In the last few decades, bacterial vaginosis (BV) has become an emerging pathology; its relationship with pregnancy, pelvic inflammatory disease (PID), infertility, preterm delivery, and neonatal small for gestational age are well established. BV substantially changes vaginal microbiome and these modifications could facilitate sexually transmitted infections (STIs). Several studies have reported an association between abnormal vaginal microbiota, in particular, BV and depletion of lactobacilli species, and increased risk of sexually transmitted infections (STIs) acquisition. Immunologic, enzymatic, and metabolic mechanisms could operate independently or in combination to enhance STIs’ transmission. Several studies have pointed out this association: vaginal microbiome modifications in BV could predispose to sexually transmitted diseases (STDs). Considering the high social impact of BV together with its relationship with STDs, it seems to be “crucial” to restore vaginal microbiome in childbearing age women in order to reduce STIs acquisition. Some experimental clinical data seem to confirm this observation: vaginal microbiome restoration by probiotics/synbiotics seems to improve not only STIs’ acquisition but also STDs’ pathology progression. Restoring vaginal microbiome could represent an international, innovative, and less-expensive gold standard to counteract STDs’ spread and acquisition.
Part of the book: Fundamentals of Sexually Transmitted Infections