{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:49:39Z","timestamp":1787028579215,"version":"build-2736575974"},"reference-count":104,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The human microbiome has emerged as a central regulator of health and disease; however, women-specific microbiome research has only recently gained focused scientific attention. Accumulating evidence demonstrates that microbial ecosystems across the gut, vagina, skin, breast tissue, and reproductive tract are dynamically shaped by female hormones, life-stage transitions, and environmental exposures. These interactions influence immune regulation, metabolic homeostasis, reproductive outcomes, mental health, and cancer risk, in part through microbiome-mediated endocrine pathways such as the estrobolome. Advances in high-resolution molecular technologies\u2014including metagenomics, metabolomics, spatial and single-cell profiling, and artificial intelligence-driven modeling\u2014have shifted microbiome research from descriptive taxonomy toward functional, mechanistic, and predictive science. These approaches highlight microbial function and metabolite production as stronger determinants of health outcomes than taxonomic composition alone. Nonetheless, major gaps persist, including limited causal evidence, methodological heterogeneity, underrepresentation of non-Western populations, and barriers to clinical translation. Microbiome-targeted interventions, including probiotics, prebiotics, postbiotics, and emerging microbiota-based therapies, have garnered increasing interest in women\u2019s health. Select Lactobacillus and Bifidobacterium strains show potential in modulating vaginal and gastrointestinal health, pregnancy outcomes, and immune function; however, clinical effects remain highly strain-specific and context-dependent. Discrepancies between experimental findings, commercial claims, and validated clinical use underscore the need for rigorous, women-centered trials and standardized outcome measures. This narrative review synthesizes current molecular insights into the women\u2019s microbiome across endocrine interactions, pregnancy, reproductive and metabolic health, lifestyle influences, and microbiome-based therapeutic strategies. We integrate clinical perspectives to identify diagnostic and translational challenges and propose future directions emphasizing precision microbiome medicine, validated biomarkers, careful evaluation of microbiome-targeted interventions, and inclusive research frameworks, including populations from the Gulf Cooperation Council (GCC). Collectively, this review positions the microbiome as a critical yet underutilized axis in women\u2019s health and outlines a roadmap toward personalized, evidence-based care across the female lifespan.<\/jats:p>","DOI":"10.3390\/ijms27062521","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T08:43:31Z","timestamp":1773132211000},"page":"2521","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Women\u2019s Microbiome: Molecular Insights, Clinical Gaps, and Future Frontiers in Precision Health with Implications for Gulf Cooperation Council Populations"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1868-8811","authenticated-orcid":false,"given":"Muriel","family":"Tahtouh Zaatar","sequence":"first","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1862-3498","authenticated-orcid":false,"given":"Rima","family":"Othman","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine and Critical Care, Johns Hopkins University, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Abushawish","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Akl","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Taha","family":"Alachkar","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghaya","family":"Almatboona","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Alriyami","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aljoud","family":"Alshaibani","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Ashkanani","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munira","family":"Basharova","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Imam","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Khassay","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mila Souha","family":"Mikhael","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozhin","family":"Naderi Far","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1305-5295","authenticated-orcid":false,"given":"Sophia","family":"Shaqra","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiara","family":"Verwey","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alika","family":"Suleimanova","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Yousafzada","sequence":"additional","affiliation":[{"name":"Department of Biological and Physical Sciences, American University in Dubai, Dubai P.O. Box 28282, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuliya","family":"Burmagina","sequence":"additional","affiliation":[{"name":"Mediclinic City Hospital, Dubai P.O. Box 505030, United Arab Emirates"},{"name":"Optima Medical Center, Dubai P.O. 