Growth of opportunistic pathogens would increase would you expect to happen to the vaginal microbiota of a patient with a defect in estrogen production.
The vaginal microbiome is a complex ecological system that lives on the vaginal surfaces and in its cavity and regulates its own homeostasis through mutualistic interactions with the host. Estrogens play a significant role in the composition of the vaginal microbiome as well as the composition of the vaginal epithelium.
The gradual rise in oestrogen levels from puberty to reproductive age causes the change from low glycogen levels, high microbial diversity, high vaginal pH, and thin vaginal epithelium during puberty to high glycogen deposits in the epithelial cells and free glycogen available for Lactobacillus spp., which then dominate.
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