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Cross-niche microbial interactions amplify systemic risks: gut-derived toxins are linked to vascular inflammation, vaginal dysbiosis facilitates urinary pathogen colonization, and bile acid disruption impairs bone\u2013immune homeostasis. This review synthesizes current mechanistic evidence illustrating how microbial networks propagate postmenopausal comorbidities. We propose the framework of \u201cPostmenopausal Microbiota Network Medicine\u201d which integrates microbial dynamics with host omics to transition from symptomatic management toward root-cause interception by strengthening microbial network resilience.<\/jats:p>","DOI":"10.3389\/fmicb.2026.1702700","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:43:09Z","timestamp":1771483389000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Multi-site microbiota crosstalk in the postmenopausal: from dysbiosis mechanisms to precision interventions"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiaqing","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Affiliated Women and Children's Hospital of Ningbo University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobo","family":"He","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Affiliated Women and Children's Hospital of Ningbo University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Affiliated Women and Children's Hospital of Ningbo University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"20536","DOI":"10.1021\/acs.jmedchem.5c01736","article-title":"Discovery of an orally active PDE1 inhibitor for disease-modifying treatment of postmenopausal osteoporosis via dual anabolic-antiresorptive mechanisms","volume":"68","author":"Abbasi","year":"2025","journal-title":"J. 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