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Cycle biodynamics of women\u2019s microbiome in the urinary and reproductive systems. J. Clin. Med., 12.","DOI":"10.3390\/jcm12124003"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.maturitas.2017.06.025","article-title":"Estrogen\u2013gut microbiome axis: Physiological and clinical implications","volume":"103","author":"Baker","year":"2017","journal-title":"Maturitas"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"G\u00fcnther, V., Allahqoli, L., Watrowski, R., Maass, N., Ackermann, J., von Otte, S., and Alkatout, I. (2022). Vaginal microbiome in reproductive medicine. Diagnostics, 12.","DOI":"10.3390\/diagnostics12081948"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Aljuraiban, G.S., Alfhili, M.A., Aldhwayan, M.M., Aljazairy, E.A., and Al-Musharaf, S. (2020). Metagenomic shotgun sequencing reveals human gut microbiota associated with insulin resistance and body fat distribution in Saudi women. Biomolecules, 13.","DOI":"10.3390\/biom13040640"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1038\/s41522-025-00682-1","article-title":"Strain-level variation among vaginal Lactobacillus crispatus and Lactobacillus iners as identified by comparative metagenomics","volume":"11","author":"Nori","year":"2025","journal-title":"NPJ Biofilms Microbiomes"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wang, L., Zhang, J., Zhang, M., Xu, Z., Zheng, Y., Lv, B., and Pan, M. (2025). Insights into the alteration of vaginal microbiota and metabolites in pregnant women with preterm delivery: Prospective cohort study. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1580801"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Shen, L.P., Cai, B.J., Guan, J.X., Peng, T., and Jin, L. (2025). Comprehensive analysis of vaginal microbiota, metabolites, and inflammatory factors in preterm and term pregnancies. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1689494"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1038\/s41597-025-05995-6","article-title":"A spatial transcriptomics dataset of the endometrium from repeated implantation failure patients","volume":"12","author":"Zhang","year":"2025","journal-title":"Sci. Data"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2236749","DOI":"10.1080\/19490976.2023.2236749","article-title":"Gut microbial beta-glucuronidase: A vital regulator in female estrogen metabolism","volume":"15","author":"Hu","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"18586","DOI":"10.1074\/jbc.RA119.010950","article-title":"Gut microbial \u03b2-glucuronidases reactivate estrogens as components of the estrobolome","volume":"294","author":"Ervin","year":"2019","journal-title":"J. Biol. Chem."},{"key":"ref_13","first-page":"djw029","article-title":"The intestinal microbiome and estrogen receptor-positive female breast cancer","volume":"108","author":"Kwa","year":"2016","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Sui, Y., Wu, J., and Chen, J. (2021). The role of gut microbial \u03b2-glucuronidase in estrogen reactivation and breast cancer. Front. Cell Dev. Biol., 9.","DOI":"10.3389\/fcell.2021.631552"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Liu, P., Lu, Y., Li, R., and Chen, X. (2023). Use of probiotic lactobacilli in the treatment of vaginal infections: In vitro and in vivo investigations. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1153894"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Plummer, E.L., Bradshaw, C.S., Doyle, M., Fairley, C.K., Murray, G.L., Bateson, D., Masson, L., Slifirski, J., Tachedjian, G., and Vodstrcil, L.A. (2021). Lactic acid-containing products for bacterial vaginosis and their impact on the vaginal microbiota: A systematic review. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0246953"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Chen, X., Lu, Y., Chen, T., and Li, R. (2021). The female vaginal microbiome in health and bacterial vaginosis. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.631972"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Amabebe, E., and Anumba, D.O.C. (2018). The vaginal microenvironment: The physiologic role of lactobacilli. Front. Med., 5.","DOI":"10.3389\/fmed.2018.00181"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.chom.2011.10.003","article-title":"Microbiome and malignancy","volume":"10","author":"Plottel","year":"2011","journal-title":"Cell Host Microbe"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1002\/ijc.35427","article-title":"The estrobolome: Estrogen-metabolizing pathways of the gut microbiome and their relation to breast cancer","volume":"157","author":"Larnder","year":"2025","journal-title":"Int. J. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kowalczyk, K., Kad\u0142ubek, S., Kru\u017cel, A., Sikora, D., Daniluk, J., and Madej, P. (2025). Dietary patterns and metabolic and hormonal parameters in women with suspected PCOS. J. Clin. Med., 14.","DOI":"10.3390\/jcm14082708"},{"key":"ref_22","first-page":"e202501","article-title":"Gut microbiota\u2013estrogen axis: Its influence on female health outcomes-A narrative review","volume":"96","author":"Atoum","year":"2025","journal-title":"Acta Biomed."