Risk factors for infectious and inflammatory diseases of the lower genital tract in women using contraception

Objective. To develop recommendations for the choice of modern contraceptives, depending on the vaginal microbiocenosis and individual genetic characteristics. Subjects and methods. The investigation enrolled 120 women of reproductive age (18-45 years) who desired to use contraception; they were randomly divided into four equal groups: 1) 30 patients using barrier contraceptive methods; 2) 30 patients taking a monophasic combined oral estrogen-gestagenic contraceptive; 3) 30 women using a vaginal ring; 4) 30 women having a hormone-releasing intrauterine system. A clinical examination was performed 3, 6, and 9 months after starting hormonal contraceptives in order to estimate the frequency of and time to the occurrence of their adverse reactions. The composition of the vaginal microbiota was quantitatively assessed by Femoflor 16 PCR. To study gene polymorphism, DNA was isolated from peripheral blood. Results. In women using hormonal contraception, vaginal dysbiosis due the higher proportion of Gardnerella vaginalis was a significant risk factor for inflammatory diseases. Groups at risk for developing dysbiosis were determined in the examined groups using contraception. Patients with the IL4: -590 T/Tgenotype or carriers of the T allele of the IL1R1 polymorphic locus: Pst11970 C>T were shown to have a high risk for developing inflammatory diseases and to require monitoring of the vaginal microbiocenosis during hormonal contraception. Conclusion. Thus, dysbiosis is an important prognostic criterion when prescribing a contraceptive method. It is advisable to assess the vaginal biocenosis during hormonal contraception once every 12 months.

vaginal microbiocenosis, hormonal contraception, Femoflor, PCR, gene polymorphism, dysbiosis, vaginitis