The use of combined oral contraceptive pill is associated with an increased incidence of

Ans. is b i.e. Chlamydial endocervicitis This is a tricky question as some believe Option "b should be the answer while others believe Option "c" should be concerned. As far as candidial (monilial) vaginitis is concerned, OCP's use increase their incidence. But for Chlamydial infections : "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 "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" I then had to confirm the answer from Clinical Gynaecologic Endocrinology and Infeility 7,/e by Leon Speroff (It is the most authentic and reliable book for all problems related to Endocrinology, Contraception and Infeility) "Fifteen of the 17 published studies repoed 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 wohwhile for both patients and clinicians to be ale for symptoms of cervicitis or salpingitis in women on oral contraceptives who are at high risk of sexually transmitted infections." As far as HPV infection i.e. Vaginal was 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' ... Leon Speroff 7/e, p 904 So, now we can be sure that the answer is Chlamydial endocervicitis. Also know : Infections and Oral contraception : Use of OCP is associated with Increased risk of infection - Candida (Moniliasis) - Gonorrheadeg - Viral STI's i.e. HIVdeg . HPVdeg - Chlamydia - Trichomonasdeg - Hepatitis B virus - Urinary tract infections - Bacterial vaginosis - Herpes simplex virus Note : 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 hospitalisation 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.