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Miko, E., Csaszar, A., Bodis, J., and Kovacs, K. (2022). The maternal\u2013fetal gut microbiota axis: Physiological changes, dietary influence, and modulation possibilities. Life, 12.","DOI":"10.3390\/life12030424"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"102309","DOI":"10.1016\/j.mib.2023.102309","article-title":"The maternal gut microbiome during pregnancy and its role in maternal and infant health","volume":"74","author":"Sinha","year":"2023","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4326","DOI":"10.1038\/s41467-025-58533-8","article-title":"Maternal gut microbiota influences immune activation at the maternal\u2013fetal interface affecting pregnancy outcome","volume":"16","author":"Giugliano","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Lu, X., Shi, Z., Jiang, L., and Zhang, S. (2024). Maternal gut microbiota in the health of mothers and offspring: From the perspective of immunology. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1362784"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13643-020-1277-0","article-title":"Maternal and birth cohort studies in the Gulf Cooperation Council countries: A systematic review","volume":"9","author":"Ali","year":"2020","journal-title":"Syst. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"121606","DOI":"10.1016\/j.lfs.2023.121606","article-title":"New insights on the impact of gut microbiota on premenstrual disorders","volume":"321","author":"Nabeh","year":"2023","journal-title":"Life Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"711137","DOI":"10.3389\/fmicb.2021.711137","article-title":"The Gut Microbiome and Sex Hormone-Related Diseases","volume":"12","author":"He","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Zhang, J., Wei, L., Tan, H., and Pang, W. (2024). Gut microbiota and postpartum depression: A Mendelian randomization study. Front. Psychiatry, 15.","DOI":"10.3389\/fpsyt.2024.1282742"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1159\/000543691","article-title":"The perinatal microbiota\u2013gut\u2013brain axis: Implications for postpartum depression","volume":"32","author":"Armbruster","year":"2025","journal-title":"Neuroimmunomodulation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"285","DOI":"10.5005\/jp-journals-10006-2411","article-title":"Exploring the role of the gut-microbiota-brain axis in postpartum depression","volume":"16","author":"Rai","year":"2024","journal-title":"J. South Asian Fed. Obstet. Gynaecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/s40168-022-01337-5","article-title":"Lactic acid from vaginal microbiota enhances cervicovaginal epithelial barrier integrity","volume":"10","author":"Jesaveluk","year":"2022","journal-title":"Microbiome"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1186\/s40168-025-02223-6","article-title":"Cervicovaginal microbiome alters transcriptomic and chromatin accessibility signatures","volume":"13","author":"Anton","year":"2025","journal-title":"Microbiome"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Delgado-Diaz, D.J., Tyssen, D., Hayward, J.A., Gugasyan, R., Hearps, A.C., and Tachedjian, G. (2020). Distinct immune responses elicited by lactic acid and short-chain fatty acids. Front. Cell. Infect. Microbiol., 9.","DOI":"10.3389\/fcimb.2019.00446"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Bokulich, N.A., \u0141aniewski, P., Adamov, A., Chase, D.M., Caporaso, J.G., and Herbst-Kralovetz, M.M. (2022). Multi-omics integration reveals the metabolome as the top predictor of the cervicovaginal microenvironment. PLoS Comput. Biol., 18.","DOI":"10.1371\/journal.pcbi.1009876"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e00452-22","DOI":"10.1128\/msphere.00452-22","article-title":"Commensal Lactobacilli Metabolically Contribute to Cervical Epithelial Homeostasis in a Species-Specific Manner","volume":"8","author":"Jimenez","year":"2023","journal-title":"mSphere"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1038\/s41564-024-01751-5","article-title":"A multi-kingdom reference genome collection for the human vaginal microbiome","volume":"9","author":"Huang","year":"2024","journal-title":"Nat. Microbiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/s40168-020-00875-0","article-title":"Microbiome definition re-visited: Old concepts and new challenges","volume":"8","author":"Berg","year":"2020","journal-title":"Microbiome"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Han, Y., Liu, Z., and Chen, T. (2021). Role of vaginal microbiota dysbiosis in gynecological diseases. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.643422"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Safarchi, A., Al-Qadami, G., Tran, C.D., and Conlon, M. (2025). Dysbiosis and resilience in the human gut microbiome. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1559521"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Hrncir, T. (2022). Gut Microbiota Dysbiosis: Triggers, Consequences, Diagnostic and Therapeutic Options. Microorganisms, 10.","DOI":"10.3390\/microorganisms10030578"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Moreno, A., and Aguilera, M. (2020). Probiotics for modulating endocrine and fertility microbiota dysbiosis. Nutrients, 12.","DOI":"10.3390\/nu12030757"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1093\/infdis\/jiu330","article-title":"Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection","volume":"210","author":"Brotman","year":"2014","journal-title":"J. