title: The effects of reproductive hormones on the physical properties of cervicovaginal fluid.
abstract: OBJECTIVE
  The purpose of this study was to determine the impact of contraception, menopause, and vaginal flora on the physical and biochemical properties of cervicovaginal fluid (CVF).
  
  
  METHODS
  Vaginal swabs, CVF, and cervicovaginal lavage (CVL) were collected from a total of 165 healthy asymptomatic women including: postmenopausal women (n = 29), women in the proliferative (n = 26) or follicular (n = 27) phase, and women using the levonogestrel intrauterine device (n = 28), depomedroxyprogesterone acetate (n = 28) or combined oral contraceptives (n = 27). Vaginal smears were evaluated using the Nugent score. The osmolality, viscosity, density, and pH of CVL samples were measured.
  
  
  RESULTS
  CVL from postmenopausal women and women with abnormal vaginal flora was less viscous and had higher pH than premenopausal women and women with normal flora, respectively. Women using hormonal contraceptives had more viscous CVL as compared with premenopausal women not using hormonal contraceptives, but this increase in viscosity was mitigated in the presence of bacterial vaginosis. Women using depomedroxyprogesterone acetate had less total protein in the CVL as compared with women using the levonogestrel intrauterine device, and had similar protein content when compared with postmenopausal women.
  
  
  CONCLUSIONS
  The differences in CVL protein content between depomedroxyprogesterone acetate and levonogestrel intrauterine device suggest that type of progesterone and route of delivery impact the vaginal environment. Contraceptive hormone users had more viscous CVL than women not using contraceptives. However, the presence of bacterial vaginosis impacted both the pH and viscosity (regardless of hormonal contraceptive use), demonstrating that vaginal flora has a greater impact on the physical properties of CVF than reproductive hormones.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Chappell
authors.affiliation: Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Rohan
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Moncla
authors.affiliation: Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Meyn
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Bunge
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Hillier
mesh_terms: D000293:Adolescent; D000328:Adult; D001826:Body Fluids / Q000737:chemistry; D002584:Cervix Uteri / Q000378:metabolism*; D003267:Contraception; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D016912:Levonorgestrel / Q000494:pharmacology; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology; D008875:Middle Aged; D011506:Proteins / Q000032:analysis; D014621:Vagina / Q000378:metabolism*; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000378:metabolism; D014783:Viscosity
chemical_list: D011506:Proteins; D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate
keywords: bacterial vaginosis; cervicovaginal fluid; contraceptives