THE SILENT SUFFERING WOMEN - A POPULATION-BASED STUDY ON THE ASSOCIATION BETWEEN REPORTED SYMPTOMS AND PAST AND PRESENT INFECTIONS OF THE LOWER GENITAL-TRACT

Objectives-To assess the prevalence of lower genital tract symptoms an d the association between reported symptoms and past and present signs of sexually transmitted diseases (STD) in young women. Design-All wom en belonging to the 19-, 21-, 23- and 25-year age cohorts and Living i n the catchment area of the community health centre, were invited by m ail to take part in a population-based study. The participants answere d a structured questionnaire and a gynaecologic examination was perfor med. Samples for wet smear, cervical Pap smear, HPV DNA determination and Chlamydia trachomatis culture were taken at the ,gynaecologic exam ination. The presence of genital warts was noted. A blood sample was a nalysed for antibodies against C trachomatis and HSV-2. Setting-The co mmunity health care centre was located in Umea, a city in Northern Swe den. Results-Of the 886 women who were eligible, 611 (70%) participate d in the investigation. One out of four women reported symptoms from t he lower genital tract. The most commonly reported symptoms were itchi ng, followed by discharge, and soreness. The most commonly reported ST D was C trachomatis (15%). The most prevalent present STD was HPV infe ction (20%) whereas C trachomatis infection could be isolated from 2.7 % of the women. Antibodies against C trachomatis and HSV-2 were presen t among 22% and 6% ofthe women, respectively. There was a significant correlation between the women's complaint of vaginal discharge and pre vious C trachomatis infection, lack of lactobacilli and presence of le ucocytosis in wet smear. Conclusions-We have in a population-based stu dy of young healthy women found that one out of four women had some ki nd of lower genital tract complaint. Itching was the most commonly rep orted symptom and was associated with pseudohyphae and acetowhite patc hes. Reported vaginal discharge and soreness were associated with the history of a past C trachomatis infection and signs of a disturbed vag inal flora.