Aim

akusherstvo

Obstetrics, Gynecology and Reproduction

Акушерство, Гинекология и Репродукция

2313-73472500-3194

IRBIS LLC

10.17749/2313-7347/ob.gyn.rep.2026.808

akusherstvo-2923

Research Article

REVIEW ARTICLE

НАУЧНЫЙ ОБЗОР

Stress and microbiocenosis of the female reproductive tract

Влияние стресса на микробиоценоз женского репродуктивного тракта

https://orcid.org/0009-0009-2602-1268

Тутова

А. В.

Tutova

A. V.

Тутова Анна Владимировна

308000 Белгород, ул. Некрасова, д. 8/9

Anna V. Tutova, MD.

8/9 Nekrasova Str., Belgorod 308000

https://orcid.org/0000-0002-7188-6780

Лебедева

О. П.

Lebedeva

O. P.

Лебедева Ольга Петровна, д.м.н., проф.

Scopus Author ID: 55655876400.

WoS ResearcherID: E-5969-2015.

eLibrary SPIN-code: 9201-0850.

117198 Москва, ул. Миклухо-Маклая, д. 6; 308015 Белгород, ул. Победы, д. 85

Olga P. Lebedeva, MD, Dr Sci Med, Prof.

Scopus Author ID: 55655876400.

WoS ResearcherID: E-5969-2015.

eLibrary SPIN-code: 9201-0850.

6 Miklukho-Maklaya Str., Moscow 117198; 85 Pobedy Str., Belgorod 308015

safonova2@yandex.ru

https://orcid.org/0009-0004-2302-2760

Калюжнова

Е. П.

Kaluzhnova

E. P.

Калюжнова Елена Павловна

308015 Белгород, ул. Победы, д. 85

Elena P. Kaluzhnova

85 Pobedy Str., Belgorod 308015

https://orcid.org/0009-0009-8393-555X

Чадюк

М. К.

Chadyuk

M. K.

Чадюк Мария Константиновна

308015 Белгород, ул. Победы, д. 85

Maria K. Chadyuk

85 Pobedy Str., Belgorod 308015

https://orcid.org/0000-0003-1480-2234

Козаренко

О. Н.

Kozarenko

O. N.

Козаренко Олеся Николаевна, к.м.н.

Scopus Author ID: 57443919600.

eLibrary SPIN-code: 8670-3005.

308015 Белгород, ул. Победы, д. 85

Olesya N. Kozarenko, MD, PhD.

Scopus Author ID: 57443919600.

eLibrary SPIN-code: 8670-3005.

85 Pobedy Str., Belgorod 308015

https://orcid.org/0000-0002-8334-2967

Калашникова

И. В.

Kalashnikova

I. V.

Калашникова Ирина Владимировна, к.м.н.

308000 Белгород, ул. Некрасова, д. 8/9; 308015 Белгород, ул. Победы, д. 85

Irina V. Kalashnikova, MD, PhD.

8/9 Nekrasova Str., Belgorod 308000; 85 Pobedy Str., Belgorod 308015

https://orcid.org/0000-0002-8573-5916

Нагорный

А. В.

Nagorny

A. V.

Нагорный Андрей Владимирович, к.м.н.

308000 Белгород, ул. Некрасова, д. 8/9; 308015 Белгород, ул. Победы, д. 85

Andrey V. Nagorny, MD, PhD.

8/9 Nekrasova Str., Belgorod 308000; 85 Pobedy Str., Belgorod 308015

https://orcid.org/0000-0001-8685-0118

Селиванова

А. В.

Selivanova

A. V.

Селиванова Алина Владимировна, к.м.н.

308015 Белгород, ул. Победы, д. 85; 308036 Белгород, ул. Губкина, д. 46

Alina V. Selivanova, MD, PhD.

85 Pobedy Str., Belgorod 308015; 46 Gubkina Str., Belgorod 308036

ОГБУЗ «Белгородская областная клиническая больница Святителя Иоасафа»РоссияBelgorod Regional Clinical Hospital of St. JoasaphRussian Federation

ФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»; ФГАОУ ВО «Белгородский государственный национальный исследовательский университет»РоссияPeoples’ Friendship University of Russia; Belgorod National Research UniversityRussian Federation

ФГАОУ ВО «Белгородский государственный национальный исследовательский университет»РоссияBelgorod National Research UniversityRussian Federation

ОГБУЗ «Белгородская областная клиническая больница Святителя Иоасафа»; ФГАОУ ВО «Белгородский государственный национальный исследовательский университет»РоссияBelgorod Regional Clinical Hospital of St. Joasaph; Belgorod National Research UniversityRussian Federation

ФГАОУ ВО «Белгородский государственный национальный исследовательский университет»; ОГБУЗ «Городская больница № 2 г. Белгорода»РоссияBelgorod National Research University; Belgorod Municipal Hospital № 2Russian Federation

2026

31082026

Online First

2923

2026

Тутова А.В., Лебедева О.П., Калюжнова Е.П., Чадюк М.К., Козаренко О.Н., Калашникова И.В., Нагорный А.В., Селиванова А.В.

