Influence of contraception on the vaginal microbiota in Argentine women.

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.