Diversity in women and their vaginal microbiota

Sandra Condori-Catachura¹, Sarah Ahannach², Monica Ticlla³, Josiane Kenfack⁴, Esemu Livo⁵, Kingsley C Anukam⁶, Viviana Pinedo-Cancino⁷, Maria Carmen Collado⁸, Maria Gloria Dominguez-Bello⁹, Corrie Miller¹⁰, Gabriel Vinderola¹¹, Sonja Merten¹², Gilbert G G Donders¹³, Thies Gehrmann¹; Isala Sisterhood Consortium¹⁴; Sarah Lebeer¹⁵

Affiliations

¹ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
² Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; U-MaMi Centre of Excellence, University of Antwerp, Antwerp, Belgium.
³ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; Unit Society, Gender and Health - Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
⁴ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon; Centre for Research on Emerging and Reemerging Diseases, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon.
⁵ Centre for Research on Emerging and Reemerging Diseases, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon; Strengthening Health and Applied Research, Yaounde, Cameroon.
⁶ Department of Medical Microbiology and Public Health, Faculty of Medical Laboratory Science, Nnamdi Azikiwe University, Nigeria.
⁷ Laboratorio de Investigación de Productos Naturales Antiparasitarios de la Amazonía (LIPNAA), Centro de Investigaciones de Recursos Naturales de la UNAP (CIRNA), Universidad Nacional de la Amazonía Peruana (UNAP), Iquitos, Peru; Facultad de Medicina Humana, Universidad Nacional de la Amazonía Peruana (UNAP), Iquitos, Peru.
⁸ Department of Biotechnology, Institute of Agrochemistry and Food Technology - National Research Council (IATA-CSIC), Paterna, Valencia, Spain.
⁹ Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, NJ, USA; Department of Anthropology, Rutgers University, New Brunswick, NJ, USA; Humans and the Microbiome Program, Canadian Institute for Advanced Research, Toronto, Ontario, Canada.
¹⁰ Department of Obstetrics, Gynecology, and Women's Health, Division of Maternal Fetal Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA.
¹¹ Instituto de Lactología Industrial (INLAIN, CONICET-UNL), Facultad de Ingeniería Química, Universidad Nacional del Litoral, Santa Fe, Argentina.
¹² Unit Society, Gender and Health - Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
¹³ Department of Obstetrics and Gynaecology, University Hospital Antwerp, Edegem, Belgium.; Regional Hospital Heilig Hart, Tienen, Belgium; Femicare Clinical Research for Women, Tienen, Belgium.
¹⁴ U-MaMi Centre of Excellence, University of Antwerp, Antwerp, Belgium.
¹⁵ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; U-MaMi Centre of Excellence, University of Antwerp, Antwerp, Belgium. Electronic address: sarah.lebeer@uantwerpen.be.

PMID: 39919958
PMCID: PMC12628047
DOI: 10.1016/j.tim.2024.12.012

Review

Diversity in women and their vaginal microbiota

Sandra Condori-Catachura et al. Trends Microbiol. 2025 Nov.

. 2025 Nov;33(11):1163-1172.

doi: 10.1016/j.tim.2024.12.012. Epub 2025 Feb 6.

Authors

Affiliations

¹ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
² Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; U-MaMi Centre of Excellence, University of Antwerp, Antwerp, Belgium.
³ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; Unit Society, Gender and Health - Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
⁴ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon; Centre for Research on Emerging and Reemerging Diseases, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon.
⁵ Centre for Research on Emerging and Reemerging Diseases, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon; Strengthening Health and Applied Research, Yaounde, Cameroon.
⁶ Department of Medical Microbiology and Public Health, Faculty of Medical Laboratory Science, Nnamdi Azikiwe University, Nigeria.
⁷ Laboratorio de Investigación de Productos Naturales Antiparasitarios de la Amazonía (LIPNAA), Centro de Investigaciones de Recursos Naturales de la UNAP (CIRNA), Universidad Nacional de la Amazonía Peruana (UNAP), Iquitos, Peru; Facultad de Medicina Humana, Universidad Nacional de la Amazonía Peruana (UNAP), Iquitos, Peru.
⁸ Department of Biotechnology, Institute of Agrochemistry and Food Technology - National Research Council (IATA-CSIC), Paterna, Valencia, Spain.
⁹ Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, NJ, USA; Department of Anthropology, Rutgers University, New Brunswick, NJ, USA; Humans and the Microbiome Program, Canadian Institute for Advanced Research, Toronto, Ontario, Canada.
¹⁰ Department of Obstetrics, Gynecology, and Women's Health, Division of Maternal Fetal Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA.
¹¹ Instituto de Lactología Industrial (INLAIN, CONICET-UNL), Facultad de Ingeniería Química, Universidad Nacional del Litoral, Santa Fe, Argentina.
¹² Unit Society, Gender and Health - Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
¹³ Department of Obstetrics and Gynaecology, University Hospital Antwerp, Edegem, Belgium.; Regional Hospital Heilig Hart, Tienen, Belgium; Femicare Clinical Research for Women, Tienen, Belgium.
¹⁴ U-MaMi Centre of Excellence, University of Antwerp, Antwerp, Belgium.
¹⁵ Laboratory of Applied Microbiology and Biotechnology, Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium; U-MaMi Centre of Excellence, University of Antwerp, Antwerp, Belgium. Electronic address: sarah.lebeer@uantwerpen.be.

