Microbiota and Pelvic Inflammatory Disease Original paper

Researched by:

  • Divine Aleru ID
    Divine Aleru

    User avatarI 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.

June 19, 2025

  • Women’s Health
    Women’s Health

    Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.

  • Bacterial Vaginosis
    Bacterial Vaginosis

    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.

  • Pelvic Inflammatory Disease (PID)
    Pelvic Inflammatory Disease (PID)

    Pelvic Inflammatory Disease (PID) 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 (MBTIs) such as probiotics, prebiotics, and transplants are redefining how we prevent and treat PID. This page dives deep into these innovations, offering a glimpse into the future of personalized, biologically informed women’s healthcare.

Researched by:

  • Divine Aleru ID
    Divine Aleru

    User avatarI 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.

Last Updated: 2025

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.

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.

What was reviewed?

This review examined the complex relationship between pelvic inflammatory disease (PID) and the genital microbiota. It focused on recent advancements in molecular microbiological techniques and their implications for understanding the diverse bacterial communities in both healthy and diseased states of the female genital tract. It also explored how changes in these microbial communities (dysbiosis), specifically bacterial vaginosis, could significantly increase the risk of PID, sexually transmitted infections (STIs), HIV, and adverse reproductive outcomes.

Who was reviewed?

The review analyzed findings from several clinical and molecular microbiology studies involving women diagnosed with pelvic inflammatory disease or other genital infections. It included detailed analyses of microbial communities identified through culture-based methods and advanced molecular techniques, such as 16S rRNA sequencing, PCR-based identification, and cloning and sequencing methods. Patient groups ranged from asymptomatic healthy individuals to women with symptomatic PID, endometriosis, salpingitis, and tubo-ovarian abscesses (TOAs).

What were the most important findings?

The most important findings were that PID is typically polymicrobial, involving a diverse range of pathogens beyond traditional culprits like Chlamydia trachomatis and Neisseria gonorrhoeae. Advanced molecular techniques revealed that bacterial vaginosis-associated bacteria (BVAB), including Gardnerella vaginalis, Atopobium vaginae, and several anaerobic species (e.g., Prevotella, Sneathia, and BVAB 1, 2, and 3), significantly associate with PID development. This contrasts with earlier beliefs that focused primarily on classic sexually transmitted pathogens. The data strongly indicate that vaginal microbiota disturbances, especially reductions in protective Lactobacillus species, substantially increase the risk of ascending infections to the upper genital tract.

Clinicians are increasingly recognizing novel microbial phylotypes and traditionally overlooked anaerobes in PID, especially in severe cases like TOAs. Anaerobes such as Prevotella, Bacteroides, and Peptostreptococcus have frequently emerged as critical players. The identification of BV-associated microbes in salpingitis and abscesses reinforces the microbial continuum from vaginal dysbiosis to upper genital tract infections, providing substantial evidence that microbial dysbiosis directly predisposes women to PID.

What are the greatest implications of this review?

This review significantly impacts clinical practice by underscoring the importance of maintaining a healthy vaginal microbiota to prevent upper genital tract infections. Clinicians should recognize BV as a critical modifiable risk factor for PID and associated complications, including infertility and ectopic pregnancy. The findings emphasize the urgent need for improved screening and treatment strategies for BV to reduce PID incidence and associated reproductive health complications. Additionally, molecular identification of novel pathogens stresses the necessity of broad-spectrum antimicrobial regimens capable of targeting a diverse microbial landscape, especially anaerobes. Future research must continue exploring the therapeutic and preventive potential of maintaining a healthy vaginal microbiome.

Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) 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 (MBTIs) such as probiotics, prebiotics, and transplants are redefining how we prevent and treat PID. This page dives deep into these innovations, offering a glimpse into the future of personalized, biologically informed women’s healthcare.

Bacterial Vaginosis

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.

Endometriosis

Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.

Infertility

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.

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