Tutova A.V., Lebedeva O.P., Kaluzhnova E.P., Chadyuk M.K., Kozarenko O.N., Kalashnikova I.V., Nagorny A.V., Selivanova A.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.gynecology.su/jour/article/view/2923

Aim

Aim: to systematically evaluate the evidence on psychosocial stress impacting on the microbiocenosis of the female reproductive tract and to delineate the underlying pathogenetic mechanisms.

Materials and Methods

Materials and Methods. A comprehensive literature review was conducted across PubMed/MEDLINE, Google Academy, and eLibrary databases covering a 25-year period. Search terms for query included "stress," "vaginal microbiome/microbiocenosis/microflora," "cervical microbiome," and "uterine microbiome" in both Russian and English. Original studies, systematic reviews, and meta-analyses were included; animal experiments, conference abstracts, non-full-text publications, and off-topic articles were excluded.

Results

Results. Chronic psychosocial stress activates the hypothalamic-pituitary-adrenal axis and the sympathoadrenal system, leading to hypercortisolemia and elevated catecholamine levels. Key pathogenetic mechanisms include Th1-to-Th2 (T-helpers 1/T-helpers 2) immune shift followed by consequently suppressed cell-mediated immunity, estrogen deficiency-driven reduction of vaginal epithelial glycogen, impaired glucose metabolism, and direct catecholamine-mediated enhancement of bacterial virulence and proliferation. In the lower reproductive tract, stress is an independent predictor of bacterial vaginosis, recurrent vulvovaginal candidiasis, genital herpes reactivation, and high-risk human papillomavirus (HPV) persistence with increased risk of cervical intraepithelial neoplasia and invasive cervical cancer. Stress also elevates susceptibility to sexually transmitted infections. In the upper reproductive tract, depression and anxiety are associated with increased incidence of pelvic inflammatory disease and reduced implantation success in assisted reproductive technology programs.

Conclusion

Conclusion. Psychosocial stress is an independent, modifiable risk factor for reproductive tract dysbiosis. Assessing psychosocial status should be integrated into clinical evaluation of women with inflammatory and dysbiotic conditions of the reproductive tract, and psychological intervention should be considered a component of comprehensive treatment strategies.

Цель

Цель: провести комплексный анализ научной литературы о влиянии психоэмоционального стресса на микробиоценоз женского репродуктивного тракта и выявить патогенетические механизмы данного влияния.

Материалы и методы

Материалы и методы. Проведен комплексный обзор литературы, индексированной в базах данных PubMed/MEDLINE, Google Academy и eLibrary за период 25 лет, с использованием ключевых слов на русском и английском языках по темам: стресс, влагалищный микробиом, микробиоценоз цервикального канала и эндометрия. В анализ включены оригинальные исследования, систематические обзоры и метаанализы; исключены эксперименты на животных, тезисы конференций, публикации без полного текста и нерелевантные работы.

Результаты

Результаты. Хронический психоэмоциональный стресс активирует гипоталамо-гипофизарно-надпочечниковую ось и симпато-адреналовую систему, вызывая гиперкортизолемию и повышение уровня катехоламинов, что оказывает многофакторное влияние на микробиоценоз репродуктивного тракта. К основным патогенетическим механизмам стресса относятся: иммуносупрессия со сдвигом баланса Т-хелперов 1-го и 2-го типов (англ. T-helpers 1/T-helpers 2, Th1/Th2) в сторону Th2, снижение уровня эстрогенов и, как следствие, уменьшение содержания гликогена в эпителии влагалища, нарушение метаболизма глюкозы, а также прямое стимулирующее действие катехоламинов на вирулентность и пролиферацию бактерий. В нижних отделах репродуктивного тракта стресс является независимым предиктором бактериального вагиноза, рецидивирующего кандидозного вагинита, реактивации генитального герпеса и персистенции вируса папилломы человека (ВПЧ) с повышенным риском развития предрака и рака шейки матки, а также увеличивает риск заражения инфекциями, передаваемыми половым путем. В верхних отделах репродуктивного тракта для пациенток с психоэмоциональным стрессом характерен повышенный риск воспалительных заболеваний органов малого таза и снижение частоты успешной имплантации в программах вспомогательных репродуктивных технологий.

Заключение

Заключение. Психоэмоциональный стресс представляет собой самостоятельный модифицируемый фактор риска нарушений микробиоценоза женского репродуктивного тракта. Полученные данные обосновывают необходимость включения оценки психоэмоционального статуса в стандарты обследования пациенток с дисбиотическими и воспалительными заболеваниями женских половых органов.

стресскортизолмикробиоммикробиота влагалищаженский репродуктивный трактбактериальный вагинозгипоталамо-гипофизарно-надпочечниковая осьлактобактерии

stresscortisolmicrobiomevaginal microbiotafemale reproductive tractbacterial vaginosishypothalamic-pituitary-adrenal axislactobacilli

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The authors declare that there are no conflicts of interest present.