Effects of contraception on cervical cytology: data from Mardin City

Mardin is an area of low socioeconomic level with low rates of contraceptive method use. Our aim in this study was to evaluate the effects of the contraceptive methods used in the area on epithelial cell abnormalities and vaginal flora changes.

Cervical smear samples received at the Pathology Department between 2010 and 2012 of 526 patients who had used a contraceptive method and 112 who had never used one were included in the study. The cases were divided into 3 groups as those using hormonal contraception (107, 20.3%), those using an intrauterine device (343, 65.2%) and those using a barrier method (76, 14.4%). The evaluation was made using the Bethesda 2001 criteria for cervical epithelial abnormalities and specific cervicovaginal infections.

There was no significant difference between the groups for epithelial cell abnormalities while bacterial vaginitis (12%, p=0.03) and Trichomonas vaginalis (7.6%) were more common in the IUD users. The Actinomyces rate in RIA users was 1.3%. There was only 1 case of bacterial vaginitis in the barrier group and none of the other patients had a specific infection.

We did not find a significant cytopathic effect of using a IUD or hormonal contraception in our study. There was a low rate of epithelial abnormality in the barrier method group. IUD was seen to increase the incidence of bacterial vaginitis, Trichomonas vaginalis and Actinomyces. We did not find a significant effect of hormone use on the vaginal flora.