Effects of long-term use of nonoxynol-9 on vaginal flora

Courtney A. Schreiber, Leslie A. Meyn, Mitchell D Creinin, Kurt T. Barnhart, Sharon L. Hillier

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVE: Products containing nonoxynol-9 have been used as spermicidal contraceptives for many years, but limited data have been published describing the long-term effects of nonoxynol-9 use on the vaginal microbial ecosystem. This longitudinal study was conducted to examine the effects of nonoxynol-9 on the vaginal ecology. METHODS: Vaginal swabs were obtained from 235 women enrolled in a randomized clinical trial before initiation of use of 1 of 5 different formulations of nonoxynol-9 for contraception, and up to 3 more samples were gathered over 7 months of use. The swab samples were evaluated in a single laboratory. The prevalence of several constituents of the normal vaginal flora was evaluated. The associations between nonoxynol-9 dosage, formulation, average product use per week, and number of sex acts per week were calculated. RESULTS: The changes in prevalence of vaginal microbes after nonoxynol-9 use were minimal for each of the different nonoxynol-9 formulations. However, when both nonoxynol-9 concentration and number of product uses are taken into account, nonoxynol-9 did have dose-dependant effects on the increased prevalence of anaerobic gram-negative rods (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1-5.3), H2O2-negative lactobacilli (OR 2.0, 95% CI 1.0-4.1), and bacterial vaginosis (OR 2.3, 95% CI 1.1-4.7). CONCLUSION: This study demonstrated that most nonoxynol-9 users experienced minimal disruptions in their vaginal ecology. There were no differences between the different formulations evaluated with respect to changes in vaginal microflora. However, independent of the nonoxynol-9 formulation, there was a dose-dependent effect with increased exposure to nonoxynol-9 on the risk of bacterial vaginosis and its associated flora.

Original languageEnglish (US)
Pages (from-to)136-143
Number of pages8
JournalObstetrics and Gynecology
Volume107
Issue number1
StatePublished - Jan 2006
Externally publishedYes

Fingerprint

Nonoxynol
Bacterial Vaginosis
Odds Ratio
Confidence Intervals
Ecology
Lactobacillus
Contraceptive Agents
Contraception

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Schreiber, C. A., Meyn, L. A., Creinin, M. D., Barnhart, K. T., & Hillier, S. L. (2006). Effects of long-term use of nonoxynol-9 on vaginal flora. Obstetrics and Gynecology, 107(1), 136-143.

Effects of long-term use of nonoxynol-9 on vaginal flora. / Schreiber, Courtney A.; Meyn, Leslie A.; Creinin, Mitchell D; Barnhart, Kurt T.; Hillier, Sharon L.

In: Obstetrics and Gynecology, Vol. 107, No. 1, 01.2006, p. 136-143.

Research output: Contribution to journalArticle

Schreiber, CA, Meyn, LA, Creinin, MD, Barnhart, KT & Hillier, SL 2006, 'Effects of long-term use of nonoxynol-9 on vaginal flora', Obstetrics and Gynecology, vol. 107, no. 1, pp. 136-143.
Schreiber CA, Meyn LA, Creinin MD, Barnhart KT, Hillier SL. Effects of long-term use of nonoxynol-9 on vaginal flora. Obstetrics and Gynecology. 2006 Jan;107(1):136-143.
Schreiber, Courtney A. ; Meyn, Leslie A. ; Creinin, Mitchell D ; Barnhart, Kurt T. ; Hillier, Sharon L. / Effects of long-term use of nonoxynol-9 on vaginal flora. In: Obstetrics and Gynecology. 2006 ; Vol. 107, No. 1. pp. 136-143.
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abstract = "OBJECTIVE: Products containing nonoxynol-9 have been used as spermicidal contraceptives for many years, but limited data have been published describing the long-term effects of nonoxynol-9 use on the vaginal microbial ecosystem. This longitudinal study was conducted to examine the effects of nonoxynol-9 on the vaginal ecology. METHODS: Vaginal swabs were obtained from 235 women enrolled in a randomized clinical trial before initiation of use of 1 of 5 different formulations of nonoxynol-9 for contraception, and up to 3 more samples were gathered over 7 months of use. The swab samples were evaluated in a single laboratory. The prevalence of several constituents of the normal vaginal flora was evaluated. The associations between nonoxynol-9 dosage, formulation, average product use per week, and number of sex acts per week were calculated. RESULTS: The changes in prevalence of vaginal microbes after nonoxynol-9 use were minimal for each of the different nonoxynol-9 formulations. However, when both nonoxynol-9 concentration and number of product uses are taken into account, nonoxynol-9 did have dose-dependant effects on the increased prevalence of anaerobic gram-negative rods (odds ratio [OR] 2.4, 95{\%} confidence interval [CI] 1.1-5.3), H2O2-negative lactobacilli (OR 2.0, 95{\%} CI 1.0-4.1), and bacterial vaginosis (OR 2.3, 95{\%} CI 1.1-4.7). CONCLUSION: This study demonstrated that most nonoxynol-9 users experienced minimal disruptions in their vaginal ecology. There were no differences between the different formulations evaluated with respect to changes in vaginal microflora. However, independent of the nonoxynol-9 formulation, there was a dose-dependent effect with increased exposure to nonoxynol-9 on the risk of bacterial vaginosis and its associated flora.",
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AB - OBJECTIVE: Products containing nonoxynol-9 have been used as spermicidal contraceptives for many years, but limited data have been published describing the long-term effects of nonoxynol-9 use on the vaginal microbial ecosystem. This longitudinal study was conducted to examine the effects of nonoxynol-9 on the vaginal ecology. METHODS: Vaginal swabs were obtained from 235 women enrolled in a randomized clinical trial before initiation of use of 1 of 5 different formulations of nonoxynol-9 for contraception, and up to 3 more samples were gathered over 7 months of use. The swab samples were evaluated in a single laboratory. The prevalence of several constituents of the normal vaginal flora was evaluated. The associations between nonoxynol-9 dosage, formulation, average product use per week, and number of sex acts per week were calculated. RESULTS: The changes in prevalence of vaginal microbes after nonoxynol-9 use were minimal for each of the different nonoxynol-9 formulations. However, when both nonoxynol-9 concentration and number of product uses are taken into account, nonoxynol-9 did have dose-dependant effects on the increased prevalence of anaerobic gram-negative rods (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1-5.3), H2O2-negative lactobacilli (OR 2.0, 95% CI 1.0-4.1), and bacterial vaginosis (OR 2.3, 95% CI 1.1-4.7). CONCLUSION: This study demonstrated that most nonoxynol-9 users experienced minimal disruptions in their vaginal ecology. There were no differences between the different formulations evaluated with respect to changes in vaginal microflora. However, independent of the nonoxynol-9 formulation, there was a dose-dependent effect with increased exposure to nonoxynol-9 on the risk of bacterial vaginosis and its associated flora.

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