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Although the diversity and function of microbial communities across these sites are becoming increasingly understood, the extent to which modifiable lifestyle and environmental factors such as smoking, diet, alcohol intake, obesity, physical activity, stress, hygiene, and sexual behaviours shape these microbiomes remains underexplored. This review is restricted to modifiable lifestyle and environmental factors and does not comprehensively assess pharmaceutical exposures (e.g., antibiotics or hormonal therapies) or hormonal influence. To date, no review has comprehensively assessed and compiled evidence across the four microbial sites in females, despite their unique hormonal, physiological, and reproductive characteristics that distinctly influence microbial composition and function. This review provides a comprehensive examination of how such factors influence the dynamics of microbial composition and function along with site-specificity while also assessing cross-site microbial interactions. We focus exclusively on females to address a critical knowledge gap to provide a foundation from which future research and interventions can be tailored to women\u2019s health. This review discusses the underlying mechanisms driving microbial shifts and their impact on host health, highlighting critical gaps in our current knowledge. The integration of findings from multi-site microbiome research, highlights the potential to inform targeted, preventative, and therapeutic strategies that utilise the inherent dynamic nature of the microbiome to improve health outcomes across the female lifespan.<\/jats:p>","DOI":"10.1007\/s00248-026-02747-w","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T02:15:36Z","timestamp":1774750536000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Shaping the Female Microbiome: A Review of Lifestyle Factors Influencing the Vaginal, Gut, Oral, and Skin Microenvironments"],"prefix":"10.1007","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4672-7922","authenticated-orcid":false,"given":"Isabella","family":"M. 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We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript have been approved by all of us. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property. We understand that the Corresponding Author is the sole contact for the Editorial process (including Editorial Manager and direct communications with the office). He is responsible for communicating with the other authors about progress, submissions of revisions and final approval of proofs. 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