Cervical gonorrhea in women using different methods of contraception

Abstract

Cultures were made from the cervix, rectum, and oropharynx of 2,019 women to determine the prevalence of gonorrhea. For patients of similar race and age, the rates of cervical gonorrhea among users of oral contraceptives (10.6/100) or IUD users (9.5/100) were significantly greater than observed with patients using barrier methods, condom-diaphragm-foam (1.7/100). On the other hand, there were no significant differences in rates of rectal or oral infection by method of contraception. Postpartum patients were found to have similar infection rates at all three sites as a comparable group of nonpuerperas. Recommendations for utilization of barrier methods are made for suitable patients, including those in the immediate puerperium.

PIP: More than 2000 women attending a family planning clinic in Louisiana were screened for gonorrhea. Controlling for race and age, patients using oral contraceptives or IUDs had higher rates of cervical gonorrhea than users of barrier methods of contraception, e.g., condoms, diaphragms, or foam. These statistically significant differences among users of different contraceptive methods did not hold true for rates of rectal or oral infection. It is possible that medical methods may alter naturally occurring vaginal protective mechanisms in some way. Since this was not an experimental setting, it is also possible that the choice of contraceptive method was related in some way to specific sexual practices. Since the use of barrier methods of contraception seems to be associated with lower rates of cervical gonorrhea, their use by selected patients might be recommended.