant (VMT) involves transferring healthy vaginal flora from a donor to a recipient to treat conditions like recurrent bacterial vaginosis. It aims to restore balance in the vaginal microbiome, potentially offering a non-pharmacological treatment option for persistent gynecological disorders.
Fecal Microbiota Transplantation (FMT) involves transferring fecal bacteria from a healthy donor to a patient to restore microbiome balance.
Metformin is a synthetic derivative of guanidine derived from the guanidine alkaloid of the plant Galega officinalis L. with significant hypoglycemic effects. It is a first-line antihyperglycemic agent due to its efficacy, low cost, and favorable safety profile.
Phage therapy uses viruses to target and kill specific bacteria, offering a precise alternative to antibiotics, especially for resistant infections.
Hyperbaric Oxygen Therapy (HBOT) involves breathing pure oxygen in a pressurized chamber, which increases the amount of oxygen dissolved in the blood and delivered to tissues.
References
- Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan. Al-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.. (Medicine (Baltimore). 2023 Oct 6;102(40):e35014)
- The challenge of pelvic inflammatory disease. Crossman SH.. (Am Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.)
- Pelvic inflammatory disease: a family practice perspective. Sellors JW.. (Can Fam Physician. 1989 Jun;35:1309-14.)
- Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan. Al-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.. (Medicine (Baltimore). 2023 Oct 6;102(40):e35014)
- Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan. Al-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.. (Medicine (Baltimore). 2023 Oct 6;102(40):e35014)
- Microbiota and pelvic inflammatory disease. Sharma H, Tal R, Clark NA, Segars JH.. (Semin Reprod Med. 2014 Jan;32(1):43-9.)
- Research Progress on the Interaction between Intestinal Flora and MicroRNA in Pelvic Inflammatory Diseases. Dong, Shuhan, et al.. (Non-coding RNA Research, vol. 11, 2025, pp. 303-312,)
- Pelvic inflammatory disease: a family practice perspective. Sellors JW.. (Can Fam Physician. 1989 Jun;35:1309-14.)
- Pelvic inflammatory disease: a family practice perspective. Sellors JW.. (Can Fam Physician. 1989 Jun;35:1309-14.)
- Pelvic inflammatory disease and the risk of ovarian cancer: a meta-analysis. Zhou Z, Zeng F, Yuan J, Tang J, Colditz GA, Tworoger SS, Trabert B, Su X.. (Cancer Causes Control. 2017 May;28(5):415-428)
- Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan. Al-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.. (Medicine (Baltimore). 2023 Oct 6;102(40):e35014)
- Pelvic inflammatory disease: a family practice perspective. Sellors JW.. (Can Fam Physician. 1989 Jun;35:1309-14.)
- The challenge of pelvic inflammatory disease. Crossman SH.. (Am Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.)
- Pelvic inflammatory disease: a family practice perspective. Sellors JW.. (Can Fam Physician. 1989 Jun;35:1309-14.)
- Epidermiological markers in pelvic inflammatory disease (PID) among the women of reproductive age group. Pachori, R., & Kulkarni, N. (2016). (European Journal of Biomedical and Pharmaceutical Science, 3(2), 193-196.)
- Association of pelvic inflammatory disease (PID) with ovarian cancer: a nationwide population-based retrospective cohort study from Taiwan. Chang, C.YY., Lin, K.YH., Huang, CC. et al.. (BMC Women’s Health 21, 274 (2021))
- Pelvic Inflammatory Disease Trends Among Emergency Department Visits in North Carolina, 2008 to 2017. Neo DT, Samoff E, Cope A.. (Sex Transm Dis. 2022 Jan 1;49(1):43-49)
- Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan. Al-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.. (Medicine (Baltimore). 2023 Oct 6;102(40):e35014)
- Pelvic Inflammatory Disease Trends Among Emergency Department Visits in North Carolina, 2008 to 2017. Neo DT, Samoff E, Cope A.. (Sex Transm Dis. 2022 Jan 1;49(1):43-49)
- Microbiota and pelvic inflammatory disease. Sharma H, Tal R, Clark NA, Segars JH.. (Semin Reprod Med. 2014 Jan;32(1):43-9.)
