{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:22:30Z","timestamp":1778001750271,"version":"3.51.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinical Medical Research Center for Obstetrics and Gynecology Diseases in Qinghai Province","award":["2024-SF-L03"],"award-info":[{"award-number":["2024-SF-L03"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Dysbiosis of the female genital tract microbiota represents a key pathological basis underlying clinical symptoms such as vaginal dryness and dyspareunia, which subsequently contribute to diminished sexual quality of life (QoL) in women. Although conventional antimicrobial therapies may provide short-term relief from infectious symptoms, they often fail to restore vaginal microbial homeostasis\u2014thereby exhibiting inherent limitations, including high recurrence rates and increased risks of antimicrobial resistance. Vaginal microbiota transplantation (VMT), an emerging ecological restoration strategy, aims to reconstitute the recipient\u2019s vaginal microbiota by transferring a complete, functionally intact microbial community from a rigorously screened healthy donor. This review systematically delineates the multidimensional mechanistic links between genital tract dysbiosis and impaired female sexual quality of life; elucidates the core clinical value of VMT; comprehensively summarizes recent advances in both preclinical research and clinical trials; and critically examines major challenges currently facing the field\u2014including the lack of standardized donor screening criteria, variability in procedural protocols, insufficient long-term safety data, and evolving ethical and regulatory considerations. Furthermore, we propose forward-looking perspectives on future directions, such as the development of individualized, precision-based VMT approaches; the establishment of standardized, evidence-based technical frameworks; and the acceleration of clinical translation and implementation. This review is intended to provide a robust theoretical foundation and practical guidance for the scientifically sound promotion, standardized application, and further investigation of VMT\u2014ultimately advancing women\u2019s reproductive health and holistic sexual well-being.<\/jats:p>","DOI":"10.3389\/fmed.2026.1812754","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:47:54Z","timestamp":1776059274000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The interventional value and research progress of vaginal microbiota transplantation in improving female sexual quality of life associated with dysbiosis of the reproductive microecosystem"],"prefix":"10.3389","volume":"13","author":[{"given":"Runzhi","family":"Shi","sequence":"first","affiliation":[{"name":"Clinical Medical College of Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Ye","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangyang","family":"Tan","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruxue","family":"Zhou","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangjie","family":"Zheng","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liehong","family":"Wang","sequence":"additional","affiliation":[{"name":"Qinghai Red Cross Hospital","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"127857","DOI":"10.1016\/j.micres.2024.127857","article-title":"Cervicovaginal microbiome, high-risk HPV infection and cervical cancer: mechanisms and therapeutic potential","volume":"287","author":"Huang","year":"2024","journal-title":"Microbiol Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1186\/s12934-020-01464-4","article-title":"Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health","volume":"19","author":"Chee","year":"2020","journal-title":"Microb Cell Factories"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.1007\/s10096-024-04915-7","article-title":"The association between lifestyle factors and the composition of the vaginal microbiota: a review","volume":"43","author":"Morsli","year":"2024","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"3793","DOI":"10.1007\/s00203-021-02414-3","article-title":"Vaginal microbiome: normalcy vs dysbiosis","volume":"203","author":"Saraf","year":"2021","journal-title":"Arch Microbiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"347","DOI":"10.3238\/arztebl.m2023.0090","article-title":"Bacterial vaginosis\u2014vaginal polymicrobial biofilms and dysbiosis","volume":"120","author":"Swidsinski","year":"2023","journal-title":"Dtsch Arztebl Int"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1016\/j.bpobgyn.2014.07.006","article-title":"Recurrent vulvovaginitis","volume":"28","author":"Powell","year":"2014","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/j.annepidem.2017.08.010","article-title":"Recurrent vulvovaginal candidiasis","volume":"27","author":"Blostein","year":"2017","journal-title":"Ann Epidemiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1016\/s0002-9378(85)80003-x","article-title":"Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis","volume":"152","author":"Sobel","year":"1985","journal-title":"Am J Obstet Gynecol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1128\/CMR.9.3.335","article-title":"Immunopathogenesis of recurrent vulvovaginal candidiasis","volume":"9","author":"Fidel","year":"1996","journal-title":"Clin Microbiol Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"fnz025","DOI":"10.1093\/femsle\/fnz025","article-title":"Vaginal microbiota transplantation for the treatment of bacterial vaginosis: a conceptual analysis","volume":"366","author":"Ma","year":"2019","journal-title":"FEMS Microbiol Lett"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1163\/18762891-20220103","article-title":"Lactobacillus probiotics restore vaginal and gut microbiota of pregnant women with vaginal candidiasis","volume":"14","author":"Ang","year":"2023","journal-title":"Benef Microbes"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"20230743","DOI":"10.1515\/med-2023-0743","article-title":"Risk factors of recurrent bacterial vaginosis among women of reproductive age: a cross-sectional study","volume":"18","author":"Zeng","year":"2023","journal-title":"Open Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s12941-020-0347-4","article-title":"Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review","volume":"19","author":"Kalia","year":"2020","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e74378","DOI":"10.1371\/journal.pone.0074378","article-title":"The burden of bacterial vaginosis: women\u2019s experience of the physical, emotional, sexual and social impact of living with recurrent bacterial vaginosis","volume":"8","author":"Bilardi","year":"2013","journal-title":"PLoS One"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"qfad039","DOI":"10.1093\/sexmed\/qfad039","article-title":"Pre-and post-LEEP: analysis of the female urogenital tract microenvironment and its association with sexual dysfunction","volume":"11","author":"Giovannetti","year":"2023","journal-title":"Sex Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"108210","DOI":"10.1016\/j.maturitas.2025.108210","article-title":"Diabetes