Influence of Contraception on Basic Vaginal States: A Prospective Study

Abstract

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 (x 2 = 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.