Abstract
Background:The vaginal microbiome is influenced by a wide variety of factors, including contraceptive methods.Aim:To evaluate the effect of contraceptive methods on vaginal microbiota and to compare MALDI-TOF MS and 16S rDNA sequencing for lactobacilli identification.Patients and Methods:One hundred and one (101) women consulting for birth control were included in a prospective study. Their vaginal content was sampled and analyzed once before they started using the contraceptive method of their choice, and twice after the initiation of contraception, at three months (94/101 women attended) and at six months (89/101 women attended). The relative frequencies of yeasts and trichomonas were analyzed. MALDI-TOF MS and 16S rDNA sequence analysis were applied for the identification of lactobacilli in their vaginal microbiota. The following contraceptive methods were assessed: Combined Oral Contraceptive Pill (COCP), Condom (CON) and The Rhythm Method (RHYT). McNemar’s statistical test was applied.Results:A statistically significant association between COCP and normal microbiota was observed after three months (p< 0.01) and after six months (p< 0.0001), when the vaginal microbiota was modified. At six months, inflammatory reaction was detected in 3/7 women in the CON group, while 6/7 patients using RHYT showed the same state. Yeast colonization increased with the COCP. Identification of lactobacilli by MALDI-TOF MS analysis compared to 16S rDNA sequencing yielded 92.9% concordant results. Lactobacillus gasseri and L. crispatus were the predominant species.Conclusion:The pattern of vaginal states was significantly modified. Hormone administration apparently corrected the alterations and retained a normal vaginal state. MALDI-TOF MS has the potential of being an accurate tool for the identification of vaginal lactobacilli species L. murinus was for the first time isolated from the vagina.
Highlights
The vaginal microbiota provides the first line of defense for the lower genital tract
Distribution of the Basic Vaginal States According to the Contraception Method
The basal set of test results obtained from the 101 women included in the study before they started using the contraceptive method of their choice was as follows: 55 (54.5%) showed BVS I, (15.8%) BVS inflammatory reaction (II), 3 (3%) BVS intermediate microbiota (III), (16.8%) BVS IV and 10 (9.9%) BVS V
Summary
The vaginal microbiota provides the first line of defense for the lower genital tract. The microenvironment, with its vaginal microbiota primarily regulated by a hormonal immune system, can be protected or altered by a wide variety of factors, including contraceptive methods. Culture-dependent techniques and microscopic observation of the “normal” Vaginal Content (VC) typically show a predominance of Lactobacillus species, which are believed to promote a healthy vaginal milieu by providing numerical dominance, and by producing lactic acid to maintain an acid environment, inhibiting different types of pathogenic or potentially pathogenic microorganisms, showing a negative correlation with Bacterial Vaginosis (BV) [5]. The vaginal microbiome is influenced by a wide variety of factors, including contraceptive methods
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