Compounding to Prevent and Treat Dysbiosis of the Human Vaginal Microbiome.
Homeostasis of the human vaginal microbiome, which consists of the bacteriome (colonizing bacteria) and the mycobiome (resident fungi), is essential to the health of the female reproductive system. Dysbiosis of either microbial community can be caused by a variety of factors ranging from behavioral issues (personal-hygiene practices, the choice of contraceptives, smoking, etc.) to biological variables (the host-microbiome composition, menstruation, the robustness of the host's immune response). Clinicians often consult compounding pharmacistsbabout the formulation and use of customized preparations to treat vaginal diseases and re-establish a healthful vaginal microenvironment when commercially manufactured products have failed or are unavailable. In this article, the function of the human vaginal bacteriome and mycobiome are examined, a common microorganism identified in each of those microenvironments is discussed, factors that cause dysbiosis are reviewed, and the role of biofilm in the vaginal microbiota is explored. A question typical of those asked by prescribers committed to improving women's health and decreasing the incidence of recurring bacterial vaginosis or fungal infections is answered. Formulations for compounds that help ensure or reestablish the homeostasis of the human vaginal bacteriome and mycobiome are also provided.