Although there were few differences overall in vaginal cytokine and microbiota profiles before and after condomless vaginal intercourse between women who use lubricants vs those who do not, women who used lubricants were found to have a decreased abundance of Lactobacillus crispatus species, according to study results published in BMC Infectious Diseases.

In this nested case-control study of a larger 10-week observational study conducted at the University of Alabama in Birmingham, researchers evaluated the impact of routine use of vaginal lubricants in women who engage in condomless vaginal intercourse. They compared 22 women reporting use of lubricants (cases) with 22 women matched on race/ethinicity who did not use lubricants during intercourse (controls).

Participants self-collected mid-vaginal swabs before and after sexual activity, which were promptly frozen in home freezers and sent to the research clinic in weekly batches on frozen ice packs. A total of 88 vaginal swab specimens were analyzed. “Cytokine concentrations were quantified using a magnetic bead 41-plex panel assay and read using a Bio-Plex 200 array reader,” the researchers noted. The presence and relative abundance of key vaginal bacteria was estimated via 16 rRNA gene amplicon sequencing.


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Of the 44 women included in the study, 63.6% were Black and the mean age was 29.8 years. Participants in both  groups were similar in terms of age, douching, use of hormonal contraception, and number of sexual partners.

At baseline, 3 cytokines (eotaxin, Flt-3L, and PDG-Fab) were significantly increased among participants who used vaginal lubricants vs the control group. In multivariate modeling, however, this difference did not remain statistically significant before and after lubricant use between the groups. In addition, only 1 chemokine (macrophage derived chemokine) was statistically increased before and after lubricant use among participants in the lubricant group vs those in the control group (P =.03).

Microbiota data analyses disclosed few differences between the 2 groups at baseline, including changes in the overall structure of vaginal microbiota before and after lubricant use. However, analysis of patients’ vaginal swab specimens showed that the relative abundance of L crispatus was increased before lubricant use compared with after lubricant use, particularly in women who were L iners-dominated prior to lubricant use.

This study was limited by its small sample size and the lack of information on types of lubricants used, which prevented researchers from assessing whether the lubricants had elevated osmolalities. In addition, the timing of specimen collection after lubricant use was not rigidly controlled, and the researchers did not distinguish between dead and live bacteria when describing the vaginal microbiota.

Future larger studies are needed “to carefully assess the impact of different types of over-the-counter vaginal lubricants, including those with [increased] osmolarity…to further evaluate the effect of vaginal lubricants on the vaginal microenvironment and inflammation,” the researchers concluded.

Disclosure: Some author(s) declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of disclosures.

Reference

Tuddenham S, Stennett CA, Cone RA, et al. Vaginal cytokine profile and microbiota before and after lubricant use compared with condomless vaginal sex: a preliminary observational study. BMC Infect Dis. 2021;21(1):973. doi:10.1186/s12879-021-06512-x