{"doi":"10.1016/j.contraception.2025.110936","title":"Effect of contraceptive methods on the vaginal microbiome and host immune factors","abstract":"OBJECTIVE: The 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 DESIGN: We 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. RESULTS: Copper 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. CONCLUSIONS: Contraceptive 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.","journal":"Contraception","year":2025,"id":514720,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9531,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":575769,"name":"David Edwards","orcid":"0000-0003-2964-8620","position":1,"is_corresponding":false},{"id":438005,"name":"Khatija Ahmed","orcid":"0000-0003-0309-1641","position":2,"is_corresponding":false},{"id":901547,"name":"Veronique Bailey","orcid":"0000-0002-3626-285X","position":3,"is_corresponding":false},{"id":907329,"name":"Mags Beksinska","orcid":"0000-0002-4169-4112","position":4,"is_corresponding":false},{"id":670150,"name":"Laahirie Edupuganti","orcid":null,"position":5,"is_corresponding":false},{"id":934573,"name":"Rushil Harryparsad","orcid":null,"position":6,"is_corresponding":false},{"id":1087938,"name":"Florence Lefebvre d’Hellencourt","orcid":"0009-0007-3794-4864","position":7,"is_corresponding":false},{"id":1087935,"name":"Bahiah Meyer","orcid":"0000-0003-0641-3546","position":8,"is_corresponding":false},{"id":1088449,"name":"Celia Mehou‐Loko","orcid":null,"position":9,"is_corresponding":false},{"id":1263422,"name":"Nina Radzey","orcid":null,"position":10,"is_corresponding":false},{"id":1087936,"name":"Ongeziwe Taku","orcid":"0000-0003-4402-4891","position":11,"is_corresponding":false},{"id":818051,"name":"Anna‐Lise Williamson","orcid":"0000-0002-5467-1200","position":12,"is_corresponding":false},{"id":413244,"name":"Jennifer Smit","orcid":"0000-0002-5337-5995","position":13,"is_corresponding":false},{"id":1168093,"name":"Katherine M. Spaine","orcid":null,"position":14,"is_corresponding":false},{"id":379067,"name":"Bin Zhu","orcid":"0000-0003-2829-2925","position":15,"is_corresponding":false},{"id":493779,"name":"Kimberly K. Jefferson","orcid":"0000-0003-1052-1988","position":16,"is_corresponding":false},{"id":426438,"name":"Kavita Nanda","orcid":"0000-0001-7650-2929","position":17,"is_corresponding":false},{"id":301374,"name":"Jerome F. Strauss","orcid":"0000-0001-6199-0480","position":18,"is_corresponding":false},{"id":469092,"name":"Charles Morrison","orcid":"0000-0002-9873-3194","position":19,"is_corresponding":false},{"id":438001,"name":"Jennifer Deese","orcid":"0000-0003-1535-1076","position":20,"is_corresponding":false},{"id":536265,"name":"Lindi Masson","orcid":"0000-0002-2539-817X","position":21,"is_corresponding":false},{"id":29050,"name":"Gregory A. Buck","orcid":"0000-0003-4621-3987","position":22,"is_corresponding":false},{"id":59345,"name":"Myrna G. Serrano","orcid":"0000-0003-4327-0193","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:48:34.431522Z","pmid":"40345368","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}