Abstract
Objectives
Prior studies suggest that the composition of the vaginal microbiome may positively
or negatively affect susceptibility to sexually transmitted infections (STIs) and
bacterial vaginosis (BV). Some female hormonal contraceptive methods also appear to
positively or negatively influence STI transmission and BV. Therefore, changes in
the vaginal microbiome that are associated with different contraceptive methods may
explain, in part, effects on STI transmission and BV.
Study design
We performed a retrospective study of 16S rRNA gene survey data of vaginal samples
from a subset of participants from the Human Vaginal Microbiome Project at Virginia
Commonwealth University. The subset included 682 women who reported using a single
form of birth control that was condoms, combined oral contraceptives (COCs), depot
medroxyprogesterone acetate (DMPA) or the levonorgestrel-releasing intrauterine system
(LNG-IUS).
Results
Women using COCs [adjusted odds ratio (aOR) 0.29, 95% confidence interval (CI) 0.13–0.64]
and DMPA (aOR 0.34, 95% CI 0.13–0.89), but not LNG-IUS (aOR 1.55, 95% CI 0.72–3.35),
were less likely to be colonized by BV-associated bacteria relative to women who used
condoms. Women using COCs (aOR 1.94, 95% CI 1.25–3.02) were more likely to be colonized
by beneficial H2O2-producing Lactobacillus species compared with women using condoms, while women using DMPA (aOR 1.09, 95%
CI 0.63–1.86) and LNG-IUS (aOR 0.74, 95% CI 0.48–1.15) were not.
Conclusions
Use of COCs is significantly associated with increased vaginal colonization by healthy
lactobacilli and reduced BV-associated taxa.
Implications
COC use may positively influence gynecologic health through an increase in healthy
lactobacilli and a decrease in BV-associated bacterial taxa.
Keywords
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Article info
Publication history
Published online: November 29, 2016
Accepted:
November 22,
2016
Received in revised form:
November 21,
2016
Received:
April 27,
2016
Footnotes
☆Funding: This work was supported by the National Institutes of Health (grants 4UH3AI083263, “The Vaginal Microbiome: Disease, Genetics and the Environment,” P60 MD002256, the “VCU NIMHD Comprehensive Center of Excellence” and U54 DE023786-01 “A Multi-’omic Analysis of the Vaginal Microbiome during Pregnancy”).
☆☆Conflict of interests: The authors declare that there is no conflict of interest.
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