Vaginal dysbiosis-associated infections: Current and emerging treatment strategies

The vaginal microbiome plays a crucial role in female reproductive health, protecting against pathogens through a Lactobacillus -dominated ecosystem. Disruption of this microenvironment, termed vaginal dysbiosis, is implicated in a range of infections, including bacterial vaginosis, vulvovaginal candidiasis, aerobic vaginitis, and mixed vaginitis. Despite their distinct etiologies, these conditions often present with overlapping clinical symptoms, leading to empirical treatment with broad-spectrum antimicrobials. While such interventions may provide brief symptom relief, they frequently fail to eradicate the underlying dysbiosis, resulting in high recurrence rates and the emergence of antimicrobial-resistant strains. This highlights the urgent need for targeted, microbiome-informed therapeutic interventions capable of restoring a stable, health-associated vaginal microbial community and reducing reliance on non-specific antibiotic regimens. This review article gives an overview of the current understanding of this topic, spanning from the heterogeneity of vaginal dysbiosis and its pathogenesis to the current treatment strategies employed and the future therapeutic prospects.