Rezk Mohamed, Sayyed Tarek, Masood Alaa, Dawood Ragab
a Department of Obstetrics and Gynaecology, Faculty of Medicine , Menoufia University , Shibin El Kom , Egypt.
Eur J Contracept Reprod Health Care. 2017 Oct;22(5):344-348. doi: 10.1080/13625187.2017.1365835. Epub 2017 Aug 29.
The study assessed the risk of bacterial vaginosis, Trichomonas vaginalis and Candida albicans infection among new users of either a combined oral contraceptive pill (COC) or the levonorgestrel-releasing intrauterine system (LNG-IUS).
This prospective observational study included 430 women, without active vaginitis at inclusion, who were divided into two groups according to their chosen method of contraception: COC group (n = 236) and LNG-IUS group (n = 194). Participants were examined for bacterial vaginosis, T. vaginalis and C. albicans infection initially and then at 6 weeks, 6 months and 12 months after the start of contraceptive use. Data were collected and statistically analysed.
The rates of acquisition of bacterial vaginosis, T. vaginalis and C. albicans infection during follow-up were significantly increased and comparable between the groups (p < .001) and decreased in frequency over time (p < .05). The rates of acquisition of bacterial vaginosis among COC users (Nugent score) were 24.6, 18.6 and 15.2% and among LNG-IUS users 20.6, 13.5 and 9.3% at 6 weeks, 6 months and 12 months, respectively (p < .001). Body mass index >25 kg/m, history of bacterial vaginosis, history of sexually transmitted infection, vaginal douching more than five times per week and coital frequency more than five times per week were strong risk factors for acquisition of bacterial vaginosis during the follow-up period (p < .001).
The use of COCs and LNG-IUS is associated with an increased, comparable risk of acquisition of bacterial vaginosis, T. vaginalis and C. albicans infections, which is greatest during initial use of the method but which improves over time.
本研究评估了复方口服避孕药（COC）或左炔诺孕酮宫内节育系统（LNG-IUS）新使用者中细菌性阴道病、阴道毛滴虫和白色念珠菌感染的风险。
这项前瞻性观察性研究纳入了430名入组时无活动性阴道炎的女性，根据其选择的避孕方法分为两组：COC组（n = 236）和LNG-IUS组（n = 194）。最初对参与者进行细菌性阴道病、阴道毛滴虫和白色念珠菌感染检查，然后在开始使用避孕药后的6周、6个月和12个月进行检查。收集数据并进行统计分析。
随访期间细菌性阴道病、阴道毛滴虫和白色念珠菌感染的发生率显著增加，且两组之间具有可比性（p <.001），并且随着时间的推移频率降低（p <.05）。COC使用者中细菌性阴道病（Nugent评分）的发生率在6周、6个月和12个月时分别为24.6%、18.6%和15.2%，LNG-IUS使用者中分别为20.6%、13.5%和9.3%（p <.001）。体重指数>25 kg/m²、细菌性阴道病史、性传播感染史、每周阴道灌洗超过五次以及每周性交频率超过五次是随访期间发生细菌性阴道病的强烈危险因素（p <.001）。
使用COC和LNG-IUS与细菌性阴道病、阴道毛滴虫和白色念珠菌感染的发生风险增加且具有可比性相关，这种风险在开始使用该方法时最大，但随着时间的推移会有所改善。
