Bacteriological and Cytokine Profiles for Women Using Hormonal Contraceptive Drugs

Background: Hormonal contraceptives that contain estrogen and progesterone alter the genital tract epithelial configuration which has been suggested to be associated with shifts in the vaginal flora, changes that occurring as a result of contraceptive measures may disrupt the resident vaginal flora.

Aim of Study: To evaluate the effect of hormonal contraceptives on vaginal bacteriological profile and some of immunological markers.

Study Design: Case control study.

Place and Duration of the Study: This study was carried out in family planning clinic at Babylon hospital for maternity and children in Hilla, Iraq and Department of Medical Microbiology-College of Medicine -Babylon university, Hilla-Iraq. The period of study was from August 2014 to April 2015.

Methodology: This study involved 60 women, 40 of them were used oral combined contraceptive pills that contained progesterone and estrogen, and 20 women were used injectable contraception that contained only progesterone, while 30 women were healthy women never use contraception as a control. Samples taken from all women were high vaginal swab for Bacterial isolation and blood for measurement of serum interferon –gamma (IFN-γ), interleukin-2 (IL-2) and interleukin-8 (IL-8) by enzyme linked immunosorbent assay (ELISA) technique.

Results: Lactobacillus spp were the predominant among the control group (93.3%), while only (5%) in both contraceptive groups. Gram negative and Gram positive bacteria were isolated (68.39%, and 31.56%) respectively from women with contraceptive drugs. Immunological assay showed a significant decrease in serum concentration of both IFN- γ and IL- 8 in both contraceptive group compared to control group (p value less than 0.05). While, there is no significant difference in serum level of IL-2 among study groups.

Conclusions: Both types of hormonal contraceptives lead to inhibition of vaginal Lactobacilli and decrease serum level of both IFN-ɣ and IL-8.