Mechanisms by Which the Cervicovaginal Microbiota Mediates Endometrial Repair Following Uterine Injury: A Review of Recent Advances.

AIM: To summarize current evidence on the molecular mechanisms by which the cervicovaginal microbiota mediates post-injury endometrial repair and to discuss relevant microbiota-targeted intervention strategies.

METHODS

A narrative review was conducted based on relevant English-language literature retrieved from PubMed, Embase, and Web of Science up to April 30, 2026. The literature was synthesized with a focus on the role of the cervicovaginal microbiota in endometrial repair through the TGF-β1/Smad, TLR4/NF-κB, and Wnt/β-catenin signaling pathways, as well as relevant microbiota-targeted intervention strategies.

RESULTS

Cervicovaginal microbiota dysbiosis promotes endometrial fibrosis and impairs tissue regeneration via dysregulation of the above signaling pathways. Lactobacillus-dominant microbiota homeostasis plays an important upstream regulatory role in endometrial repair. Probiotic preparations, particularly Lactobacillus crispatus, have demonstrated promising effects in animal models and clinical studies of chronic endometritis, intrauterine adhesions, and thin endometrium.

CONCLUSION

The cervicovaginal microbiota is an important regulator of post-injury endometrial repair. Microbiota-targeted interventions represent a promising therapeutic direction, though current evidence remains largely observational and further high-quality clinical trials are needed.