Vaginal flora changes on Pap smears after insertion of levonorgestrel-releasing intrauterine device |
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| Authors: | Donders Gilbert G G Berger Judith Heuninckx Hélène Bellen Gert Cornelis Ann |
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| Affiliation: | aFemicare vzw, Clinical Research for Women, 3300 Tienen, Belgium;bDepartment of Obstetrics and Gynaecology, Heilig Hart Ziekenhuis, Kliniekstraat 45, 3300 Tienen, Belgium;cDepartment of Pathology, Heilig Hart Ziekenhuis, 3300 Tienen, Belgium;dDepartment of Obstetrics and Gynaecology, Gasthuisberg University Hospital, 3000 Leuven, Belgium |
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| Abstract: | BackgroundThe levonorgestrel intrauterine system (LNG-IUS) combines a uterine foreign body and the continuous release of low-dose levonorgestrel for contraception. Its influence on the rate of vulvovaginal infections and flora disturbance is insufficiently known, but important for contraceptive advice in women, especially those who develop recurrent vaginosis or Candida vulvovaginitis.Study DesignSlides of 286 women who had a Pap smear taken before and 1 to 2 years after placement of a LNG-IUS were blindly reviewed for the presence of abnormal vaginal flora (AVF), bacterial vaginosis (BV), aerobic vaginitis (AV) and Candida vaginitis (CV).ResultsPrior to insertion, there were no differences in vaginal flora abnormalities between women using different kinds of contraception. LNG-IUS users did not have different rates of AVF, BV, AV or CV, but the general risk to develop any infection was increased. Uterine bleeding after insertion did not seem to predict a different flora type.ConclusionWe found that Pap smears suggested more vaginal infections after 1 year of LNG-IUS use than prior to insertion of the device. |
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| Keywords: | Lactobacillary grades Abnormal vaginal flora Vaginitis Intrauterine device Levonorgestrel Progestin Candida |
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