ABSTRACT
Mycoplasmas Mycoplasma hominis, Ureaplasma urealyticum
Yeast Candida albicans
Virus Human papillomavirus
Vaginal estrogen Decreases vaginal pH and fosters lactobacilli predominance concentration Genetics Individual variations in production of immune activators or inhibitors influences the capacity of the
host to eliminate specific microorganisms Immune status Vaginal immediate hypersensitivity reactions or immune tolerance to specific microbial antigens effect
the ability of the immune system to control microbial proliferation Sexual activities Deposition of semen, saliva, or foreign objects into the vagina alters vaginal pH and immune functions
and elicits the direct deposition of exogenous microorganisms.The ability of H2O2-producing lactobacilli to inhibit growth of E. coli is inhibited by semen
Oral or vaginal Alter local immune status, vaginal pH, and ability of select microorganisms to survive and replicate medications (Candida species) Vaginal blood Increases vaginal pH, alters microbial ecology by providing nutrients for a select group of microorganisms Contraception Oral contraceptives alter vaginal estrogen levels, diaphragm and condom usage are associated with
increased vaginal levels of enterobacteria, intrauterine devices have been associated with increased levels of Bacteroides species and group B streptococci
Vaginal products Douches, deodorants, pads, tampons can alter the vaginal ecosystem
1,2. Ethnic differences in the composition of the vaginal flora have not received sufficient attention, but recent investigations using gene amplification technology indicate that there can be pronounced differences between white and black women.
