Condoms Cut Risk of Pelvic Problems in Women

Reduces incidence of painful inflammatory disease

THURSDAY, July 29, 2004 (HealthDayNews) -- Using condoms regularly does more than protect couples from unwanted pregnancies and sexually transmitted infections.

Habitual use also reduces the odds of women getting repeated bouts of pelvic inflammatory disease (PID), a condition that can result in pelvic pain and infertility, according to a study appearing in the August issue of the American Journal of Public Health.

Consistent condom users were half as likely to have a repeat episode of PID as women whose partners never used condoms, found a team led by Dr. Roberta Ness of the University of Pittsburgh. The researchers also discovered they were 60 percent less likely to become infertile.

They followed 684 women, aged 14 to 37, who were enrolled at 13 U.S. health centers between March 1996 and February 1999. All women had symptoms consistent with a diagnosis of PID at enrollment, and were interviewed regularly for nearly three years about their use of birth control.

"It's consistent condom use that is important, meaning every single time," Ness said.

"The study is the first to show over time that recurrent PID is reduced with condom use," said study co-author Kevin Kip, an assistant professor of epidemiology at Pittsburgh. While many studies have focused on condom use and their ability to reduce the risk of acquiring viral sexually transmitted diseases, less is known about how condom use may help prevent bacterial STDs and PID, Kip said.

"These data support the notion that condom use by male partners reduces the likelihood of recurrent PID and its consequences, such as chronic pain and infertility," Kip said.

Every year in the United States, more than 1 million women experience an episode of acute PID, according to the National Institutes of Health (NIH). About 8 percent of women will have the condition at some time in their reproductive lives, according to Ness. The condition occurs when disease-causing organisms migrate upward from the cervix and the urethra into the upper genital tract.

While many organisms can cause PID, most cases are associated with gonorrhea and chlamydia, two very common sexually transmitted diseases, according to the NIH.

"The condom is basically a barrier to the gonorrhea and chlamydia their partners may be carrying," Ness said.

Symptoms of PID include lower abdominal pain and abnormal vaginal discharge. There can also be fever, pain in the upper right abdomen, painful intercourse and irregular menstrual bleeding. In the study, 15 percent of the women had gonorrhea, 16 percent had chlamydial infections, and 6 percent had both.

Having PID once boosts the chances of having it again. Women with PID are more likely to have scarring of the Fallopian tubes, leading to infertility, chronic pelvic pain or tubal pregnancy, in which the egg is fertilized but cannot pass into the uterus to grow, usually attaching instead in the Fallopian tube between the ovary and the uterus. Infertility occurs in about 20 percent of women who have had PID, according to the NIH.

The study findings are called "very encouraging" by another expert, Dr. Scott Spear, an associate professor of pediatrics at the University of Wisconsin-Madison and chairman of the National Medical Committee for the Planned Parenthood Federation of America.

"It's a prospective study, meaning it took women who initially had PID and followed these women over time, asking about condom use," he said. "And it found those who used the condoms more consistently were less likely to get another case of PID and less likely to get the negative outcomes of PID, which is tubal infertility as well as pelvic pain."

"Previous studies have established a connection between condom use and PID prevention," Spear said. "This one's a stronger study."

"All women who have had a case of PID should use condoms in the future," Spear said.

More information

To learn more about pelvic inflammatory disease, visit the National Institute of Allergy and Infectious Diseases.

SOURCES: Roberta Ness, M.D., M.P.H., professor and chairwoman, epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh; Kevin Kip, Ph.D., assistant professor, epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh; Scott Spear, M.D., associate professor, pediatrics, University of Wisconsin-Madison, and chairman, National Medical Committee, Planned Parenthood Federation of America; August 2004 American Journal of Public Health
Consumer News