ORAL CONTRACEPTION AND THE RECOGNITION OF ENDOMETRITIS

OBJECTIVE: Oral contraceptive use has been associated with a lower ris k of symptomatic pelvic inflammatory disease but a higher risk of chla mydial cervicitis. To explain these seemingly contradictory findings, we asked whether oral contraceptive use was more common among women wi th unrecognized endometritis than among women with recognized endometr itis. STUDY DESIGN: A multicenter case-control study was performed. Wo men without signs of pelvic inflammatory disease were ascertained thro ugh contact tracing of partners with sexually transmitted diseases or through presentation with cervicitis. Women with symptomatic pelvic in flammatory disease met a set of standard clinical criteria. We compare d the 43 cases without signs of pelvic inflammatory disease but with e ndometritis (''unrecognized endometritis'') with the 111 controls with recognized pelvic inflammatory disease and endometritis (''recognized endometritis''). RESULTS: Women with unrecognized endometritis were 4 .3 times (95% confidence interval 1.6 to 11.7) more likely than women with recognized endometritis to use oral contraceptives. CONCLUSION: F uture studies need to fully characterize the risks and benefits of ora l contraceptives in relation to sexually transmitted diseases.