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January 3, 1986

Oral Contraceptives and Chlamydia Infections-Reply

Author Affiliations

Centers for Disease Control Atlanta
University of California School of Medicine San Francisco

JAMA. 1986;255(1):38-39. doi:10.1001/jama.1986.03370010040017

In Reply.—  We appreciate Dr Gall's thoughtful letter in which he highlights our major point that insufficient data exist to draw definitive conclusions about the relations between OCs, Chlamydia trachomatis, and PID.Regarding his specific comments, first, we agree that certain variables cannot be eliminated as possible confounding factors because of limitation in the information available in many studies of OCs and chlamydial infection. However, at least one study1 we cited, and another2 completed since our report that controlled for these variables (sexual activity, marital status, parity, and exposure to nongonococcal urethritis) found a statistically significant association between OC use and C trachomatis infection.Second, we agree that the possible effect of OCs on severity of acute PID and subsequent fertility prognosis should not be trivialized. This finding, however, does not address the effects of contraceptive method on the incidence of PID, particularly protection against chlamydial PID, or