mellitus, vaginal microbiome and sexual function: outcomes in postmenopausal women","volume":"194","author":"Scairati","year":"2025","journal-title":"Maturitas"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e2022275","DOI":"10.23750\/abm.v93i4.12461","article-title":"Dependence of the dynamics of changes in the quality of life of patients with bacterial vaginosis on local levels of TNF-\u03b1 and IL-1\u03b2","volume":"93","author":"Grebeniuk","year":"2022","journal-title":"Acta Biomed"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"17455057231216537","DOI":"10.1177\/17455057231216537","article-title":"Psychosocial impact of recurrent urogenital infections: a review","volume":"19","author":"Thomas-White","year":"2023","journal-title":"Womens Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"403253","DOI":"10.3389\/fendo.2018.00568","article-title":"Psychosocial stress, cortisol levels, and maintenance of vaginal health","volume":"9","author":"Amabebe","year":"2018","journal-title":"Front Endocrinol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2935","DOI":"10.1007\/s11136-025-04031-9","article-title":"Microbiome impacts quality of life in patients with endometrial cancer and benign gynecological conditions","volume":"34","author":"Gautam","year":"2025","journal-title":"Qual Life Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"107359","DOI":"10.1016\/j.micpath.2025.107359","article-title":"Vulvovaginal candidiasis-an overview of current trends and the latest treatment strategies","volume":"200","author":"Bhosale","year":"2025","journal-title":"Microb Pathog"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"90","DOI":"10.4274\/jtgga.galenos.2019.2019.0077","article-title":"Association of sexual function and psychological symptoms including depression, anxiety and stress in women with recurrent vulvovaginal candidiasis","volume":"21","author":"Moshfeghy","year":"2020","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"S23","DOI":"10.1016\/j.jfma.2018.08.011","article-title":"Fecal microbiota transplantation: review and update","volume":"118","author":"Wang","year":"2019","journal-title":"J Formos Med Assoc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"3820","DOI":"10.13345\/j.cjb.210163","article-title":"Vaginal microbiota transplantation for treatment of bacterial vaginosis: a review","volume":"37","author":"Wei","year":"2021","journal-title":"Sheng Wu Gong Cheng Xue Bao"},{"key":"ref25","first-page":"475","article-title":"Vulvovaginal candidiasis from non-albicans species: retrospective study of recurrence rate after fluconazole therapy","volume":"51","author":"Ventolini","year":"2006","journal-title":"J Reprod Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1186\/s12866-025-04097-y","article-title":"Probiotics may improve vaginal microbiota, metabolic disorders and ovarian function-related markers by modulating gut microbiota in POI mice","volume":"25","author":"Cao","year":"2025","journal-title":"BMC Microbiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2025-08","DOI":"10.1101\/2025.08.27.25334544","article-title":"Donation strain engraftment demonstrates feasibility of vaginal microbiota transplantation to prevent recurrent bacterial vaginosis","author":"Hussain","year":"2025","journal-title":"medRxiv"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3390\/diseases14020042","article-title":"Microbiota transplantation as a future novel therapeutic strategy approach","volume":"14","author":"Kumar","year":"2026","journal-title":"Diseases"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"102070","DOI":"10.1016\/j.eclinm.2023.102070","article-title":"Antibiotic-free vaginal microbiota transplant with donor engraftment, dysbiosis resolution and live birth after recurrent pregnancy loss: a proof of concept case study","volume":"61","author":"Wr\u00f8nding","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14712598.2025.2484303","article-title":"Microbiota transplantation and administration of live biotherapeutic products for the treatment of dysbiosis-associated diseases","volume":"25","author":"Flores-Trevi\u00f1o","year":"2025","journal-title":"Expert Opin Biol Ther"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1007\/s13238-018-0541-8","article-title":"Microbiota transplantation: concept, methodology and strategy for its modernization","volume":"9","author":"Zhang","year":"2018","journal-title":"Protein Cell"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.gtc.2016.09.012","article-title":"Fecal microbiota transplantation","volume":"46","author":"Vindigni","year":"2017","journal-title":"Gastroenterol Clin N Am"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1001\/jama.2017.6466","article-title":"Fecal microbiota transplantation","volume":"318","author":"Gupta","year":"2017","journal-title":"JAMA"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1177\/1756283X15607414","article-title":"Fecal microbiota transplantation: in perspective","volume":"9","author":"Gupta","year":"2016","journal-title":"Ther Adv Gastroenterol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.gie.2013.03.1329","article-title":"An overview of fecal microbiota transplantation: techniques, indications, and outcomes","volume":"78","author":"Brandt","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1016\/j.gtc.2012.08.008","article-title":"Fecal microbiota transplantation: techniques, applications, and issues","volume":"41","author":"Borody","year":"2012","journal-title":"Gastroenterol Clin"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1552134","DOI":"10.3389\/fmicb.2025.1552134","article-title":"Association between endometriosis and gut microbiota: systematic review and meta-analysis","volume":"16","author":"Yuanyue","year":"2025","journal-title":"Front Microbiol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e0306780","DOI":"10.1371\/journal.pone.0306780","article-title":"Correlation between dysbiosis of vaginal microecology and endometriosis: a systematic review and meta-analysis","volume":"19","author":"Qing","year":"2024","journal-title":"PLoS One"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"351","DOI":"10.3390\/medicina62020351","article-title":"Gut microbiota alterations and reproductive tract Dysbiosis in endometriosis: a systematic review","volume":"62","author":"Crestani","year":"2026","journal-title":"Medicina"}],"updated-by":[{"DOI":"10.3389\/fmed.2026.1858640","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000}}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1812754\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:04:52Z","timestamp":1778000692000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1812754\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":39,"alternative-id":["10.3389\/fmed.2026.1812754"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1812754","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"article-number":"1812754"}}