The use of combined OCPs is associated with an increased incidence of:
Ans. is b, i.e. Chlamydial endocervicitisRef: Novak 14th/ed, p275; CGDT 9th/ed, p727; Leon Speroff 7th/ed, p904-905This is a tricky question as some believe Option "b" i.e. chlamydial endocervicitis should be the answer while others believe Option "c" i.e. vaginal warts should be concerned. As far as candidial (monilial) vaginitis is concerned, OCPs use increase their incidence.But for Chlamydial infections: CGDT 9th/ed, p727 says:"Persons who use barrier contraception are less frequently infected by C. trachomatis than those who use no contraception, and women who use oral contraceptives may have a higher incidence of cervical infection than women not using oral contraceptives".As if replying to CGDT Novak 13th/ed, p259; 14th/ed, p275 says:"Chlamydial colonization of the cervix appears more likely in OC users than in non users, but despite this, there is a 40-50% reduction in risk for Chlamydial PID"Clinical gynecologic endocrinology and Infertility 7th/ed by Leon Speroff says: (It is the most authentic and reliable book for all problems related to Endocrinology, Contraception and Infertility)"Fifteen of the Seventeen published studies reported a positive association of oral contraception with lower Genital tract infections caused by Chlamydial cervicitis. Because lower genital tract infection are on the rise (now the most prevalent STI in the US) and the rate of hospitalization for PID is also increased, it is worthwhile for both patients and clinicians to be alert for symptoms of cervicitis or salpingitis in women on oral contraceptives who are at high risk of sexually transmitted infections." - Ref: Leon Speroff 7th/ed, p905As far as HPV infection i.e. Vaginal warts is concerned'The viral sexually transmitted infections (STI's) include HIV, human papilloma virus (HPV), herpes simplex virus (HSV) and hepatitis B (HBV). At the present time, no known associations exist between oral contraception and the viral STI'S' - Ref: Leon Speroff 7th/ed, p904So, now we can be sure that the answer is Chlamydial endocervicitis.Also know:Infections and Oral contraception:Use of OCP is associated withIncreased risk of infectionDecreased risk of infectionNo association with* Candida (Moniliasis)* Chlamydia* Urinary tract infections* GonorrheaQ* TrichomonasQ* Bacterial vaginosis* Viral STI's i.e. HIVQ, HPVQ* Hepatitis B virus* Herpes simplex virusNote:* If question says PID and does not specify any organism -- Then OCP'S overall not only decrease the incidence of PID but also risk of hospitalization and severity of the disease is decreased.* For protection against PID, at least 12 months of continuous use is necessary and this protection is limited only to current users.
Bacterial vaginosis
Chlamydial endocervicitis
Vaginal warts
Genital herpes
Contraceptives