Abstract

The vaginal microbiome is a dynamic and diverse microbial community that plays a fundamental role in women’s 
reproductive health. Dominated primarily by Lactobacillus species, it maintains vaginal homeostasis through 
acidification, antimicrobial compound production, and pathogen inhibition. Disruptions in this balance, influenced 
by hormonal fluctuations, sexual activity, hygiene practices, antibiotic use, and lifestyle factors, can lead to 
dysbiosis, bacterial vaginosis, and increased susceptibility to sexually transmitted infections. The composition of 
the vaginal microbiome varies across different stages of life, pregnancy, and ethnic groups, with distinct 
community state types (CSTs) conferring varying degrees of protection or risk. Growing evidence underscores its 
impact on fertility, pregnancy outcomes, neonatal health, and postpartum complications. Advances in sequencing 
technologies have deepened understanding of its composition and function, highlighting opportunities for 
microbiome-based diagnostics and therapeutic interventions to improve reproductive and maternal health.