Sexually transmitted diseases and Chlamydia trachomatis in women consulting for contraception
Avonts, D.; Sercu, M.; Heyerick, P.; Vandermeeren, I.; Piot, P.
Journal of the Royal College of General Practitioners 39(327): 418-420
1989
ISSN/ISBN: 0035-8797 PMID: 2560023 Document Number: 376421
The prevalence of genital micro-organisms was investigated in 248 women who presented to a family practice in Belgium in 1981-84 to obtain contraception. 141 were seeking a new or replacement IUD, while the remaining 107 were oral contraceptive (OC) users. Study participants had no signs or symptoms of a genital infection at the time of screening. The cultures revealed clue cells in 21.0%, Candida albicans in 12.9%, Trichomonas vaginalis in 2%, and Neisseria gonorrhoeae in 0.5%. Chlamydia trachomatis was isolated in 14 women (6.3%); among women requesting an IUD, the prevalence of C trachomatis was 7.5%. A history of 2 or more sex partners in the preceding 3 month period and previous use of OCs each conferred a 2.5 times increased risk of a positive chlamydia finding. Isolation of C trachomatis was not correlated with age at first intercourse, gravidity, an abnormal cervix, or a history of pelvic inflammatory disease (PID), however. 9 of the 14 women infected with chlamydia had nonspecific symptoms of a genital infection, e.g., vulval irritation, odor, or vaginal discharge, and 2 had an abnormal bimanual palpation. Available evidence suggests that IUD linked PID is caused by genital micro-organisms, especially C trachomatis and N gonorrhoeae, that enter the uterine cavity during IUD insertion. Given the 6% prevalence of C trachomatis in the young women presenting for contraception in this study, screening for this micro-organism is urged before an IUD is inserted in order to reduce the complication of PID.