`Normal' vaginal microbiology of women of childbearing age in relation to the use of oral contraceptives and vaginal tampons

Abstract

SYNOPSIS The vaginal microbiology of women attending a family planning clinic was found to be unrelated to the use of oral contraceptives and vaginal tampons.Beta haemolytic streptococci isolated from this 'normal' population were compared with those from 1,104 women attending general practitioners complaining of vaginal discharge. There is a caution regarding the indications for antibiotic therapy.Observations were made on the effects of contamination of vaginal swabs with yeasts and /3-haemolytic streptococci from the vulva. The persistent character of the vaginal flora over a sixmonth period is described.Reports of monilial vulvo-vaginitis associated with oral contraceptives (Yaffee and Grots, 1965;Porter and Lyle, 1966;Catterall, 1966)

Site‐Specific Prevalence and Cell Densities of Selected Microbesin the Lower Reproductive Tract of Menstruating Tampon Users

“…It might be speculated that the tampon removal cord that extends from the vagina could be a conduit for organisms from the external genitalia, but there is no evidence that this is the case. On the contrary, results from this and other studies suggest that vaginal colonization with externally derived enterococci and GNEs is more common when pads are used 14,15,30 . In summary, there was a decreasing prevalence of enterococci and GNEs from the perineum to the posterior fornix of the vagina, with similar prevalence of these organisms across the hymen sites.…”

“…For example, enterococci prevalence rates of 1.4% were found in the vaginal fornix of 145 women with normal discharge 15 , compared with 15% in swab samples of the posterior vagina taken from 22 women at any time during the menstrual cycle 24 . Like the enterococci, GNEs (and Escherichia coli in particular) have been isolated more frequently during menses or in the first half of the menstrual cycle 3,6,14,15,26,30 . Colonization with GNEs was significantly more common in pad users than tampon users 14,15,30 ; because pads cover the perineal area, the higher frequency of recovery of vaginal enterococci and GNEs in pad users is consistent with the gastrointestinal tract as the source of colonization.…”

“…Studies indicate that tampon use has little effect on the overall qualitative or quantitative composition of the vaginal flora [11][12][13][14]27 . It might be speculated that the tampon removal cord that extends from the vagina could be a conduit for organisms from the external genitalia, but there is no evidence that this is the case.…”

“…Bacterial vaginosis (BV) is associated with pronounced shifts in the endogenous flora, and agents such as systemic antibiotics, topical antifungal preparations, spermicides and douches may profoundly or selectively alter the balance of organisms present. Menstrual products do not cause broadscale qualitative or quantitative changes in the composition of vaginal flora [11][12][13][14] but effects on selected organisms have been observed 15,16 . Studies that examined the prevalence and relative proportions of microorganisms in the lower genital tract of women have produced disparate results 4,15,17,18 .…”

A Prospective, Randomized, Double-Blind Study of Vaginal Microflora and Epithelium in Women Using a Tampon with an Apertured Film Cover Compared with Those in Women Using a Commercial Tampon with a Cover of Nonwoven Fleece

“…Underlying public acceptance is the safety of tampons, which has been demonstrated repeatedly in studies involving microbiological analyses, gynecological examination, and subject evaluation (7,13,17). Tampons have been shown to not substantially alter the vaginal microflora, and studies of vaginal microflora at various times during the menstrual cycle have demonstrated that tampons have no significant effect on the normal changes that occur in prevalences and total colony counts of either aerobic or anaerobic organisms during menses (10,14,15,16).…”