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.Letunovskaya A.B., Serov V.N., Baranov I.I., Donnikov A.E.
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/T genotype 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.
Keywords
vaginal microbiocenosis
hormonal contraception
Femoflor
PCR
gene polymorphism
dysbiosis
vaginitis
References
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Received 08.06.2021
Accepted 18.06.2021
About the Authors
Anna B. Letunovskaya, obstetrician-gynecologist, doctor of ultrasound diagnostics, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.E-mail: annletynovskaya@yandex.ru. 117997, Russia, Moscow, Oparina str., 4.
Vladimir N. Serov, Dr. Med. Sci., Academician of the Russian Academy of Sciences, Professor, Chief Researcher of the Department of Scientific and Educational Programs of the Department of Organization of Scientific Activities, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, President of RSOG. E-mail: v_serov@oparina4.ru. ORCID: 0000-0001-6640-1235. 117997, Russia, Moscow, Oparina str., 4.
Igor I. Baranov, Dr. Med. Sci., Professor, Head of the Scientific and Organizational Department, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.
E-mail: i_baranov@oparina4.ru. ORCID: 0000-0002-8898-9612. 117997, Russia, Moscow, Oparina str., 4.
Andrey E. Donnikov, Ph.D., Head of the Laboratory of Molecular Genetic Methods, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.
E-mail: donnikov@oparina4.ru. ORCID: 0000-0003-3504-2406. 117997, Russia, Moscow, Oparina str., 4.
For citation: Letunovskaya A.B., Serov V.N., Baranov I.I., Donnikov A.E. Risk factors for infectious and inflammatory diseases of the lower genital tract in women using contraception.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 6: 132-137 (in Russian)
https://dx.doi.org/10.18565/aig.2021.6.132-137
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