Aging in women – The microbiome perspective
Maria Laura Ferrando, Fabio Busonero, Francesca Crobu, Serena Sanna
Abstract
Menopause is a hallmark of women's aging and is frequently portrayed as a medical issue. It also encompasses social and biological aspects often neglected and not well-understood, leaving women with insufficient support and attention. With the decline in estrogen levels, starting years before menopause is fully established, women experience various physical symptoms, and the risk of many age-related diseases increases sharply soon after these hormonal changes occur. Notably, these hormonal shifts also significantly impact the vaginal and gut microbiomes, contributing to dysbiosis and influencing the onset and progression of several diseases. Here, we examined the complex and dynamic relationship among aging, menopause, and microbiome changes with a particular focus on the vaginal and gut ecosystems. Emerging research highlights diet as a potential modulator for maintaining microbiome health during menopause. A deeper understanding of microbiome changes across life stages suggests the potential for microbiome-targeted strategies to support well-aging in women. The graphical abstract illustrates the different aspects of aging in women discussed in the review. • The decline of menopause-related estrogen affects the vaginal and gut microbiota, likely influencing onset and progression of age-related conditions • In most postmenopausal women (60-70%), the vaginal microbiome presents anaerobic communities and greater microbial diversity. • Aging during menopause is linked to decreased gut bacterial diversity, with women’s microbiota being more similar to men’s microbiota. • Key taxa shifts include reductions in SCFA-producers, estrobolome microbes, and beneficial bacteria and increase of Bacteroides and some pathobionts • The gut-vaginal axis represents a bidirectional relationship between the gut microbiome and the vaginal microbiome, where microbial communities in these two regions interact and influence each other. • Diet represents a great opportunity for intervention, either to support medical therapy or as a stand-alone approach.