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Some minor female reproductive system disorders: findings in the Oxford-Family Planning Association contraceptive study
  1. Martin Vessey, FRCOG, FRS, Emeritus Professor of Public Health and
  2. David Yeates, PhD, Computer Scientist
  1. Unit of Health Care Epidemiology, University of Oxford, Oxford, UK
  1. Correspondence to Professor Martin Vessey, Unit of Health Care Epidemiology, Rosemary Rue Building, Old Road Campus, Headington, Oxford OX3 7LF, UK. E-mail: martin.vessey{at}dphpc.ox.ac.uk

Abstract

Background The Oxford-Family Planning Association (Oxford-FPA) contraceptive study has provided information on many serious diseases of the female reproductive tract. No information has been published about a number of common minor conditions. This report fills the gap with regard to uterine polyp, cervicitis, cervical erosion, and vaginitis and vulvitis.

Methods The Oxford-FPA study includes 17 032 married women recruited at ages 25–39 years between 1968 and 1974 from clinics in England and Scotland. These women were followed up until mid-1994. Information collected during follow-up included details of contraceptive use, cervical smears taken at the clinic, pregnancies and hospital referrals.

Results Oral contraceptive (OC) use was associated with a reduction in first hospital referral for uterine polyp and for vaginitis and vulvitis, which became more marked with increasing duration of use. There was a slightly increased rate of hospital referral for cervicitis in OC users. Referral for cervical erosion was markedly increased in current and recent OC users (rate ratio 2.1, 95% confidence interval 1.8–2.4). This increase in risk steadily declined after OC use was discontinued. First hospital referral for both uterine polyp and cervical erosion showed a highly significant negative association with numbers of cigarettes smoked per day. The explanation for these observations is unknown.

Conclusions It should be remembered that the OCs studied were mainly those used in the 1970s and 1980s and mostly contained 50 μg estrogen. On balance, the overall effect of OC use on the conditions considered was neutral or beneficial. The apparent protective effect of cigarette smoking against uterine polyp and cervical erosion, even if valid, counts as nothing against the overwhelming adverse effects of smoking on health.

  • cervical erosion
  • cervicitis
  • oral contraceptives
  • uterine polyp
  • vaginitis/vulvitis
  • Accepted February 11, 2009.

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