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While the hormonal regulation of innate and adaptive immunity in the FRT during the menstrual cycle is well\u2010studied, changes in mucosal immune protection throughout the FRT that occur with aging after menopause remain largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review summarizes hormonal and age\u2010related immune changes throughout the FRT, focusing on their effects on the function of epithelial cells and immune cells in the uterus, cervix and vagina, highlighting implications for HIV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After menopause, as reproductive function ceases, two interconnected processes, menopause and immunosenescence, drive alterations in immune protection. As women age following menopause, significant aspects of innate and adaptive immunity in the FRT are compromised in a site\u2010specific manner. At some FRT sites, as cell numbers decline, immunological compensation characterized by increased immunological activity is observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, these changes in mucosal immune protection contribute to a heightened risk of STIs and HIV acquisition. Further research is essential to establish a basis for developing new therapeutic interventions to restore immune protection and mitigate conditions that endanger the health and lives of aging women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aji.70269","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:25:23Z","timestamp":1781871923000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effects of Sex Hormones and Aging on the Mucosal Immune System in the Human Female Reproductive Tract and Implications for HIV Acquisition"],"prefix":"10.1111","volume":"95","author":[{"given":"Charles R.","family":"Wira","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology Geisel School of Medicine at Dartmouth  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5963-1534","authenticated-orcid":false,"given":"Mickey V.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology Geisel School of Medicine at Dartmouth  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Faber","sequence":"additional","affiliation":[{"name":"C. S. Mott Center for Human Growth and Development, Department of Obstetrics and Gynecology Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Fu","sequence":"additional","affiliation":[{"name":"C. S. Mott Center for Human Growth and Development, Department of Obstetrics and Gynecology Wayne State University School of Medicine  Detroit Michigan USA"},{"name":"Department of Biochemistry, Microbiology and Immunology Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Rodriguez\u2010Garcia","sequence":"additional","affiliation":[{"name":"C. S. 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