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.immuni.2016.12.013","article-title":"Lactobacillus-Deficient Cervicovaginal Bacterial Communities Are Associated with Increased HIV Acquisition in Young South African Women","volume":"46","author":"Gosmann","year":"2017","journal-title":"Immunity"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1097\/QAD.0000000000001768","article-title":"Vaginal microbiota and susceptibility to HIV","volume":"32","author":"Eastment","year":"2018","journal-title":"AIDS"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"193","DOI":"10.4274\/jtgga.galenos.2019.2019.0051","article-title":"Vaginal microbiota and HPV: A systematic review","volume":"21","author":"Mortaki","year":"2020","journal-title":"J. Turk. Ger. Gynecol. Assoc."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Chiu, S.-F., Huang, P.-J., Cheng, W.-H., Huang, C.-Y., Chu, L.J., Lee, C.-C., Lin, H.-C., Chen, L.-C., Lin, W.-N., and Tsao, C.-H. (2021). Vaginal microbiota of sexually transmitted infections caused by Chlamydia trachomatis and Trichomonas vaginalis in women with vaginitis in Taiwan. Microorganisms, 9.","DOI":"10.3390\/microorganisms9091864"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1093\/humupd\/dmab035","article-title":"The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain","volume":"28","author":"Salliss","year":"2022","journal-title":"Hum. Reprod. Update"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1093\/humrep\/dez065","article-title":"The vaginal microbiome as a predictor for outcome of in vitro fertilization with or without intracytoplasmic sperm injection: A prospective study","volume":"34","author":"Koedooder","year":"2019","journal-title":"Hum. Reprod."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Dube, R., and Kar, S.S. (2022). Genital microbiota and outcome of assisted reproductive treatment: A systematic review. Life, 12.","DOI":"10.3390\/life12111867"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Huang, Y., Fang, R., Xiong, T., Li, W., and Yu, N. (2025). The relationship between gut microbiota and recurrent spontaneous abortion. Microorganisms, 13.","DOI":"10.3390\/microorganisms13051073"},{"key":"ref_53","doi-asserted-by":"crossref","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":"Vomstein","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1038\/s41591-019-0509-0","article-title":"Gut microbiota\u2013bile acid\u2013interleukin-22 axis orchestrates polycystic ovary syndrome","volume":"25","author":"Qi","year":"2019","journal-title":"Nat. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s40168-015-0094-5","article-title":"The vocabulary of microbiome research: A proposal","volume":"3","author":"Marchesi","year":"2015","journal-title":"Microbiome"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2389","DOI":"10.1056\/NEJMcp1000274","article-title":"Endometriosis","volume":"362","author":"Giudice","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Escorcia, M.P., Valbuena, D., and Diez-Juan, A. (2025). The role of the gut microbiota in female reproductive and gynecological health. Life, 15.","DOI":"10.3390\/life15050762"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Moustakli, E., Stavros, S., Katopodis, P., Potiris, A., Drakakis, P., Dafopoulos, S., Zachariou, A., Dafopoulos, K., Zikopoulos, K., and Zikopoulos, A. (2025). Gut microbiome dysbiosis and its impact on reproductive health. Metabolites, 15.","DOI":"10.3390\/metabo15060390"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1111\/j.1472-765X.2007.02212.x","article-title":"Role of commercial probiotic strains against human pathogen adhesion to intestinal mucus","volume":"45","author":"Collado","year":"2007","journal-title":"Lett. Appl. Microbiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/19490976.2016.1203502","article-title":"Sex differences and hormonal effects on gut microbiota composition in mice","volume":"7","author":"Org","year":"2016","journal-title":"Gut Microbes"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1249\/MSS.0000000000001495","article-title":"Exercise alters gut microbiota composition and function in lean and obese humans","volume":"50","author":"Allen","year":"2018","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Carmona-Cruz, S., Orozco-Covarrubias, L., and S\u00e1ez-de-Ocariz, M. (2022). The human skin microbiome in selected cutaneous diseases. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.834135"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/2045-7022-4-33","article-title":"Role of the skin microbiome in atopic dermatitis","volume":"4","author":"Salava","year":"2014","journal-title":"Clin. Transl. Allergy"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/jdv.15043","article-title":"Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: A brief look at the latest updates","volume":"32","author":"Corvec","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_65","first-page":"154","article-title":"Common skin conditions during pregnancy","volume":"107","author":"Erlandson","year":"2023","journal-title":"Am. Fam. Physician"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Radocchia, G., Brunetti, F., Marazzato, M., Totino, V., Neroni, B., Bonfiglio, G., Conte, A.L., Pantanella, F., Ciolli, P., and Schippa, S. (2024). Women skin microbiota modifications during pregnancy. Microorganisms, 12.","DOI":"10.3390\/microorganisms12040808"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"3443","DOI":"10.2147\/CCID.S571984","article-title":"Skin microbiome in health and disease: Mechanisms and emerging therapeutic strategies","volume":"18","author":"Li","year":"2025","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.bbcan.2019.04.001","article-title":"Microbial dysbiosis in breast cancer","volume":"1871","author":"Parida","year":"2019","journal-title":"Biochim. Biophys. Acta Rev. Cancer"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Song, X., Wei, C., and Li, X. (2022). The Relationship Between Microbial Community and Breast Cancer. