CHLAMYDIA-TRACHOMATIS IN PATIENTS WHO USED ORAL-CONTRACEPTIVES AND HAD INTERMENSTRUAL SPOTTING

Objective: To identify the incidence of positive assays for direct ant igen detection of Chlamydia trachomatis in oral contraceptive (OC) use rs with and without intermenstrual spotting and in women seeking contr aception. Methods: We studied 65 women who had used OCs for more than 3 months and who presented with intermenstrual spotting for which no r eadily demonstrable cause could be identified. They were compared with 65 matched controls who were taking OCs without intermenstrual spotti ng and who had chlamydia testing because of one or more risk factors, and 65 matched controls seeking contraception. The incidence of positi ve tests for each group was compared by chi2 test for independence usi ng the Yates formula. The strength of the relationship was analyzed by determining the Craemer phi coefficient. Results: Nineteen of the 65 women (29.2%) taking OCs for more than 3 months and experiencing bleed ing had positive tests, in contrast to seven of 65 matched controls (1 0.7%) who were also on OCs and who had had chlamydia testing because o f vaginitis or new or multiple sexual consorts, and four of 65 women ( 6.1%) who were screened for C trachomatis before initiation of contrac eption. The significance level for the chi2 statistic was P < .01. Con clusion: intermenstrual bleeding in women previously well regulated on OCs appears to be an added marker for chlamydial infection.