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The dominant microbial species of this ecosystem,\n                      <jats:italic toggle=\"yes\">Lactobacillus<\/jats:italic>\n                      , offers protection from vaginal infections by maintaining lower pH levels and reducing potential pathogen colonization. Dysbiosis, or imbalance of the vaginal microbial ecosystem, has been associated with both common infections, such as bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and urinary tract infections (UTIs), and obstetric complications, including gestational diabetes, preterm labor, and obstetric anemia. This review provides an overview of the composition and function of the vaginal microbiota, emphasizing the role of\n                      <jats:italic toggle=\"yes\">Lactobacillus<\/jats:italic>\n                      and other beneficial microbes and their mechanisms of action, including lactic acid and hydrogen peroxide production, competitive adherence, and immune modulation. Evidence from clinical trials supports the efficacy of these strains in reducing recurrence of BV, VVC, and UTIs. Additionally, emerging research shows promise for probiotic use in managing reproductive conditions such as gestational diabetes mellitus, preterm labor, and obstetric anemia. The review also discusses safety considerations, particularly in immunocompromised individuals, and the expanding interest in non-\n                      <jats:italic toggle=\"yes\">Lactobacillus<\/jats:italic>\n                      genera like\n                      <jats:italic toggle=\"yes\">Bifidobacterium<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Bacillus<\/jats:italic>\n                      . Targeted probiotic interventions have great potential for restoring and maintaining a healthy vaginal microbiome, preventing recurrent infections, and helping improve reproductive outcomes. However, in order to incorporate these approaches in clinical practice, probiotic strains, delivery method, and dosage all need standardization.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/iai.00011-26","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T13:51:42Z","timestamp":1782481902000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["The role of probiotics in restoring and maintaining vaginal microbiome health: a review"],"prefix":"10.1128","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2924-5516","authenticated-orcid":false,"given":"Binaya Krushna","family":"Sahu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k949197","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Biotechnology, Siksha \u2018O\u2019 Anusandhan (Deemed to be University)","place":["Bhubaneswar, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3123-1218","authenticated-orcid":true,"given":"Sujogya Kumar","family":"Panda","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k949197","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Biotechnology, Siksha \u2018O\u2019 Anusandhan (Deemed to be University)","place":["Bhubaneswar, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utkalika","family":"Mallick","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02k949197","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Biotechnology, Siksha \u2018O\u2019 Anusandhan (Deemed to be University)","place":["Bhubaneswar, India"]},{"id":[{"id":"https:\/\/ror.org\/01qr3vg91","id-type":"ROR","asserted-by":"publisher"}],"name":"Microbiology Division, ICMR-Regional Medical Research Centre","place":["Bhubaneswar, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita Hasini","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Fakir Mohan University","place":["Balasore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3736-2294","authenticated-orcid":true,"given":"Mahesh Chandra","family":"Sahu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01qr3vg91","id-type":"ROR","asserted-by":"publisher"}],"name":"Microbiology Division, ICMR-Regional Medical Research Centre","place":["Bhubaneswar, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-3064-9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12934-020-01464-4"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jobm.202100421"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2020-0367"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00203-021-02414-3"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/frmbi.2024.1363089"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.UTI-0025-2016"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.13005\/bpj\/2285"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2023.09.018"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.963868"},{"key":"e_1_3_4_12_2","unstructured":"Giordani B. 2020. 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