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.849022"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1038\/s41392-022-00974-4","article-title":"Microbiota in health and disease","volume":"7","author":"Hou","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e02393-17","DOI":"10.1128\/mBio.02393-17","article-title":"The colibactin genotoxin generates DNA interstrand cross-links in infected cells","volume":"9","author":"Vignard","year":"2018","journal-title":"mBio"},{"key":"ref_72","unstructured":"Gianni, P., Matenoglou, E., Geropoulos, G., Agrawal, N., Adnani, H., Zafeiropoulos, S., Miyara, S.J., Guevara, S., Mumford, J.M., and Molmenti, E.P. (2020). The Fanconi anemia pathway and Breast Cancer: A comprehensive review of clinical data. Front. Cell Dev. Biol., 8."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Huang, Y., Guo, Z., Zeng, Z., Shang, C., Zhang, Y., Ran, Z., Luo, G., Shen, S., Liu, Y., and Zhou, P. (2025). Fusobacterium nucleatum promotes breast cancer metastasis via the miR-21-3p\/FOXO3 axis. Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1530269"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s12964-023-01134-z","article-title":"Intratumoural microbiota: From theory to clinical application","volume":"21","author":"Ji","year":"2023","journal-title":"Cell Commun. Signal."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Zheng, J., and Chen, H. (2024). Effects of intratumoral microbiota on tumorigenesis, anti-tumor immunity, and microbe-based cancer therapy. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1429722"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Bernardo, G., Le Noci, V., Di Modica, M., Montanari, E., Triulzi, T., Pupa, S.M., Tagliabue, E., Sommariva, M., and Sfondrini, L. (2023). The emerging role of the microbiota in breast cancer progression. Cells, 12.","DOI":"10.3390\/cells12151945"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"152398","DOI":"10.1016\/j.seminoncol.2025.152398","article-title":"The effects of microbiota-derived short-chain fatty acids on T lymphocytes: From autoimmune diseases to cancer","volume":"52","author":"Saadh","year":"2025","journal-title":"Semin. Oncol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1038\/s41423-025-01326-2","article-title":"The gut microbiota in cancer immunity and immunotherapy","volume":"22","author":"Xie","year":"2025","journal-title":"Cell. Mol. Immunol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Zhou, J., Zhang, L., Liu, S., DeRubeis, D., and Zhang, D. (2024). Toll-like receptors in breast cancer immunity and immunotherapy. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1418025"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e2412001","DOI":"10.4014\/jmb.2412.12001","article-title":"Advancing gut microbiome research: The shift from metagenomics to multi-omics and future perspectives","volume":"35","author":"Yang","year":"2025","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"100265","DOI":"10.1016\/j.advnut.2024.100265","article-title":"Is there evidence to support probiotic use for healthy people?","volume":"15","author":"Merenstein","year":"2024","journal-title":"Adv. Nutr."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"21640","DOI":"10.1038\/s41598-022-25688-z","article-title":"In vitro assessment of probiotic attributes for strains contained in commercial formulations","volume":"12","author":"Mazzantini","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Nysten, J., Sofras, D., and Van Dijck, P. (2024). One species, many faces: The underappreciated importance of strain diversity. PLoS Pathog., 20.","DOI":"10.1371\/journal.ppat.1011931"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Rezazadeh, M.B., Zanganeh, M., Jarahi, L., and Fatehi, Z. (2024). Comparative efficacy of oral and vaginal probiotics in reducing the recurrence of bacterial vaginosis: A double-blind clinical trial. BMC Womens Health, 24.","DOI":"10.1186\/s12905-024-03418-z"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s40168-024-01828-7","article-title":"Vaginal Lactobacillus crispatus persistence following application of a live biotherapeutic product: Colonization phenotypes and genital immune impact","volume":"12","author":"Armstrong","year":"2024","journal-title":"Microbiome"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2197837","DOI":"10.1080\/19490976.2023.2197837","article-title":"Effects of dietary fibers or probiotics on functional constipation","volume":"15","author":"Lai","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Smolinska, S., Popescu, F.D., and Zemelka-Wiacek, M. (2025). A Review of the Influence of Prebiotics, Probiotics, Synbiotics, and Postbiotics on the Human Gut Microbiome and Intestinal Integrity. J. Clin. Med., 14.","DOI":"10.3390\/jcm14113673"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/bs.adgen.2024.04.001","article-title":"Microbiome-based precision nutrition","volume":"111","author":"Odriozola","year":"2024","journal-title":"Adv. Genet."