Academic Achievements

Dr. Yoshikata Reimi - A new approach to women's health through changes in the microbiome - Revealing the interactions between the vagina and intestinal flora at the 18th Annual Meeting of the Japanese Society of Gender-specific Medicine and Healthcare

Dr. Yoshigata Reimi, special advisor to Midtown Clinic (chief of women's medical research) and author of "Let's start in your 40s! Menopause management" (Kodansha), spoke at the morning seminar of the 2025th Japanese Society of Gender-specific Medicine and Healthcare Academic Meeting (theme: Let's stop and think about the differences between men and women now) held at Kumamoto Civic Hall on January 1, 13.Female aging and the vaginal microbiome■Changes in the vaginal and intestinal flora: A perspective on healthcare from the perspective of crosstalk between vaginal and intestinal floraThe conference was attended by experts from a wide range of fields due to the expansion of the concept of gender-specific medicine, and this was the first presentation at the conference on an approach to women's health issues that focuses on the intestinal and vaginal microbiomes.

  • Micro biome
    The microbiome is a microbial flora, such as bacteria and viruses, that coexists with the human body and shares space inside the human body. In recent years, advances in genome analysis have led to rapid progress in microbiome research, revealing that the composition of the microbiome differs for each individual human, and that pathogenic bacteria coexist with other microbial communities without causing disease in the host human. On the other hand, the human microbiome that exists in the body has functions such as "regulating the immune system," "nutrient breakdown metabolism," and "signaling hunger and satiety," and is said to number between 10 and 100 trillion. The relationship between representative microbiomes in the human body and disease risk is as follows: In the oral cavity, Streptococcus and dental caries, Fusobacterium and intestinal cancer and infectious enteritis; Bacteroides and digestive promotion and immune system balance adjustment; and in the vagina, Lactobacillus and Lactobacillus have effects on reducing pathogens, sexually transmitted diseases, premature birth risk, and gynecological cancer risk. As such, the microbiome is closely related to our health, being related to various biological functions and diseases.

Lecture content

back ground

The key word in the lecture, "vaginal microbiome," is an area that Dr. Yoshigata has focused on in the course of her own microbiome research. Dr. Yoshigata originally studied equol (a compound similar to the female hormone estrogen) metabolized from isoflavones, and the process by which isoflavones are converted into equol as a postbiotic by intestinal bacteria, and its health benefits. As her research progressed, she deepened her interest in the vaginal microbiome from a gynecological perspective and expanded her research field. In this lecture, she focused in particular on the crosstalk between the intestinal and vaginal microbiomes, and presented a comprehensive presentation of her knowledge in this field, including basic knowledge about the microbiome in general, as well as the intestinal flora and vaginal microbiome, with examples of Dr. Yoshigata's research.

Equol-producing bacteria and intestinal bacteria

Intestinal bacteria metabolize food and produce postbiotics such as equol. The activity of equol-producing bacteria is expected to bring a wide range of health benefits, such as reducing menopausal symptoms, lowering the risk of bone loss, and improving the risk of arteriosclerosis in women, and reducing the risk of prostate disease in men.
Furthermore, it has been shown that equol production is strongly correlated with the diversity of intestinal bacteria. It has been shown that the key to activating equol-producing bacteria is to have dietary and lifestyle habits that maintain the diversity of the intestinal flora (i.e., improve the intestinal environment).

Vaginal Microbiome and Estrogen

In the vagina, lactobacillus, a type of lactic acid bacteria,■plays an important role. A diverse environment of intestinal bacteria is desirable, while a monoenvironment dominated by Lactobacillus is considered favorable in the vagina. In this respect, the bacterial environments in the intestine and vagina have contrasting characteristics.
The production of Lactobacillus is highly dependent on the female hormone estrogen. During menstruation and after menopause, estrogen levels are low, leading to a lack of Lactobacillus, which creates an environment where harmful bacteria and pathogens can proliferate and become over-diverse.

  • Lactobacillus
    The Lactobacillus genus is the largest genus of lactic acid bacteria and is widely distributed in nature, growing in fermented foods, etc. In the field of molecular research, Lactobacillus is classified into five communities, CST I to CST V, with CST IV being the type with the fewest Lactobacillus species and known as the diversity group.
    Vaginal Lactobacillus is a source of lactic acid production, which keeps the vagina acidic and maintains its self-cleaning function. An ideal vaginal environment is one in which the vaginal microbiome is rich in Lactobacillus, and previous research has shown that this state has a wide range of health benefits, including preventing sexually transmitted diseases and HPV infections, regulating the immune system, and reducing the risk of gynecological cancer.

