Ospemifene improves vaginal microbiome of women with vulvovaginal atrophy

Women with vulvovaginal atrophy exhibit a less favourable vaginal microbiome than healthy postmenopausal women, but ospemifene may restore vaginal health by reducing potentially harmful bacteria, as shown in a study.

The study included 67 postmenopausal women, of whom 39 had vulvovaginal atrophy and 28 were considered healthy controls. In the group of atrophic women, 20 received ospemifene and 19 received hormone treatment.

Researchers calculated the women’s vaginal health index. They also collected a vaginal swab to evaluate vaginal maturation index and analyse vaginal microbiome through 16S rRNA gene sequencing. Clinical/microbiological analyses were repeated after 3 months of treatment.

In the group of atrophic women, the vaginal microbiome showed significantly reduced Lactobacillus (p=0.002) and increased abundance of Streptococcus (p=0.008) and Sneathia (p=0.02). Lactobacillus abundance was positively correlated with vaginal health index and vaginal maturation index (p=0.002 and p=0.035, respectively).

Vaginal indices improved with both ospemifene and hormone treatment. Systemic hormone treatment produced changes in minority bacterial groups of the vaginal microbiome, while ospemifene was able to eradicate specific bacterial taxa, such as Staphylococcus (p=0.04) and Clostridium (p=0.01).

Bifidobacteria tended to increase with both treatments.

The findings indicate that ospemifene may improve the composition of the vaginal microbiome in postmenopausal women with vulvovaginal atrophy.