Association between lifestyle factors, traditional Chinese medicine constitution types and vaginal microbiota health in women: A case-control study

• Case-control study investigated lifestyle and constitution in vaginal health. • Long sitting time and diet are linked to vaginal microbiota imbalance. • Certain body constitution types raise risk of vaginal flora disturbance. • Traditional Chinese Medicine offers new perspective on vaginal health. • Findings support prevention tailored to lifestyle and body constitution. Vaginitis is an inflammatory condition of the female reproductive tract influenced by multiple factors, including hormone levels, lifestyle habits, and individual predispositions. In Traditional Chinese Medicine (TCM) theory, different constitution types can influence the onset and progression of vaginitis, as they determine an individual's internal balance of Yin and Yang, Qi, and Blood. This study aims to explore the correlation between lifestyle factors, TCM constitution types, and vaginal microecological abnormalities. A case-control study was conducted at the Third Affiliated Hospital of Beijing University of Chinese Medicine between August and October 2024, involving women aged 18–45 with a history of sexual activity. The exposure variables encompassed age, lifestyle habits, and TCM constitution types, while the outcome variable focused on vaginal microecological abnormalities. Associations were assessed using logistic regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression, with results reported as odds ratios (ORs) and 95 % confidence intervals (CIs). This study identified several significant risk factors for vaginal microecological imbalance. Univariate analysis showed differences between the abnormal ( n = 334) and normal groups ( n = 111) in reproductive infection score, sedentary hours, meat and dessert consumption, and TCM constitution types. Multivariate logistic regression confirmed reproductive infection score (OR = 1.2454, P < 0.0001) and sedentary hours (OR = 1.3501, P = 0.0002) as key contributors, with meat consumption nearly doubling the risk (OR = 1.9941, P = 0.0230). Additionally, dampness-heat constitution (DHC) (OR = 6.6673, P = 0.0212) and qi-deficiency constitution (QDC) (OR = 3.9269, P = 0.0420) were associated with significantly higher risks of abnormal vaginal flora. LASSO regression analysis further emphasized the critical roles of reproductive infection score and sedentary hours in driving microecological imbalance. Reproductive infection score and sedentary hours are significant contributors to vaginal microecological imbalance, while dietary habits and TCM constitution types, such as DHC and QDC, further influence the risk. These results provide valuable insights into the multifactorial nature of vaginal microecology and suggest that addressing these factors could improve preventive care and management.