Hormones, vaginal flora impact cervicovaginal lavage

(HealthDay)—Hormonal contraception use and vaginal flora all impact the properties of cervicovaginal lavage, according to a study published online March 24 in the American Journal of Obstetrics & Gynecology.

Catherine A. Chappell, M.D., from the Magee-Womens Hospital at the University of Pittsburgh Medical Center, and colleagues examined the impact of contraception, menopause, and vaginal flora on the physical and biochemical properties of the cervicovaginal fluid. Participants included 165 healthy asymptomatic women, including 29 postmenopausal women; 26 women in the proliferative and 27 in the follicular phase; 28 women using the levonogestrel intrauterine device (LNG-IUD); 28 using depomedroxyprogesterone acetate (DMPA); and 27 using combined oral contraceptives. They measured the osmolality, viscosity, density, and pH of cervicovaginal lavage samples.

The researchers found that cervicovaginal lavage was less viscous and had higher pH in postmenopausal women and those with abnormal vaginal flora compared with premenopausal women and those with normal flora, respectively. Cervicovaginal lavage was more viscous for women using hormonal contraceptives versus premenopausal women not using contraceptives, but the presence of bacterial vaginosis mitigated this increase in viscosity. Cervicovaginal lavage had less total protein for women using DMPA versus LNG-IUD, but similar protein content compared with postmenopausal women.

"Contraceptive hormone users had more viscous CVL than women not using contraceptives," the authors write. "However, the presence of bacterial vaginosis impacted both the pH and viscosity (regardless of hormonal contraceptive use), demonstrating that vaginal flora has a greater impact on the physical properties of cervicovaginal fluid than reproductive hormones."