• Novel Strategies for Prevention and Management of Recurrent Urinary and Vaginal Infections in Women of Reproductive Age
  • Maryam Tahmasbi,1,*
    1. Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Iran


  • Introduction: Recurrent urinary and vaginal infections are among the most common health problems in women of reproductive age and lead to multiple physical, psychological, and social consequences. These infections often result in repeated visits to healthcare facilities, long-term use of medications, and, in some cases, an increased risk of complications such as infertility. Recent studies (2019–2024) have demonstrated that alterations in the vaginal microbiome, bacterial drug resistance, unprotected sexual intercourse, excessive use of antibiotics, and insufficient personal hygiene are among the most important predisposing factors for these infections. In addition, psychological outcomes such as anxiety, reduced self-confidence, and disturbances in the quality of marital relationships have also been reported. Therefore, addressing novel and multidimensional strategies for the prevention and management of these infections is an inevitable necessity.
  • Methods: This study was conducted as a systematic review. A comprehensive search was performed in PubMed, Scopus, and Web of Science databases within the time frame of 2019 to 2024. The keywords Lactobacillus, Vaginal Infection, Antibiotic Resistance, Urinary Tract Infection, Women of Reproductive Age were utilized. Out of more than 250 identified articles, 45 studies were selected after screening and quality assessment and subsequently subjected to qualitative analysis. The included articles comprised clinical trials, narrative reviews, and epidemiological studies that directly addressed the prevention and management of urinary and vaginal infections in women.
  • Results: The review of studies revealed that approximately 30–40% of women of reproductive age experience at least one episode of recurrent urinary or vaginal infection. The main risk factors included vaginal microbiome dysbiosis, hormonal changes, wearing tight and non-cotton clothing, long-term use of antibiotics, and a history of previous infections. Recent clinical trials have demonstrated that the administration of probiotics containing Lactobacillus crispatus and Lactobacillus rhamnosus can restore the normal vaginal flora, inhibit the growth of pathogenic bacteria, and significantly reduce recurrence rates. Moreover, the application of molecular screening methods and rapid diagnostic tests can contribute to more accurate diagnosis and early interventions. Educational strategies promoting hygienic behaviors—such as observing proper hygiene after sexual intercourse, maintaining adequate hydration, avoiding tight and inappropriate clothing, and using suitable hygienic products—have also been reported to be highly effective in reducing the incidence of these infections.
  • Conclusion: The findings indicate that the management and prevention of recurrent urinary and vaginal infections require a combined approach. Limiting the unnecessary use of antibiotics and considering alternative strategies such as vaginal probiotics and herbal products can help reduce antibiotic resistance and improve disease control. In addition, counseling and educating women regarding personal hygiene and safe sexual practices play a key role in decreasing the incidence of recurrent infections. Future research should place greater emphasis on large, multicenter clinical trials to more accurately evaluate the effectiveness of different probiotic combinations, novel diagnostic methods, and behavioral interventions. Furthermore, the role of the vaginal microbiome and its relationship with the immune system represents a valuable avenue for future investigations. Overall, the results suggest that integrating clinical and educational strategies can effectively reduce disease burden and promote reproductive health in women.
  • Keywords: Lactobacillus, Vaginal Infection, Antibiotic Resistance, Urinary Tract Infection