title: Effects of hormonal contraception on vaginal flora.
abstract: BACKGROUND
  The sector of the market that deals with contraception offers a long list of different contraceptive methods. Within the estroprogestinic choice, the routes of administration are oral, transdermic and vaginal one. Even though efficacy is comparable with these methods, secondary and adverse effects are directly involved in the acceptability of the method.
  
  
  METHODS
  This was a prospective comparative study. During 1 year, we enrolled 60 asymptomatic women who voluntarily requested combined oral contraception (COC) or combined contraceptive vaginal ring (CCVR group). After a baseline study of vaginal milieu prior to starting hormonal contraception, we performed a follow-up. For each woman, we examined vaginal pH; quantification of leukocytes, lactobacilli, Candida and cocci on saline microscopy fluid; Gram stain with Nugent score and the presence of vaginal infection [culture for Trichomonas vaginalis, albicans and nonalbicans Candida, Group B Streptococcus (GBS)].
  
  
  RESULTS
  At the end of follow-up, there was a little change of vaginal milieu in both groups. We noted an increase of lactobacilli in the CCVR users and an increase of GBS in COC users.
  
  
  CONCLUSIONS
  CCVR compared to COC users showed an increase of the number of lactobacilli in vaginal flora. It means that an increase of leukorrhea in that group could be protective in terms of prevention of vaginal imbalance/infection.
authors.affiliation: Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, University of Trieste, Italy. fradeseta@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: De Seta
authors.forename: Stefano
authors.initials: S
authors.lastname: Restaino
authors.forename: Davide
authors.initials: D
authors.lastname: De Santo
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Stabile
authors.forename: Rubina
authors.initials: R
authors.lastname: Banco
authors.forename: Marina
authors.initials: M
authors.lastname: Busetti
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbati
authors.forename: Secondo
authors.initials: S
authors.lastname: Guaschino
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D058491:Bacterial Load; D002175:Candida / Q000302:isolation & purification; D002176:Candida albicans / Q000302:isolation & purification; D003274:Contraceptive Devices, Female / Q000009:adverse effects; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007778:Lactobacillus / Q000302:isolation & purification; D007958:Leukocyte Count; D008875:Middle Aged; D011446:Prospective Studies; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014621:Vagina / Q000737:chemistry / Q000382:microbiology*
chemical_list: D003277:Contraceptives, Oral, Combined