- The challenge of pelvic inflammatory disease. Crossman SH.. (Am Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.)
- Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan. Al-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.. (Medicine (Baltimore). 2023 Oct 6;102(40):e35014)
- Pelvic inflammatory disease: a family practice perspective. Sellors JW.. (Can Fam Physician. 1989 Jun;35:1309-14.)
- The challenge of pelvic inflammatory disease. Crossman SH.. (Am Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.)
- Characteristics of Vaginal Microbiome in Women with Pelvic Inflammatory Disease in Korea. Kim S, Seo H, Rahim MA, Tajdozian H, Kim YS, Song HY.. (Pol J Microbiol. 2021 Sep;70(3):345-357)
- Microbiota and pelvic inflammatory disease. Sharma H, Tal R, Clark NA, Segars JH.. (Semin Reprod Med. 2014 Jan;32(1):43-9.)
- Epidermiological markers in pelvic inflammatory disease (PID) among the women of reproductive age group. Pachori, R., & Kulkarni, N. (2016). (European Journal of Biomedical and Pharmaceutical Science, 3(2), 193-196.)
- Association between dietary trace minerals and pelvic inflammatory disease: Data from the 2015–2018 National Health and Nutrition Examination Surveys. Hu, P., Zhang, S., Li, H., Yan, X., Zhang, X., & Zhang, Q. (2023).. (Frontiers in Nutrition, 10, 1273509.)
- Association between Dietary Magnesium Intake and Pelvic Inflammatory Disease in US Women: A Cross-sectional Study of NHANES. Chen, Zeru, et al.. (Frontiers in Nutrition, vol. 11, 2024, p. 1430730,)
- Integrated Metabolomics and Network Pharmacology Study on the Mechanism of Kangfuxiaoyan Suppository for Treating Chronic Pelvic Inflammatory Disease.. Zhang, Z., Xie, Z., Lv, S., Shi, Y., Zhai, C., Li, X., Qiao, B., & Gao, X. (2022).. (Frontiers in Pharmacology, 13, 812587.)
- Integrated Metabolomics and Network Pharmacology Study on the Mechanism of Kangfuxiaoyan Suppository for Treating Chronic Pelvic Inflammatory Disease.. Zhang, Z., Xie, Z., Lv, S., Shi, Y., Zhai, C., Li, X., Qiao, B., & Gao, X. (2022).. (Frontiers in Pharmacology, 13, 812587.)
- Lactobacilli–lactoferrin interplay in Chlamydia trachomatis infection. Rosa Sessa, Marisa Di Pietro, Simone Filardo, Alessia Bressan, Paola Mastromarino, Alessandra Vittoria Biasucci, Luigi Rosa, Antimo Cutone, Francesca Berlutti, Rosalba Paesano, Piera Valenti,. (Pathogens and Disease, Volume 75, Issue 5, July 2017, ftx054,)
- Research Progress on the Interaction between Intestinal Flora and MicroRNA in Pelvic Inflammatory Diseases. Dong, Shuhan, et al.. (Non-coding RNA Research, vol. 11, 2025, pp. 303-312,)
- Antimicrobial and Prebiotic Activity of Lactoferrin in the Female Reproductive Tract: A Comprehensive Review. Artym J, Zimecki M.. (Biomedicines. 2021 Dec 17;9(12):1940)
- Lactobacilli–lactoferrin interplay in Chlamydia trachomatis infection. Rosa Sessa, Marisa Di Pietro, Simone Filardo, Alessia Bressan, Paola Mastromarino, Alessandra Vittoria Biasucci, Luigi Rosa, Antimo Cutone, Francesca Berlutti, Rosalba Paesano, Piera Valenti,. (Pathogens and Disease, Volume 75, Issue 5, July 2017, ftx054,)
- Possible Therapeutic Mechanisms and Future Perspectives of Vaginal Microbiota Transplantation. Tuniyazi, M., & Zhang, N. (2023).. (Microorganisms, 11(6), 1427.)
- Research Progress on the Interaction between Intestinal Flora and MicroRNA in Pelvic Inflammatory Diseases. Dong, Shuhan, et al.. (Non-coding RNA Research, vol. 11, 2025, pp. 303-312,)
- Metformin, the Rise of a New Medical Therapy for Endometriosis? A Systematic Review of the Literature. Stochino-Loi E, Major AL, Gillon TER, Ayoubi JM, Feki A, Bouquet de Joliniere J.. (Front Med (Lausanne). 2021 May 11;8:581311.)
- Metformin as a Potential Treatment Option for Endometriosis. Kimber-Trojnar Ż, Dłuski DF, Wierzchowska-Opoka M, Ruszała M, Leszczyńska-Gorzelak B.. (Cancers (Basel). 2022 Jan 24;14(3):577)
- Potential for Phages in the Treatment of Bacterial Sexually Transmitted Infections.. Cater, K., Międzybrodzki, R., Morozova, V., Letkiewicz, S., Łusiak-Szelachowska, M., Rękas, J., Weber-Dąbrowska, B., & Górski, A. (2021). (Antibiotics, 10(9), 1030.)
- Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature Review. Wang D, Jiang Y, Feng J, Gao J, Yu J, Zhao J, Liu P, Han Y.. (Evid Based Complement Alternat Med. 2022 Jan 19;2022:1364297)
- Antimicrobial peptides in the female reproductive tract: A critical component of the mucosal immune barrier with physiological and clinical implications. Yarbrough, V. L., Winkle, S., & M., M. (2015).. (Human Reproduction Update, 21(3), 353-377.)
- Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature Review. Wang D, Jiang Y, Feng J, Gao J, Yu J, Zhao J, Liu P, Han Y.. (Evid Based Complement Alternat Med. 2022 Jan 19;2022:1364297)
Al-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.
Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in JordanMedicine (Baltimore). 2023 Oct 6;102(40):e35014
Read ReviewCrossman SH.
The challenge of pelvic inflammatory diseaseAm Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.
Read ReviewSellors JW.
Pelvic inflammatory disease: a family practice perspectiveCan Fam Physician. 1989 Jun;35:1309-14.
Read ReviewAl-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.
Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in JordanMedicine (Baltimore). 2023 Oct 6;102(40):e35014
Read ReviewAl-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.
Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in JordanMedicine (Baltimore). 2023 Oct 6;102(40):e35014
Read ReviewSharma H, Tal R, Clark NA, Segars JH.
Microbiota and pelvic inflammatory diseaseSemin Reprod Med. 2014 Jan;32(1):43-9.
Read ReviewDong, Shuhan, et al.
Research Progress on the Interaction between Intestinal Flora and MicroRNA in Pelvic Inflammatory DiseasesNon-coding RNA Research, vol. 11, 2025, pp. 303-312,
Read ReviewSellors JW.
Pelvic inflammatory disease: a family practice perspectiveCan Fam Physician. 1989 Jun;35:1309-14.
Read ReviewSellors JW.
Pelvic inflammatory disease: a family practice perspectiveCan Fam Physician. 1989 Jun;35:1309-14.
Read ReviewZhou Z, Zeng F, Yuan J, Tang J, Colditz GA, Tworoger SS, Trabert B, Su X.
Pelvic inflammatory disease and the risk of ovarian cancer: a meta-analysisCancer Causes Control. 2017 May;28(5):415-428
Read ReviewAl-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.
Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in JordanMedicine (Baltimore). 2023 Oct 6;102(40):e35014
Read ReviewSellors JW.
Pelvic inflammatory disease: a family practice perspectiveCan Fam Physician. 1989 Jun;35:1309-14.
