Vaginal States: Detection of Conversion Processes in Women Using Contraception and Characterization of Vaginal Lactobacillus Species

Abstract

Background: The vaginal microenvironment, regulated by an immune system, can be protected or altered by many factors, including contraceptive methods.Objective: The objective of this study is to evaluate the impact of contraceptive methods on the basicvaginal states (BVSs) and to identify culturable vaginal Lactobacillus species.Methods: This is a prospective, consecutive, longitudinal, and descriptive study. The vaginal contentsof 208 women were sampled prior to initiating contraception and six months later. The BVSs wereestablished using the balance of vaginal content (BAVACO) methodology that evaluates microbiotaand vaginal inflammatory reaction (VIR). Lactobacillus species were characterized by biochemicaltests and mass spectrometry. The following contraceptive methods were evaluated: combined oralcontraceptive pill (COCP), condom (CON) and rhythm method (RHYT). McNemar´s test was used.Results: Of the 208 women, 171 attended both examinations. In the COCP group (n=127), 83 vaginalcontents maintained a normal microbiota, 1 sample became dysbiotic, and 37/43 dysbiotic microbiotasamples reverted to normal (p<0.0001). A conversion to BVS with VIR was detected in the CONgroup (n=31) (p=0.001). The RHYT group (n=13) maintained its initial BVSs. The predominant Lactobacillus species found were L. crispatus and L. gasseri, with a trend toward a positive associationbetween L. crispatus and COCP (OR=2.82; p=0.058).Conclusion: Hormone administration corrected the dysbiosis and preserved a normal BVS. The CONincreased the VIR. The protection of the microbiota observed in the rhythm method probably respondsto a systemic hormonal influence. The trend toward a positive association between COCP and L. crispatus, with its protective properties, evidenced an effective hormonal relationship