# Research Progress in the Treatment of Vaginitis With Bioactive Compounds: Targeting of Vaginal Microflora

**Authors:** Yongming Li, Huiyu Liu, Ruihan Li, Rong Li, Jiaqi Liu

PMC · DOI: 10.1002/mbo3.70203 · MicrobiologyOpen · 2026-02-22

## TL;DR

This paper reviews how bioactive compounds from Traditional Chinese Medicine can treat vaginitis by targeting vaginal microflora and reducing side effects compared to conventional drugs.

## Contribution

The paper highlights the novel use of TCM bioactive compounds for vaginitis treatment, emphasizing microecological restoration and reduced antibiotic resistance.

## Key findings

- TCM bioactive compounds show lower toxicity and fewer side effects compared to conventional treatments.
- Herbal medicines can inhibit bacteria, fungi, and viruses while repairing mucosa and enhancing immunity.
- Local TCM treatments like irrigation and sitz baths help maintain vaginal microecological balance.

## Abstract

Vaginitis, a common gynecological ailment among women, poses a considerable health challenge with high recurrence rates even after conventional treatment. Vaginitis includes more common forms, such as bacterial vaginosis, vulvovaginal candidiasis, and Trichomonas vaginalis (TV), and less common forms, including senile vaginitis, infantile vaginitis, viral vaginitis, and mixed vaginitis. Conventional treatment approaches for vaginitis involve medications, such as metronidazole and clindamycin; however, long‐term use of these agents raises concerns about adverse reactions, disruption of the vaginal ecosystem, and antibiotic resistance. Bioactive compounds from Traditional Chinese Medicine (TCM), known for their lower toxicity and multifaceted biological activity, are effective for treating vaginitis with fewer side effects and a focus on restoring a healthy vaginal microecology. TCM decoctions exhibit internal effectiveness, while local TCM treatments utilize external medications and modalities, such as irrigation and fumigation sitz baths. This review offers insights to guide vaginitis treatment and provides a theoretical foundation for the development and application of herbal therapies for vaginitis.

Mechanism diagram of the effect of herbal medicine on vaginitis. Herbal medicines mainly combat vaginitis by (A) inhibiting bacteria, (B) inhibiting fungi, (C) acting on the cilia of Trichomonas, (D) inhibiting virus replication, (E) repairing the mucosa, (F) enhancing immunity, and (G) maintaining the microecological balance.

## Linked entities

- **Chemicals:** metronidazole (PubChem CID 4173), clindamycin (PubChem CID 446598)
- **Diseases:** vaginitis (MONDO:0002234), bacterial vaginosis (MONDO:0005316), vulvovaginal candidiasis (MONDO:0006014), senile vaginitis (MONDO:0001410)