PMID: 39919958
PMCID: PMC12628047
DOI: 10.1016/j.tim.2024.12.012

Abstract

Women's health is essential to global societal and economic wellbeing, yet health disparities remain prevalent. The vaginal microbiota plays a critical role in health, with research indicating that reduced levels of core bacteria, such as lactobacilli, are associated with conditions like bacterial vaginosis (BV) and increased infection susceptibility. Lower levels of vaginal lactobacilli are reported more frequently in women of African and Latin American descent compared with women of European and Asian descent. However, geographical and other study inclusion and analysis biases influence current research. This opinion highlights the need for a more comprehensive understanding of a 'healthy' vaginal microbiome. It underscores efforts to broaden global research on microbiome diversity in socially relevant contexts, avoiding inappropriate applications of terms such as race and ethnicity.

Keywords: capacity building; citizen science; community outreach; health equity; internationalization; open science and transparency; taboo breaking; vaginal microbiome; women empowerment; women’s health.

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Conflict of interest statement

Declaration of interests S.C.C. has received travel support from Copan to participate in two scientific conferences to present the Isala Sisterhood. S.A. is a voluntary academic board member of the International Scientific Association on Probiotics and Prebiotics, Students, and Fellows Association (https://www.isapp-sfa.com). S.L. and G.V. are academic board members of the International Scientific Association on Probiotics and Prebiotics (www.isappscience.org), but this organization was not involved in this opinion article. M.C.C., S.L. and G.V. have received travel grants from ISAPP to participate in meetings. As a principal investigator (PI), S.L. has received research funding from several companies not involved in this opinion. She has been a scientific advisor for YUN and is now advising for Freya Biosciences. G.D. is the chairperson of Femicare vzw (https://www.facebook.com/profile.php?id=100063440664962) and has worked as a medical consultant for various industries. None of these organizations or companies was involved in the present opinion article. M.T., J.K., K.C.A., V.P.C., M.G.D.B., C.M., S.M., and T.G. declare no competing interests.

Figures

**Figure 1**
World distribution of the vaginal microbiome data studies using 16S rRNA amplicon sequencing (2019–2024). The total number of studies (light pink circles, S) and participants (light blue closed circles, ♀) are shown per continent; studies spanning multiple continents (n = 17, 2.5%) are not part of the counts per continent. The size of the circles is proportional to the percentage of studies (690 in total) or participants (125 187) in each continent, from January 2019 until September 2024. An initial extraction from PubMed using advanced search criteria^a retrieved 1177 studies, and after manual curation, only 690 studies were considered (systematic reviews, meta-analysis, studies based solely in re-analysis of data already published, or studies in animal subjects were excluded). When counting the total number of participants, we took care not to double count samples/participants (when used in more than one study). To the best of our knowledge, none are present. When defining the continent of transcontinental countries, the location of the participant’s recruitment site was considered. ^aAdvanced PubMed search: (((all[sb] NOT(animals [mh] NOT humans [mh])) AND (microbiota [mh] OR microbiota[Title/Abstract] OR microbiome[Title/Abstract])) AND (female genitalia [MeSH Terms] OR vagina[Title/Abstract] OR women[Title/Abstract] OR pregnancy[Title/Abstract] OR fertility[Title/Abstract] OR menstruation[Title/Abstract] OR menopause[Title/Abstract])) AND ((‘2019/01/01’[Date – Publication]: ‘2024/09/21’[Date – Publication])) NOT (Review[Publication Type]).

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References

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1. Younes J.A., et al. Women and their microbes: the unexpected friendship. Trends Microbiol. 2018;26:16–32. - PubMed

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Diversity in women and their vaginal microbiota

Affiliations

Diversity in women and their vaginal microbiota

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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