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Contraceptives Don't Protect Against Leading Cause of Infertility


WebMD Health News

April 17, 2001 -- Contraceptives are essential to preventpregnancy and in the case of condoms, crucial to protect against sexuallytransmitted diseases. Lots of studies have also suggested that condoms, birthcontrol pills, and other contraceptives offer protection against the leadingcause of infertility, but new research shows this is not the case.

In fact, inconsistent use of condoms just about doubles awoman's risk of developing pelvic inflammatory disease (PID), an infection ofthe upper genital tract that can spread to the uterus, ovaries, fallopiantubes, or other related structures, often resulting in future infertility.

The new findings, which appear in the May issue of the journalEpidemiology, should put to rest the controversy surrounding whether ornot contraceptives protect against PID.

While not a sexually transmitted disease per se, PID occurswhen certain disease-causing organisms, including the sexually transmitteddiseases gonorrhea and chlamydia, migrate upward into the genital tract.

PID is marked by lower abdominal pain and abnormal vaginaldischarge. Other symptoms may include fever, pain in the right upper abdomen,painful intercourse and irregular menstrual bleeding. On the other hand, PID,particularly when caused by chlamydia infection, may produce only minorsymptoms or no symptoms at all, even though it can seriously damage thereproductive organs.

PID affects more than one million women each year. More than100,000 women become infertile as a result of PID, and a large proportion ofthe 70,000 ectopic or tubal pregnancies occurring every year are due to theconsequences of PID.

"There is a lot of data that suggest that barrier methods ofcontraception such as condoms may protect against PID because they protectagainst bacterial [sexually transmitted diseases]," says researcher RobertaNess, MD, MPH, associate professor of epidemiology, medicine andobstetrics/gynecology at the University of Pittsburgh Medical Center.

Ness and colleagues looked at contraceptive use among 563 womenwith signs and symptoms of PID. They found condoms were the most popularcontraceptive, followed by birth control pills, injections, and then otherbarrier methods.

Overall, though, condoms did not reduce the risk of PID.And the inconsistent use of condoms or not using them 100% of the time actuallydoubled the risk of PID.

Women who took birth control pills had less severe PID symptomsthan those who did not take the pills, but they were not protected against thedisease.

"Inconsistent use of barrier methods of contraception,particularly condoms, is really harmful," Ness tells WebMD. "If you are goingto use barrier methods, you better make sure that you are using them correctlyand consistently."

When used correctly and consistently, male latex condoms willprevent transmission of gonorrhea and partially protect against chlamydiainfection.

As for birth control pills, the new research suggests that theymay decrease the inflammation that occurs when bacteria creeps up the genitaltract. They do not, however, protect against gonorrhea or chlamydia or theascension of any bacteria.

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