Microbiology of vaginitis associated with the intrauterine contraceptive device

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Abstract
A malodorous, homogeneous, grey, thin and non-purulent discharge, which resembles non-specific vaginitis occurs in 20% of women with an intrauterine contraceptive device (IUCD); 4 times more common than in non-users. The bacteriological etiology of this IUCD-associated vaginal discharge was studied and whether the infection was ascendent was assessed. No specific microbiological etiology was found, but the normal, Lactobacillus-dominated microbial vaginal flora was replaced by Gardnerella vaginalis and certain anerobic species in IUCD-users with the discharge. Clue cells, pepper-salt phenomenon and curved rods and/or fusiform-shaped rods demonstrated by microscopy, were typical of symptomatic patients. The endometrium and the IUCD were infected with these species in the symptomatic group more often than in IUCD-users who had no symptoms or in the control women who did not use the IUCD. [Implications for pelvic inflammatory disease are discussed.].