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s40168-021-01170-2","article-title":"Gut microbiota response to antibiotics is personalized and depends on baseline microbiota","volume":"9","author":"Rashidi","year":"2021","journal-title":"Microbiome"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.tjog.2023.09.018","article-title":"The role of probiotics in women\u2019s health: An update narrative review","volume":"63","author":"Wu","year":"2024","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Spacova, I., Binda, S., Ter Haar, J.A., Henoud, S., Legrain-Raspaud, S., Dekker, J., Espadaler-Mazo, J., Langella, P., Mart\u00edn, R., and Pane, M. (2023). Comparing technology and regulatory landscape of probiotics as food, dietary supplements and live biotherapeutics. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1272754"},{"key":"ref_92","first-page":"8747","article-title":"The promising biological role of postbiotics in treating human infertility","volume":"13","author":"Khani","year":"2025","journal-title":"Food Sci. Nutr."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Martinelli, S., Nannini, G., Cianchi, F., Staderini, F., Coratti, F., and Amedei, A. (2023). Microbiota transplant and gynecological disorders: The bridge between present and future treatments. Microorganisms, 11.","DOI":"10.3390\/microorganisms11102407"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12964-025-02041-1","article-title":"Atg5 deficiency in basophils improves metabolism in lupus mice by regulating gut microbiota dysbiosis","volume":"23","author":"Chen","year":"2025","journal-title":"Cell Commun. Signal."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Huang, F., Deng, Y., Zhou, M., Tang, R., Zhang, P., and Chen, R. (2024). Fecal microbiota transplantation from patients with polycystic ovary syndrome induces metabolic disorders and ovarian dysfunction in germ-free mice. BMC Microbiol., 24.","DOI":"10.1186\/s12866-024-03513-z"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Ozcan, G., Tanyola\u00e7 Talay, Z.G., Paerhati, E., Eren, O.C., Coskun, N., Sahin, D., Alnajjar, I., Albayrak, O., Gursoy, A., and Keskin, O. (2024). Dysbiosis in pregnant mice induced by transfer of human vaginal microbiota followed by reversal of pathological changes in the uterus and placenta via progesterone treatment. BMC Pregnancy Childbirth, 24.","DOI":"10.1186\/s12884-024-06595-9"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1038\/s41591-019-0600-6","article-title":"Vaginal microbiome transplantation in women with intractable bacterial vaginosis","volume":"25","author":"Cohen","year":"2019","journal-title":"Nat. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1177\/1073110519897725","article-title":"Introduction: The promise and challenges of microbiome-based therapies","volume":"47","author":"Hoffmann","year":"2019","journal-title":"J. Law Med. Ethics"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/1073110519897731","article-title":"Vaginal microbiota transplantation: The next frontier","volume":"47","author":"DeLong","year":"2019","journal-title":"J. Law Med. Ethics"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s43043-023-00136-8","article-title":"Reproductive tract microbiome and therapeutics of infertility","volume":"28","author":"Bhattacharya","year":"2023","journal-title":"Middle East Fertil. Soc. J."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1038\/s41579-023-00984-1","article-title":"Machine learning for microbiologists","volume":"22","author":"Asnicar","year":"2024","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Balla, B., Ill\u00e9s, A., Tobi\u00e1s, B., Pik\u00f3, H., Beke, A., Sipos, M., Lakatos, P., and K\u00f3sa, J.P. (2024). The Role of the Vaginal and Endometrial Microbiomes in Infertility and Their Impact on Pregnancy Outcomes in Light of Recent Literature. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252313227"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12958-024-01274-y","article-title":"Vaginal and endometrial microbiome dysbiosis and embryo transfer outcomes","volume":"22","author":"Su","year":"2024","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"D\u2019Urso, F., and Broccolo, F. (2024). Applications of artificial intelligence in microbiome analysis. Appl. Sci., 14.","DOI":"10.3390\/app14198627"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/6\/2521\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T08:47:35Z","timestamp":1773132455000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/6\/2521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":104,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["ijms27062521"],"URL":"https:\/\/doi.org\/10.3390\/ijms27062521","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]}}}