title: Effects of estroprogestins containing natural estrogen on vaginal flora.
abstract: Estroprogestins with "natural oestrogen" has represented a new option in terms of combined hormonal contraception. So, the aim of this study is to investigate how estroprogestins with natural estrogen may modify the vaginal niche. In literature, very few studies focused on the interaction between hormonal contraception and vaginal milieu. This is a prospective comparative study. We enrolled 60 women from January 2013 to September 2013, 30 of them were administered estradiol valerate dienogest (E2V+DNG - Klaira®) in a quadriphasic regimen, while the other 30 women were administered 17-β estradiol with nomestrol acetate (EV+NOMAC - Zoely®) in a monophasic regimen. After a baseline study of vaginal milieu at recruitment of patients (Gram stain with Nugent score, vaginal pH, vaginal wet mount for the quantification of leukocytes, Lactobacilli and/or presence of Candida), we performed the same follow-up after six months of estroprogestin therapy. Our results showed that the women treated with E2V+DNG had a trend of an improvement of vaginal health in terms of increase of lactobacillar flora and reduction of vaginal pH in place of women treated with EV+NOMAC that showed a reduction of cervical mucus. Finally, our data about the effects on vaginal flora exerted by two estroprogestin pills (EPs) containing a natural estrogen suggest slight, but interesting differences in terms of vaginal ecology. These differences could be related to the type of estrogen, type of progestin, regimen of administration and, after all, to the net balance between estrogenic and progestin component of the EPs.
authors.affiliation: Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", University of Trieste , Trieste , Italy .
authors.forename: Francesco
authors.initials: F
authors.lastname: De Seta
authors.forename: Stefano
authors.initials: S
authors.lastname: Restaino
authors.forename: Rubina
authors.initials: R
authors.lastname: Banco
authors.forename: Ester
authors.initials: E
authors.lastname: Conversano
authors.forename: Rossella
authors.initials: R
authors.lastname: De Leo
authors.forename: Maddalena
authors.initials: M
authors.lastname: Tonon
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Maso
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbati
authors.forename: Stefano
authors.initials: S
authors.lastname: Lello
mesh_terms: D000293:Adolescent; D000328:Adult; D004338:Drug Combinations; D004958:Estradiol / Q000031:analogs & derivatives* / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008535:Megestrol / Q000494:pharmacology*; D008875:Middle Aged; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000494:pharmacology; D009649:Norpregnadienes / Q000494:pharmacology*; D011446:Prospective Studies; D014621:Vagina / Q000187:drug effects* / Q000382:microbiology; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D009649:Norpregnadienes; C454300:estradiol valerate-dienogest; D004958:Estradiol; D009277:Nandrolone; C038501:nomegestrol acetate; D008535:Megestrol
keywords: Lactobacilli; leukocytes; oral contraceptive; vaginal flora