Influence of contraception on the vaginal microbiota in Argentine women

• Greater vaginal microbiota unbalance in Cupper Intrauterine Device (IUD-Cu) users. • Higher prevalence of bacterial vaginosis and yeasts in IUD-Cu users. • Higher prevalence of vaginal inflammatory reaction in IUD-Cu users. • Higher prevalence of Lactobacillus crispatus in oral contraceptive pills (OCPs) users. The study of vaginal dysfunction in women using various contraceptive methods is relevant, since each method modifies the vaginal microbiota and the host immune response differently. The aims of this study were: (1) To evaluate the prevalence of different contraceptive methods. (2) To evaluate vaginal imbalance, prevalence of bacterial vaginosis (BV), yeasts, trichomoniasis and vaginal inflammatory response (VIR). (3) To characterize Lactobacillus species in patients using different contraceptive methods (oral contraceptive pills (OCPs), condom, copper intrauterine device (Cu-IUD) and tubal ligation (TL). A total of 1326 patients underwent clinical examination and collection of vaginal fornix to study basic vaginal states (BVS) and culture; of these,1303 patients were finally included and divided into five groups: Group 1 (G1) OCs (n = 314), Group 2 (G2) condom (n = 385), Group 3 (G3) Cu-IUD (n = 92), Group 4 (G4) tubal ligation (n = 26), Group 5 (G5) control (n = 486). The prevalence of vaginal imbalance was higher in G3, 48.9% (OR 1.57, p = 0.05) compared to control. G3, 41.3% (OR 1.56, p = 0.03) and G4, 50% (OR 2.21, p = 0.05) were the groups with higher BV prevalence. The groups with the highest yeast prevalence were G3, 31.5% (OR 1.89, p = 0.01) and G4, 38.5% (OR 2.56, p = 0.02). Inflammatory states were present in 82.8% (OR 3.8, p = 0.01) of G3 with yeasts. G3 had a higher prevalence of VIR of 58.7% (OR 1.71, p = 0.01). Group 1 (31.6%) had a prevalence of Lactobacillus crispatus similar to that in the control group. A greater vaginal imbalance, prevalence of BV and yeasts was observed in Cu-IUD users. The microbiota balance and prevalence of L. crispatus was higher in OCP users. Cu-IUD users presented higher VIR. El estudio de la disfunción vaginal en usuarias de diferentes métodos anticonceptivos es relevante porque cada método modifica de manera diferencial la microbiota y la respuesta inmune del huésped. Los objetivos fueron: (1) determinar la prevalencia de los métodos anticonceptivos; (2) evaluar el desequilibrio vaginal y la prevalencia de vaginosis bacteriana (VB), levaduras, tricomonosis y reacción inflamatoria vaginal (RIV); (3) caracterizar las especies de lactobacilos en usuarias de anticonceptivos orales (ACO), preservativo, dispositivo intrauterino de cobre (DIU-Cu) y ligadura tubaria (LT). Se realizó examen clínico y toma de muestras del fondo del saco vaginal a 1326 pacientes para determinar estados vaginales básicos (EVB) y realizar cultivos. Se incluyeron 1303 mujeres distribuidas en cinco grupos: G1 ACO (n = 314), G2 preservativo (n = 385), G3 DIU-Cu (n = 92), G4 LT (n = 26) y G5 control (n = 486). La prevalencia de desbalance vaginal fue mayor en G3 que en G5 (48,9%, p = 0,05). Los mayores valores de desbalance se observaron en G3 (41,3%, p = 0,03) y G4 (50%, p = 0,05), que también presentaron mayor prevalencia de levaduras (G3: 31,5%, p = 0,01; G4: 38,5%, p = 0,02). Entre las usuarias de DIU-Cu con levaduras, el 82,8% mostró estados inflamatorios (II/V), y este grupo presentó la mayor RIV (58,7%, p = 0,01). La prevalencia de Lactobacillus crispatus en G1 fue 31,6%, similar al control. Las usuarias de DIU-Cu mostraron mayor desbalance vaginal, mayor prevalencia de VB y levaduras y mayor RIV, mientras que las usuarias de ACO presentaron mayor equilibrio de la microbiota y mayor prevalencia de L. crispatus .