BackgroundPrevious studies report association of contraceptives with moderate increase in urinary tract infection among sexually active premenopausal women. The aim of our study was to find out whether the use of hormonal contraceptives has any effect on microbiota of the vagina in the contraceptives users in Khairpur Sindh Pakistan.MethodsA prospective study in woman population of Khairpur Sindh Pakistan aged 20–30 years and 31–40 years, using Hormonal contraceptives was carried out. High vaginal swab samples (n = 100) were collected from the test populations as well as control group (n = 100) and investigated for vaginal microbial flora using standard microbiological and biochemical techniques.ResultsVaginal swabs culturing from hormonal contraceptives users in the age group 20–30 years showed statistically insignificant Candida sp (10% samples), and statistically significant (p < 0.05) Staphylococcus saprophyticus. (18% samples), Streptococcus agalactiae (23% samples), Escherichia coli (28% samples) and Lactobacillus fermentum (32% samples). In the age group 31–40 years, statistically significant percentage of samples (p < 0.05) showed Lactobacillus fermentum (28%), Candida sp (24%), and E. coli, (24%) where statistically insignificant samples showed Staphylococcus saprophyticus (13%) and Streptococcus agalactiae (11%).ConclusionsThe use of hormonal contraceptives alters the normal microbiota of vagina in women according to the age. Lactobacillus fermentum appeared as the predominant species followed by E. coli among the age group of 20–30 years and, Lactobacillus fermentum, Candida sp and E. coli as predominant among women of age group 31–40 years when compared to corresponding control groups. An inverse relationship between E. coli and Lactobacillus fermentum was observed in the women aged 20–30 years.

Objective: Contraception has gained gradual popularity in many parts of the developing world including Pakistan. Despite this increase in acceptance, the birth rate remains high. Failure of contraception has been reported in the literature, which made us aim to conduct this study. The efficiency of hormonal contraceptives in the study area was assessed and this is the first report from Pakistan. Methods: A total of 200 women (aged 20-30 and 31-40 years; n = 100 each) with minimum consistent use of hormonal contraceptives in the form of pills (Combined oral contraceptives) for 12 months were enrolled in this study. Blood samples were collected from women of each age group and corresponding control groups (n = 100) from local hospitals and reproductive health service center. Serum levels of the fertility hormones viz leutinizing and follicle stimulating hormones were measured through ELISA technique. Results: Our data revealed that over all in the both age groups, 72% women had normal, 16% increased and 12% showed decreased levels of leutinizing hormone (p > 0.05) and 67% women showed normal, 33% showed decreased and no increased levels were found for follicle stimulating hormone (p > 0.05). No age-wise significant difference in response was observed among both the age groups tested. Conclusion: Statistically insignificant difference in serum leutinizing hormone and follicle stimulating hormone seen among both the age groups of hormonal contraceptive users and control group indicates less effective hormonal contraception response in the study area.