Read ReviewCrossman SH.
The challenge of pelvic inflammatory diseaseAm Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.
Read ReviewSellors JW.
Pelvic inflammatory disease: a family practice perspectiveCan Fam Physician. 1989 Jun;35:1309-14.
Read ReviewPachori, R., & Kulkarni, N. (2016)
Epidermiological markers in pelvic inflammatory disease (PID) among the women of reproductive age groupEuropean Journal of Biomedical and Pharmaceutical Science, 3(2), 193-196.
Read ReviewChang, C.YY., Lin, K.YH., Huang, CC. et al.
Association of pelvic inflammatory disease (PID) with ovarian cancer: a nationwide population-based retrospective cohort study from TaiwanBMC Women’s Health 21, 274 (2021)
Read ReviewNeo DT, Samoff E, Cope A.
Pelvic Inflammatory Disease Trends Among Emergency Department Visits in North Carolina, 2008 to 2017Sex Transm Dis. 2022 Jan 1;49(1):43-49
Read ReviewAl-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.
Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in JordanMedicine (Baltimore). 2023 Oct 6;102(40):e35014
Read ReviewNeo DT, Samoff E, Cope A.
Pelvic Inflammatory Disease Trends Among Emergency Department Visits in North Carolina, 2008 to 2017Sex Transm Dis. 2022 Jan 1;49(1):43-49
Read ReviewSharma H, Tal R, Clark NA, Segars JH.
Microbiota and pelvic inflammatory diseaseSemin Reprod Med. 2014 Jan;32(1):43-9.
Read ReviewCrossman SH.
The challenge of pelvic inflammatory diseaseAm Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.
Read ReviewAl-Kuran OA, Al-Mehaisen L, Al-Karablieh M, Abu Ajamieh M, Flefil S, Al-Mashaqbeh S, Albustanji Y, Al-Kuran L.
Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in JordanMedicine (Baltimore). 2023 Oct 6;102(40):e35014
Read ReviewSellors JW.
Pelvic inflammatory disease: a family practice perspectiveCan Fam Physician. 1989 Jun;35:1309-14.
Read ReviewCrossman SH.
The challenge of pelvic inflammatory diseaseAm Fam Physician. 2006 Mar 1;73(5):859-64. Erratum in: Am Fam Physician. 2006 Dec 15;74(12):2024.
Read ReviewKim S, Seo H, Rahim MA, Tajdozian H, Kim YS, Song HY.
Characteristics of Vaginal Microbiome in Women with Pelvic Inflammatory Disease in KoreaPol J Microbiol. 2021 Sep;70(3):345-357
Read ReviewSharma H, Tal R, Clark NA, Segars JH.
Microbiota and pelvic inflammatory diseaseSemin Reprod Med. 2014 Jan;32(1):43-9.
Read ReviewPachori, R., & Kulkarni, N. (2016)
Epidermiological markers in pelvic inflammatory disease (PID) among the women of reproductive age groupEuropean Journal of Biomedical and Pharmaceutical Science, 3(2), 193-196.
Read ReviewHu, P., Zhang, S., Li, H., Yan, X., Zhang, X., & Zhang, Q. (2023).
Association between dietary trace minerals and pelvic inflammatory disease: Data from the 2015–2018 National Health and Nutrition Examination SurveysFrontiers in Nutrition, 10, 1273509.
Read ReviewChen, Zeru, et al.
Association between Dietary Magnesium Intake and Pelvic Inflammatory Disease in US Women: A Cross-sectional Study of NHANESFrontiers in Nutrition, vol. 11, 2024, p. 1430730,
Read ReviewZhang, Z., Xie, Z., Lv, S., Shi, Y., Zhai, C., Li, X., Qiao, B., & Gao, X. (2022).
Integrated Metabolomics and Network Pharmacology Study on the Mechanism of Kangfuxiaoyan Suppository for Treating Chronic Pelvic Inflammatory Disease.Frontiers in Pharmacology, 13, 812587.
