Effects of combined oral contraceptives, depot medroxyprogesterone acetate and the levonorgestrel-releasing intrauterine system on the vaginal microbiome
Effects of combined oral contraceptives, depot medroxyprogesterone acetate and the levonorgestrel-releasing intrauterine system on the vaginal microbiome
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DOI：
10.1016/j.contraception.2016.11.006
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发表时间：
2017-04-01
期刊：
影响因子：
2.9
通讯作者：
Jefferson, Kimberly K.
中科院分区：
文献类型：
--
作者：
Brooks, J. Paul;Edwards, David J.;Jefferson, Kimberly K.
目的：先前的研究表明，阴道微生物组的组成可能会对性传播感染 (STI) 和细菌性阴道病 (BV) 的易感性产生积极或消极的影响。一些女性激素避孕方法似乎也会对性传播感染和细菌性阴道炎产生积极或消极的影响。因此，与不同避孕方法相关的阴道微生物组的变化可以部分解释对性传播感染传播和细菌性阴道炎的影响。 研究设计：我们对来自弗吉尼亚联邦大学人类阴道微生物组项目的一部分参与者的阴道样本的 16S rRNA 基因调查数据进行了回顾性研究。该子集包括 682 名报告使用单一形式节育措施的女性，即避孕套、复方口服避孕药 (COC)、长效醋酸甲羟孕酮 (DMPA) 或左炔诺孕酮宫内缓释系统 (LNG-IUS)。 结果：使用 COC 的女性 [调整后比值比 (aOR) 0.29，95% 置信区间 (CI) 0.13-0.64] 和与使用避孕套的女性相比，DMPA（aOR 0.34，95% CI 0.13-0.89）而非 LNG-IUS（aOR 1.55，95% CI 0.72-3.35）被 BV 相关细菌定植的可能性较小。与使用避孕套的女性相比，使用 COC 的女性（aOR 1.94，95% CI 1.25-3.02）更有可能被有益的产 H2O2 乳杆菌定植，而使用 DMPA（aOR 1.09，95% CI 0.63-1.86）和 LNG-IUS（aOR 0.74，95% CI）的女性0.48-1.15）则不然。结论：COC 的使用与健康乳杆菌阴道定植增加和 BV 相关类群减少显着相关。
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.