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March 5, 1982

Of Menses—Pills and IUDs— Neisseria—and Flings— (With Apologies to Lewis Carroll)

JAMA. 1982;247(9):1321-1322. doi:10.1001/jama.1982.03320340075045

For quite some time, there have been two unresolved questions claiming the interest of those involved in the management of the sexually transmitted diseases (STDs) in the female patient.

One concerns the possibility that the rate of positive cultures for Neisseria gonorrhoeae obtained from the cervix varies in relation to the point in the menstrual cycle at which the specimen is secured. This matter has been under study since 1947 when Koch1 published her finding that the rate of the recovery of gonococci in cultures taken during the latter part of the cycle (days 22 to 25) was lower than when the specimens were obtained on other days, speculating that this was due to an inhibitory effect of progesterone and was correlated with the lower pH of the cervical secretions.

The other was related to the possibility that oral contraceptives increase the susceptibility of women to gonococcal infection. Juhlin