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

Health 2013年第7期5卷 19-24页

作者： Sonia E. Fosch Cristian Yones marta trossero Omar Grosso Biochemist-Specialist in Clinical Bacteriology Servicio de Atención Médica Ministerio de Salud 25 de Mayo 254 Sa Pereira Santa Fe Argentina Facultad de Ingeniería y Ciencias Hídricas Universidad Nacional del Litoral Pje El Pozo Santa Fe Argentina Programa de Salud Sexual y Reproductiva en el Servicio de Atención Medica Ministerio de Salud 25 de Mayo 254 Sa Pereira Santa Fe Argentina Servicio de Atención Médica Ministerio de Salud 25 de Mayo 254 Sa Pereira Santa Fe Argentina

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 ***. 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.

关键词： Vaginal Dysfunction Vaginal Content Vaginal States Contraception

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Influence of Contraception on Basic Vaginal States: A Prospective Study

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Health 2015年第2期7卷 238-244页

作者： Sonia Elena Fosch Cristian Yones marta trossero Omar Grosso Beatriz Perazzi Servicio de Atención Médica Ministerio de Salud Sa Pereira Argentina Facultad de Ingeniería y Ciencias Hídricas Universidad Nacional del Litoral Santa Fe Argentina Departamento de Bioquímica Clínica Hospital de Clínicas Facultad de Farmacia y Bioquímica Universidad de Buenos Aires Buenos Aires Argentina

To evaluate the influence of contraceptive methods on the basic vaginal states (BVSs) in women in fertile age, 108 women consulting for birth control (14 - 45 years) were included in a prospective study. The vaginal content was sampled both before they began using the chosen contraceptive method (see below) and three months later, and then analyzed using the Balance of Vaginal Content (BAVACO) methodology. Five BVSs were defined: 1) normal microbiota;2) normal microbiota with vaginal inflammatory reaction (VIR);3) intermediate microbiota;4) bacterial vaginosis and 5) non-specific microbial vaginitis. The following contraceptive methods were considered: combined oral contraceptive pill (COCP), intrauterine device (IUD), condom (CON), the rhythm method (RHYT) and simultaneous double protection (COCP + CON). The McNemar statistical test was used. COCP (n = 71): 20 samples retained normal BVSs and two were altered;nine out of the 49 altered samples returned to normal;IUD (n = 4): two samples modified their normal BVS to III and IV;CON (n = 25): the VIR increased in 20% of the samples;RHYT (n = 6): four samples retained the normal BVS;and COCP + CON (n = 2): samples preserved their initial BVS (II). The increased frequency of BVS I in the COCP group was significant (x2 = 3.3;p = 0.04). The relative frequency of each BVS was significantly modified, attributed to the type of contraceptive method used. The intake of hormones corrects alterations and retains a normal BVS. The contraceptive methods that use an external factor of local contact either maintain or alter the microbiota and VIR.

关键词： Contraception Basic Vaginal States Vaginal Content

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