The impact of combined contraceptive vaginal ring on vaginal environment: an observational, longitudinal study

Abstract

Purpose

To assess the relationship between combined contraceptive vaginal ring (CVR) and vaginal microbiome using 16S rRNA gene sequencing.

Materials and methods

We enrolled 20 women for 8 weeks in an open-label study using CVR (NuvaRing^®) that delivered 15 mcg ethinylestradiol and 120 mcg etonogestrel daily. The vaginal microbiome was assessed at baseline and after 2 months by sequencing the 16S rRNA genes amplified from the total genomic DNA isolated from the sample.

Results

Bacterial distribution richness and equity did not significantly change after 2 months, and the dominant bacterial strain was Lactobacillus crispatus. Only one woman with a history of vestibulodynia and recurrent vulvovaginitis showed an increase in bacterial biodiversity, with a switch to the relative abundance of anaerobic bacteria.

Conclusions

Our results suggest that CVR does not adversely affect the composition and structure of the vaginal microbiome. However, special care should be taken in patients with a history of vestibulodynia and/or recurrent vulvovaginal infections.

SHORT CONDENSATION

Contraceptive vaginal ring does not adversely affect vaginal microbiome except in the case of recurrent vulvovaginal infections or vestibulodynia.

摘要

目的：应用16S rRNA基因测序方法评价复方避孕阴道环（CVR）与阴道微生物群的关系。

材料和方法：我们招募了20名妇女参加了一项为期8周的开放研究, 使用CVR（NuvaRing^®）, 每天服用15微克的乙烯雌醇和120微克的雌孕酮。在基线和2个月后, 通过对从样本中提取的总基因组DNA扩增的16S rRNA基因进行测序, 评估阴道微生物组。

结果：用药2个月后细菌分布丰富度和均衡度无明显变化, 优势菌为卷曲乳杆菌。仅一例既往有前庭疼痛和复发性外阴阴道炎病史的女性表现出细菌生物多样性的增加, 并向厌氧菌的相对丰度转变。

结论：我们的结果表明CVR不会对阴道微生物群的组成和结构产生不利影响。然而, 对于有前庭疼痛史和/或反复外阴阴道感染的患者应给予特别护理。

Keywords:

• Contraceptive vaginal ring
• vaginal microbiome
• vestibulodynia
• lactobacilli
• biofilm

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was supported by the Associazione ItalianaVulvodinia, a non-profit Italian association whose mission is to improve the health and quality of life of women experiencing vulvodynia and chronic vulvar pain.