Life expectancy for women is higher than for men, and this is referred as women’s mortality advantage. However, the extra years are not healthy years, as on average the 10 last years are spent in ill health. The rates of mental ill health are increasing throughout Developed countries and across all ages, coupled with the fact that cardiovascular diseases continue to comprise a major part of the overall disease burden for women (WHO, 2016). See our Cardiovascular health and Cognitive health pages about these topics.
Looking at women’s health and illness at different life stages allows the identification of specific interventions that can minimize risks and maximize protective factors and assets. Key areas for action to reduce health inequities for women throughout the life-course are related to women’s sexual and reproductive health (WHO, 2016).
There is growing scientific research pointing out the woman’s vaginal microbiome as a key player for female reproductive health and the health of their offspring, not only influencing health and dysbiosis, but also potentially in successful fertilization and healthy pregnancies.
Large cohorts with non-pregnant healthy women have shown differences on the ‘normal’ microbiome of the vagina, related to age, race, geographical location and nutrition, however it predominantly includes a variety of Lactobacillus species, which promote a healthy, supportive environment for the embryo in the pre and peri-conceptual period.
Managing bladder and vaginal infections are generally based on antibiotic treatments and they are frequently related to recurrence, and chronic infections. This increases the necessity for new and more effective treatment or prevention options. It is possible to foresee clinical advantages for the use of biotherapeutic agents (prebiotics and/or probiotics) for treating these infections. Studies demonstrate that probiotics can be taken in association with antibiotics and antifungal agents, used to eradicate infections. So, probiotics and prebiotics can be a relevant auxiliary to pharmaceutical and other approaches used in the care of feminine health.
Pre- and probiotic beneficial effects can be delivered topically or systemically. In general, both approaches have the potential to optimize, maintain and restore the ecology of the vaginal ecosystem.
Probiotic use has indications that include reduction in vaginal and urinary tract infections, and also reduction of preterm birth, reduction of gestational diabetes mellitus and reduction of postpartum depression.
Prebiotics, as specific carbohydrates, can provide a therapeutic approach for controlling infections by stimulating the growth of the indigenous lactobacilli but inhibiting the growth and adhesion of pathogens to the vaginal epithelial cells.
Interventional clinical trials in Women's health need to be of a sufficient size and duration to understand the functional benefits of the potential pre- and probiotics. These trials should include mechanistic components focused on the biomarkers of vaginal health to link biological changes to any functional benefits that might be observed.