Vaginal microbiome of women with adenomyosis: A case-control study

Jitsupa Kunaseth, Wanwisa Waiyaput, Prangwalai Chanchaem, Vorthon Sawaswong, Rattana Permpech, Sunchai Payungporn, Areepan Sophonsritsuk
PloS one · 2022 · vol. 17(2) , pp. e0263283 · doi:10.1371/journal.pone.0263283 · PMID:35171931 · PMC8849446 · W4213330451
article OA: gold CC0 ⤵ 17 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study found greater vaginal microbial richness and altered bacterial taxa, including increased abundance of Alloscardovia and Oscillospirales, in women with adenomyosis compared to controls.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

Kunaseth and colleagues conducted an age-matched cross-sectional case-control study comparing vaginal microbiota in 40 women with ultrasound-diagnosed adenomyosis versus 40 age-matched women without adenomyosis, using vaginal swabs analyzed by 16S rDNA V3–V4 sequencing and diversity/composition analyses. They found higher vaginal microbial richness in the adenomyosis group (Chao1, p = 0.006), along with increased abundance of multiple taxa in adenomyosis (e.g., Alloscardovia, Oscillospirales, Ruminococcaceae, Enhydrobacter, Megamonas, Faecalibacterium), while several taxa were more abundant in controls. Vaginal community state types differed, with CST-III and CST-IV dominated in adenomyosis versus only CST-IV in controls, and Lactobacillus remained most abundant in both groups. The paper’s main limitation is that it is cross-sectional, so mechanisms and clinical implications are not established. This paper is centrally about endometriosis and/or adenomyosis — it directly compares the vaginal microbiome profile in women with adenomyosis versus controls.

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Abstract

Immune dysregulation can involve invasion and survival of endometrial glands inside the myometrium of the adenomyosis. There is limited available data concerning alterations of the bacterial microbiome in the reproductive tract of adenomyosis women. The present cross-sectional age-matched study aims to compare vaginal microbiota between women with and without adenomyosis. We recruited women with adenomyosis (N = 40) and age-matched women without adenomyosis (N = 40) from the Departments of Obstetrics and Gynaecology, Ramathibodi Hospital Mahidol University, from August 2020 to January 2021. Vaginal swab samples were collected from the participants. DNA isolation and bacterial 16s rDNA gene sequencing and data analyses were then performed. Comparison of the diversity of vaginal microbiota, microbiota composition, and the operational taxonomic unit (OTU) between adenomyosis and non-adenomyosis (control) groups were undertaken. Data from 40 and 38 women with and without adenomyosis, respectively, were analyzed. Alpha-diversity analysis (Chao1 index) at the species level showed higher vaginal microbial richness in the adenomyosis group when compared with the control group (p = 0.006). The linear discriminant analysis effect size technique (LeFSe) indicated an elevated abundance of several vaginal microbial taxa in the adenomyosis group, including Alloscardovia, Oscillospirales, Ruminoccoccaceae, UCG_002, Oscillospiraceae, Enhydrobacter, Megamonas, Moraxellaceae, Subdoligranulum, Selenomonadaceae, and Faecalibacterium. On the other hand, an increase in the abundance of Megaspehera, Fastidiosipila, Hungateiclostridiaceae, and Clostridia was identified in the control group. Vaginal community state type (CST)-III and -IV were dominated in adenomyosis, while only CST-IV was dominated in the non-adenomyosis group. Lactobacillus was the most abundant vaginal microbial in both groups. In this study, the differences in vaginal microbiome profile were noted between adenomyosis and non-adenomyosis group. The increasing of microbial richness was associated with adenomyosis. Nevertheless, further investigations were required to elucidate the mechanisms and apply them for clinical implications.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Bacteria Microbiota RNA, Ribosomal, 16S Vagina Adenomyosis Adenomyosis Adult Bacteria Bacteria Bacteria Case-Control Studies Cross-Sectional Studies Female Humans RNA, Ribosomal, 16S RNA, Ribosomal, 16S Thailand Thailand Vagina

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