Microbiome, probiotics and lifestyle modulation in women’s health across the lifespan: endocrine, immune, and microbial interconnections

Hormonal fluctuations throughout a woman’s life, from puberty to menopause, profoundly influence the composition of the vaginal and gut microbiota, with major implications for reproductive, metabolic, and psychological health. Recent findings indicate that lifestyle factors, such as diet, stress, sleep, and physical activity, modulate microbial communities and hormonal balance through an integrated microbiome–immune–endocrine axis. This review examines the evolution of the vaginal microbiota, the effects of hormonal changes on microbial balance, and evidence for probiotic and lifestyle-based interventions in conditions such as bacterial vaginosis, endometriosis, polycystic ovary syndrome, pregnancy complications, and menopausal disorders. Particular attention is given to the estrobolome, gut–brain communication, and metabolic regulators as mediators of systemic effects.