The influence of different contraceptive methods on vaginal microbiota: Clinical study

摘要

Objective: The aim of this work was to evaluate the vaginal content of women attending family planning controls and its relationship with the contraceptive practice used (oral contraceptive pills, intrauterine device, condoms, or rhythm method) as well as its relationship with the lack of regular contraception. Design: Observational, descriptive study. Setting: Servicio de Atención Médica—Ministerio de Salud—Sa Pereira—Santa Fe.Argentina. Population: A total of 250 women were studied following the BAVACO (balance of the vaginal content). Methods: Standard method, which included the wet mount test, and Giemsa and Gram stain under the Nugent score. Results: Obtained from the vaginal microbiota, the vaginal inflammatory response, presence of yeast and Trichomonas allowed defining five basic vaginal microbial states which were statistically related to contraceptive methods. Main Outcome Measures: The association of each of the five vaginal states with the different contraceptive practices was determined by X2 test, considering p < 0.05 as a significant difference (Program EPI-INFO 6. Version 6.04). Results: A significantly positive association was found between oral contraceptives and normal microbiota (OR 3.98 – p = 0.000);intrauterine device and bacterial vaginosis (OR 10.1 – p = 0.000);whereas a negative relationship (OR 0.18 – p = 0.005) was found between oral contraceptives and bacterial vaginosis (OR 0.21 – p = 0.000). Conclusions: a) the positive association of combined oral contraceptives with a normal microbiota indicates a positive trend of protection, b) intrauterine devices increase whereas oral contraceptives decrease the risk for bacterial vaginosis, while oral contraceptives reduce the frequency.