title: Do users of the intrauterine system (Mirena) have different genital symptoms and vaginal flora than users of the intrauterine contraceptive device?
abstract: The copper intrauterine contraceptive device (IUCD) is strongly associated with bacterial vaginosis (BV). Hormonal influences may play a role in the control of vaginal flora. It is unclear whether use of the progesterone-incorporated intrauterine system (IUS; Mirena) is associated with abnormal vaginal flora or genital symptoms. One hundred and seventy-two women were assessed for symptoms and abnormal vaginal flora prior to and at intervals after insertion of either a copper IUCD or an IUS. Women were significantly more likely to have developed an abnormal vaginal discharge 4-6 weeks after insertion of an IUCD compared with an IUS (27% cf. 14%, P = 0.04), although this trend was not significant six months postinsertion. More women with an IUCD developed BV compared with an IUS at 4-6 weeks and six months. However, there were insufficient numbers of women with BV to demonstrate any significant difference between the vaginal flora of the two groups.
authors.affiliation: Department of Genitourinary Medicine, Royal Cornwall Hospital NHS Trust, Truro, Cornwall TR1 3LJ, UK. rachel.neale@rcht.cornwall.nhs.uk
authors.forename: R
authors.initials: R
authors.lastname: Neale
authors.forename: I
authors.initials: I
authors.lastname: Knight
authors.forename: F
authors.initials: F
authors.lastname: Keane
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects / Q000706:statistics & numerical data; D007435:Intrauterine Devices, Copper / Q000009:adverse effects / Q000706:statistics & numerical data; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects; D015995:Prevalence; D014621:Vagina / Q000382:microbiology* / Q000473:pathology; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel