The effects of hormone replacement therapy on the microbiomes of postmenopausal women

Abstract

The sex steroid hormone estrogen plays a number of regulatory roles in female development. During menopause, estrogen synthesis in the ovaries decreases, which results in adverse physiological remodeling and increased risk of disease. Reduced bone density, changes in the community composition profiles of the gut and vaginal microbiome, mood swings and changes in the vaginal environment are to be expected during this time. To alleviate these changes, postmenopausal women can be prescribed hormone replacement therapy (HRT) through the use of exogenous estradiol, often in conjunction with progestin treatment, which re-induces estrogenic action throughout the body. The microbiome and estrogen have a bidirectional, regulatory relationship in the gut, while in the vaginal environment estrogen works indirectly on the microbiome through restoring the vaginal tissue environment that leads to microbial homeostasis. This review discusses what is known about how the gut and vaginal microbiomes of postmenopausal women are responding to HRT, and the potential future of microbe-based therapeutics for symptoms of menopause.

摘要

性激素雌激素在女性发育中起着许多重要的调节作用。在绝经期, 卵巢合成的雌激素减少, 导致许多病理结果和疾病风险增加。在这一期间, 患者将会出现骨密度降低、肠道和阴道微生态菌群发生变化、情绪波动和阴道内环境改变。为了缓解这些变化, 可以给予绝经后女性应用激素替代治疗, 即应用外源性雌激素, 通常与孕激素联合治疗, 这样可以在全身重新发挥雌激素作用。肠道微生态和雌激素具有双向调节关系, 而在阴道内环境中, 雌激素可以通过阴道组织环境间接作用于阴道微生态, 导致微生态稳态平衡。这篇综述讨论了关于绝经后女性肠道和阴道微生态如何对激素治疗产生反应, 以及基于微生态的绝经激素治疗的潜在未来。

Keywords:

• Microbiome
• hormone replacement therapy
• menopause
• estrobolome

Potential conflict of interest.

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the article.

Source of funding.

Nil.