Effects of contraceptive vaginal ring treatment on vaginal bacteriology and cytology

The presence of aerobic and anaerobic bacteria, yeasts and mycoplasma/ureaplasma was investigated in seventeen women before and after six months use of a contraceptive vaginal ring releasing levo-Norgestrel and estradiol and in 16 women using an oral contraceptive containing levo-Norgestrel and ethinylestradiol. Apart from an increase in yeasts in both groups, no significant changes in the vaginal bacteriology could be found. Vaginal smears were examined before and during treatment for up to two years in a group of 120 women participating in a clinical trial of the contraceptive vaginal ring. No changes in the squamous epithelium or cylinder cells were found. The amount of leucocytes increased in the smears. The results indicate that use of the contraceptive vaginal ring does not affect the bacterial ecology of the vagina. The increase in leucocytes indicates a weak inflammatory reaction which might explain the increase in vaginal discharge often observed by women using the contraceptive vaginal ring.