    Reference research:
    Dr. Reimi Yoshikata gives a presentation on "New Perspectives on Women's Health Care from the Perspective of Female Aging and Microbiome Changes" at the General Meeting of the Japanese Society of Anti-Aging Medicine
    https://www.amcare.co.jp/research/20230704-1669/

Crosstalk between vaginal and intestinal flora

It has been found that there is a correlation between the intestinal and vaginal bacterial flora. Dr. Yoshigata's research also conducted a simultaneous genetic analysis of the intestinal and vaginal bacterial flora, and confirmed that in the premenopausal group, there were many Lactobacillus species in the vagina and intestine that matched and correlated. Furthermore, in the menopausal group, in addition to a similar trend, a correlation was observed with a greater number of miscellaneous bacteria. These findings suggest that there may be a mutual influence between the bacteria in the intestine and vagina. Furthermore, it was suggested that the diversity of intestinal bacteria is related to equol production, which in turn has a positive impact on the vaginal environment.

Use of probiotics and postbiotics

Oral intake of probiotics (such as lactobacilli and bifidobacteria) that regulate intestinal bacteria may also contribute to improving the vaginal environment through crosstalk between the intestinal and vaginal flora. In addition, transvaginal probiotics are expected to have a direct effect of improving the vaginal environment. Ingestion of equol supplements as a postbiotic has been shown to contribute to the alleviation of menopausal symptoms as well as the reduction of the risk of lifestyle-related diseases.

Summary

~A new perspective on women's health from the intestinal and vaginal microbiomes~

1. The importance of regulating your gut microbiome

Diversity of the intestinal flora is important for producing good postbiotics such as equol.
Diet: A synbiotic approach combining fermented foods and dietary fiber is recommended.
The key is to improve overall lifestyle habits, such as quitting smoking, drinking in moderation, maintaining regular bowel habits, and exercising moderately.

2. The importance of maintaining a healthy vaginal microbiome in women

By maintaining an abundance of Lactobacillus in the vagina, it is expected that the risk of sexually transmitted diseases will be reduced and GSM (genitourinary syndrome associated with menopause) will be alleviated.
After menopause, when the vaginal environment is prone to change due to a decline in estrogen, conscious care of the femzone is necessary.
FemCare products such as vaginal gels as vaginal probiotics may also be an effective option.

3. A new perspective on health that takes into account crosstalk between the intestine and the vagina

It is possible that "if you regulate your intestines, your vagina will also be regulated," and vice versa.
Throughout a woman's life, hormonal fluctuations and the microbiome are closely correlated, and a virtuous cycle can be created through proper lifestyle habits and self-care.

Comment from Dr. Yoshikata

These findings provide a new perspective for considering women's health. In particular, the concept that the intestinal and vaginal flora do not exist independently, but are closely intertwined with each other, is important. Practicing microbiome care according to a woman's life stage and engaging in self-care from the perspectives of both the intestinal and vaginal flora is thought to play a major role in maintaining women's health.

<Doctor introduction>

Remi Yoshikata

Doctor of Medicine
Japan Society of Obstetrics and Gynecology, Obstetrician and Gynaecologist
Vice President, Japan Society of Menopause and Aging Health Care
Special Advisor to Midtown Clinic (Chief of Women's Health Research)
Special Advisor to the Medical Corporation Shinkokai
Gynaecologist at Hamamatsucho Hamasite Clinic
Grand Himedic Club Club Doctor
Part-time lecturer at the Department of Obstetrics and Gynecology, Tokyo Women's Medical University Hospital

Graduated from Tokyo Women's Medical University School of Medicine. As an obstetrician-gynecologist, she is at the forefront of medical care, performing gynecological tumor surgery, and is also involved in various clinical research projects in women's medicine and menopausal medicine. With a desire to spread preventive medical care for women, she became the director of Hamamatsucho Hamasite Clinic in 2010. Currently, in addition to working as a gynecologist at the hospital, she is also engaged in preventive medical research at multiple facilities. She specializes in hormone management for women's bodies, which are prone to fluctuations such as irregular menstruation, pregnancy efforts, and menopause. In July 2022, she published "Let's start menopause management in your 7s! (published by Kodansha).

<Qualifications>
Specialist in Obstetrics and Gynecology, Doctor of Medicine, Clinical Training Supervisor, Japan Society of Obstetrics and Gynecology
Representative of the Japanese Society of Women's Medicine and certified specialist of the same society
Vice President of the Japan Society of Menopause and Aging Health Care
Councillor of the Japanese Society of Anti-Aging Medicine
Japan Society for Women's Nutrition and Metabolism, etc.

<Affiliated academic societies>
Japan Obstetrics and Gynecology Association
Japanese Society of Women's Health
Japan Society of Menopause and Aging Health Care
Japanese Society of Anti-Aging Medicine, Japanese Osteoporosis Society, Japanese Society of Psychosomatic Medicine for Women
Japanese Society for Women's Nutrition and Metabolism
North American Menopause Society
International Menopause Society and others

The information on this page is current as of January 2025, 2.

           

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