## Full-text entities

- **Genes:** NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, EGF (epidermal growth factor) [NCBI Gene 1950] {aka HOMG4, URG}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, CDH1 (cadherin 1) [NCBI Gene 999] {aka Arc-1, BCDS1, CD324, CDHE, ECAD, LCAM}, IFNA1 (interferon alpha 1) [NCBI Gene 3439] {aka IFL, IFN, IFN-ALPHA, IFN-alphaD, IFNA13, IFNA@}
- **Diseases:** organ dysfunction (MESH:D009102), urticaria (MESH:D014581), kidney deficiency (MESH:D007680), genital itching (MESH:D011537), dysuria (MESH:D053159), Inflammation (MESH:D007249), headache (MESH:D006261), metallic taste (MESH:D013651), BV (MESH:D016585), glossitis (MESH:D005928), vulvar irritation (MESH:D014845), irritation (MESH:D001523), liver and kidney deficiencies (MESH:D051437), Senile (MESH:D000544), atrophy (MESH:D001284), spleen-deficiency syndromes (MESH:D013160), estrogen deficiency (MESH:D056828), bacterial infection (MESH:D001424), dry mouth (MESH:D014987), TCM syndrome (MESH:C562377), liver damage (MESH:D056486), C. albicans infection (MESH:D002177), Infantile vaginitis (MESH:D014627), fungal (MESH:D009181), Trichomonas vaginitis (MESH:D014247), genital herpes (MESH:D006558), infectious (MESH:D003141), Viral Vaginitis (MESH:D014777), TV (MESH:D014245), dyspareunia (MESH:D004414), Trichomonad infection with (MESH:D007239), immune system dysfunction (MESH:D007154), VVC (MESH:D002181), toxicity (MESH:D064420)
- **Chemicals:** Miconazole (MESH:D008825), clindamycin (MESH:D002981), glycogen (MESH:D006003), Genistein (MESH:D019833), tinidazole (MESH:D014011), borneol (MESH:C022871), Pyr (MESH:D019289), sugar (MESH:D000073893), d-lactic acid (MESH:D019344), Polysaccharides (MESH:D011134), estradiol (MESH:D004958), benzoic acid (MESH:D019817), azole (MESH:D001393), Metronidazole (MESH:D008795), fluconazole (MESH:D015725), polyphenols (MESH:D059808), cysteine (MESH:D003545), nifuratel (MESH:D009545), potassium hydroxide (MESH:C029943), glucose (MESH:D005947), flavonoids (MESH:D005419), penciclovir (MESH:C053539), Perillaldehyde (MESH:C033342), beta-glucan (MESH:D047071), ROS (MESH:D017382), saponins (MESH:D012503), Berberine (MESH:D001599), H2O2 (MESH:D006861), A. macrocephalae polysaccharides (-), cefuroxime (MESH:D002444), glycerol (MESH:D005990), n-butanol (MESH:D020001), matrine (MESH:D000093842), oxymatrine (MESH:C037573), ergosterol (MESH:D004875), isoflavone (MESH:D007529), amine (MESH:D000588), Dioscin (MESH:C019357)
- **Species:** Zanthoxylum bungeanum (Sichuan-pepper, species) [taxon 328401], Gardnerella vaginalis (species) [taxon 2702], Enterococcus casseliflavus (species) [taxon 37734], Mentha canadensis (American wild mint, species) [taxon 294733], Prunus mume (Japanese apricot, species) [taxon 102107], Streptococcus pyogenes (species) [taxon 1314], Enterococcus (genus) [taxon 1350], Klebsiella (genus) [taxon 570], Arachis hypogaea (goober, species) [taxon 3818], Lactobacillus jensenii (species) [taxon 109790], Sophora flavescens (species) [taxon 49840], Coptis chinensis (species) [taxon 261450], Candida albicans (species) [taxon 5476], Escherichia coli (E. coli, species) [taxon 562], Glycine max (soybean, species) [taxon 3847], Wolfiporia cocos (species) [taxon 81056], Euphorbia helioscopia (species) [taxon 154990], Vigna angularis (adzuki bean, species) [taxon 3914], Taraxacum officinale (dandelion, species) [taxon 50225], Mus musculus (house mouse, species) [taxon 10090], Rheum officinale (yao yong da huang, species) [taxon 137220], Hippophae rhamnoides (sallowthorn, species) [taxon 193516], Persicaria hydropiper (water-pepper, species) [taxon 46901], Lacticaseibacillus rhamnosus (species) [taxon 47715], Trichomonas vaginalis (species) [taxon 5722], Scutellaria baicalensis (Baikal skullcap, species) [taxon 65409], Saccharomyces cerevisiae (baker's yeast, species) [taxon 4932], Artemisia argyi (species) [taxon 259893], Perilla frutescens (beefsteak-mint, species) [taxon 48386], Lactobacillus crispatus (species) [taxon 47770], Limosilactobacillus reuteri (species) [taxon 1598], Human alphaherpesvirus 2 (no rank) [taxon 10310], P. chinensis [taxon 255799], Pulsatilla chinensis (species) [taxon 714493], Gentiana scabra (species) [taxon 292393], Phellodendron chinense (species) [taxon 354508], TV [taxon 2844102], Centella asiatica (Asiatic pennywort, species) [taxon 48106], Atractylodes macrocephala (species) [taxon 265785], Lactobacillus gasseri (species) [taxon 1596], Staphylococcus aureus (species) [taxon 1280], Vibrio cholerae (species) [taxon 666], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Haemophilus influenzae (species) [taxon 727], Homo sapiens (human, species) [taxon 9606], Candida [taxon 1535326]
- **Mutations:** C-30 C, Y238X
- **Cell lines:** VK2/E6E7 — Homo sapiens (Human), Transformed cell line (CVCL_6471), MCF-7 — Homo sapiens (Human), Invasive breast carcinoma of no special type, Cancer cell line (CVCL_0031), Vero — Chlorocebus sabaeus (Green monkey), Spontaneously immortalized cell line (CVCL_0059)

## Full text

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## Figures

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## References

91 references — full list in the complete paper: https://tomesphere.com/paper/PMC12928029/full.md

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Source: https://tomesphere.com/paper/PMC12928029