Read ReviewZhang, Z., Xie, Z., Lv, S., Shi, Y., Zhai, C., Li, X., Qiao, B., & Gao, X. (2022).
Integrated Metabolomics and Network Pharmacology Study on the Mechanism of Kangfuxiaoyan Suppository for Treating Chronic Pelvic Inflammatory Disease.Frontiers in Pharmacology, 13, 812587.
Read ReviewRosa Sessa, Marisa Di Pietro, Simone Filardo, Alessia Bressan, Paola Mastromarino, Alessandra Vittoria Biasucci, Luigi Rosa, Antimo Cutone, Francesca Berlutti, Rosalba Paesano, Piera Valenti,
Lactobacilli–lactoferrin interplay in Chlamydia trachomatis infectionPathogens and Disease, Volume 75, Issue 5, July 2017, ftx054,
Read ReviewDong, Shuhan, et al.
Research Progress on the Interaction between Intestinal Flora and MicroRNA in Pelvic Inflammatory DiseasesNon-coding RNA Research, vol. 11, 2025, pp. 303-312,
Read ReviewArtym J, Zimecki M.
Antimicrobial and Prebiotic Activity of Lactoferrin in the Female Reproductive Tract: A Comprehensive ReviewBiomedicines. 2021 Dec 17;9(12):1940
Read ReviewRosa Sessa, Marisa Di Pietro, Simone Filardo, Alessia Bressan, Paola Mastromarino, Alessandra Vittoria Biasucci, Luigi Rosa, Antimo Cutone, Francesca Berlutti, Rosalba Paesano, Piera Valenti,
Lactobacilli–lactoferrin interplay in Chlamydia trachomatis infectionPathogens and Disease, Volume 75, Issue 5, July 2017, ftx054,
Read ReviewTuniyazi, M., & Zhang, N. (2023).
Possible Therapeutic Mechanisms and Future Perspectives of Vaginal Microbiota TransplantationMicroorganisms, 11(6), 1427.
Read ReviewDong, Shuhan, et al.
Research Progress on the Interaction between Intestinal Flora and MicroRNA in Pelvic Inflammatory DiseasesNon-coding RNA Research, vol. 11, 2025, pp. 303-312,
Read ReviewStochino-Loi E, Major AL, Gillon TER, Ayoubi JM, Feki A, Bouquet de Joliniere J.
Metformin, the Rise of a New Medical Therapy for Endometriosis? A Systematic Review of the LiteratureFront Med (Lausanne). 2021 May 11;8:581311.
Read ReviewKimber-Trojnar Ż, Dłuski DF, Wierzchowska-Opoka M, Ruszała M, Leszczyńska-Gorzelak B.
Metformin as a Potential Treatment Option for EndometriosisCancers (Basel). 2022 Jan 24;14(3):577
Read ReviewCater, K., Międzybrodzki, R., Morozova, V., Letkiewicz, S., Łusiak-Szelachowska, M., Rękas, J., Weber-Dąbrowska, B., & Górski, A. (2021)
Potential for Phages in the Treatment of Bacterial Sexually Transmitted Infections.Antibiotics, 10(9), 1030.
Read ReviewWang D, Jiang Y, Feng J, Gao J, Yu J, Zhao J, Liu P, Han Y.
Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature ReviewEvid Based Complement Alternat Med. 2022 Jan 19;2022:1364297
Read ReviewYarbrough, V. L., Winkle, S., & M., M. (2015).
Antimicrobial peptides in the female reproductive tract: A critical component of the mucosal immune barrier with physiological and clinical implicationsHuman Reproduction Update, 21(3), 353-377.
Wang D, Jiang Y, Feng J, Gao J, Yu J, Zhao J, Liu P, Han Y.
Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature ReviewEvid Based Complement Alternat Med. 2022 Jan 19;2022:1364297
Read Review