Step II gyn question

[AbuJadenDO]

So in my board prep a few books mentioned a reduced risk of PID with use of OCP's...I asked my FP attending to explain and he was clueless...any thoughts???

I looked this up online and all I found were JAMA and Journal of OBGYN entries that state this association but none of them say how/why.

thanks!

UPDATE FROM UPTODATE: Oral contraceptives — Oral contraceptives (OCs) have a complex interaction with PID. Several studies have shown that OC use nearly doubles the prevalence of both chlamydial and gonococcal infection of the cervix [47]. However, OC use has traditionally been associated with a 50 percent reduction in PID risk [48].

Resolution of this apparent quandary is emerging. Among OC users with cervical infection, asymptomatic endometritis is fourfold more common than among their counterparts not using OCs [49], although gross salpingitis is reduced fivefold [50]. Thus, women using OCs appear to develop PID in response to cervical initiating agents about as frequently as other women, but the severity of the infection — with respect to both symptoms and tissue damage — is substantially diminished.

 

[hondo55]

OCPs can effect the lining of the uterus i think by increasing viscosity of the secretions which can effect implantation. Perhaps this mechanism alters the ability of the bacteria to work retrograde into the tubes. You could probable answer this for sure by googling it. You should ask your OB/gyn attending. This probably won't show up on your exam.