Evidence map›Paper›PMID 40345368›Full record

Trial reportContraception2025

Effect of contraceptive methods on the vaginal microbiome and host immune factors.

Myrna G Serrano, David Edwards, Khatija Ahmed, Veronique C Bailey, Mags Beksinska, Laahirie Edupuganti, Rushil Harryparsad, Florence L D'Hellencourt, Bahiah Meyer, Celia Mehou-Loko and 13 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Contraception, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Observational
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Myrna G SerranoMicrobiology and Immunology Department, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.
David EdwardsMicrobiology and Immunology Department, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA; Statistical Science, College of Humanity and Sciences, Virginia Commonwealth University, Richmond, VA, USA.
Khatija AhmedSetshaba Research Centre, Tshwane, South Africa; Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Veronique C BaileySetshaba Research Centre, Tshwane, South Africa.
Mags BeksinskaMatCH Research Unit (MRU), University of the Witwatersrand, Durban, South Africa.
Laahirie EdupugantiMicrobiology and Immunology Department, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.
Rushil HarryparsadInstitute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Florence L D'HellencourtFHI 360, Cary, NC, USA.
Bahiah MeyerInstitute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Celia Mehou-LokoInstitute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Nina RadzeyInstitute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Ongeziwe TakuInstitute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Anna-Lise WilliamsonInstitute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Jennifer SmitMatCH Research Unit (MRU), University of the Witwatersrand, Durban, South Africa.
Katherine SpaineMicrobiology and Immunology Department, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.
Bin ZhuMicrobiology and Immunology Department, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.
Kimberly K JeffersonMicrobiology and Immunology Department, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA.
Kavita NandaFHI 360, Cary, NC, USA.
Jerome F Strauss IiiDepartment of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Charles S MorrisonFHI 360, Cary, NC, USA.
Jennifer DeeseFHI 360, Cary, NC, USA.
Lindi MassonInstitute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa; Centre for the AIDS Programme of Research in South Africa, Durban, South Africa; Central Clinical School, Monash University, Melbourne, Australia.
Gregory A BuckMicrobiology and Immunology Department, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: Gregory.buck@vcuhealth.org.

Funding

Understanding the Impact of Lower Dose Medroxyprogesterone Acetate on Female Genital Tract Microbiome and ImmunologyR01HD096937 · NICHD · FAMILY HEALTH INTERNATIONAL · PI DEESE, JENNIFER CARAWAY, MASSON, LINDI · 2018 to 2022
$3.7M
NICHD NIH HHS R01 HD096937
6 · The paper itself

Abstract

objectiveThe objective of this study was to assess alterations in vaginal microbiota and immune markers over the first 3 months following initiation of copper intrauterine device (copper IUD), levonorgestrel (LNG) implant, and intramuscular depot medroxyprogestone acetate (DMPA-IM). STUDY

designWe included 162 participants from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial, which enrolled healthy, HIV-negative women seeking contraception and randomized them to a copper IUD, LNG implant, or DMPA-IM. Microbiome and immune profiles in vaginal swab samples collected at enrollment, 1 month and 3 months were analyzed. We categorized microbiome profiles as ''optimal'', ''intermediate'', or ''non-optimal'' based on established criteria [1]. We compared microbiome and immune markers across contraceptive groups and evaluated changes to 1 and 3 months.

resultsCopper IUD users had a more diverse vaginal microbiome and generally increased inflammatory cytokines and antimicrobial peptides over the 3-month follow-up, compared to LNG-implant and DMPA-IM users [2]. LNG-implant users had less complex vaginal microbiomes with reduced inflammation, while DMPA-IM showed little change in either microbiome composition or inflammatory markers. Copper IUD users exhibited lower microbiome stability and a higher likelihood of transitioning to less optimal profiles. In contrast, LNG-implant users showed greater stability and a higher probability of transition to optimal microbiome and immune marker profiles.

conclusionsContraceptive methods affect the vaginal microbiome differently. Copper IUD use may lead to less favorable profiles and increased levels of some immune markers, indicating potential adverse health effects. Conversely, LNG-implant usage promotes a more favorable microbiome and immune marker balance. IMPLICATIONS: Our findings suggest that copper IUDs are associated with decreased prevalence of Lactobacillus-dominated microbiomes, higher transition rates towards less optimal microbiome and increased inflammatory profiles, which may lead to negative implications for gynecologic and reproductive health, the LNG-implant may offer positive health benefits with increased prevalence of L. crispatus-dominated microbiomes.

Indexed as

Contraceptive Agents, FemaleIntrauterine Devices, CopperLevonorgestrelMedroxyprogesterone AcetateMicrobiotaVaginaAdultCytokinesDrug ImplantsFemaleHumansYoung AdultContraceptive Agents, FemaleCytokinesDrug ImplantsLevonorgestrelMedroxyprogesterone AcetateCopper IUDDMPA-IMInflammationLactobacillusLNG-implantVaginal microbiome

Identifiers

PMID40345368
PMCPMC12360276

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.