Effect of a topical contraceptive on endocervical culture for Neisseria gonorrhoeae

Abstract

An attempt was made to determine whether the shortterm presence of a topical contraceptive in the vagina has any effect on established gonorrhea or on the standard diagnostic technique. Patients with positive endocervical cultures for N. gonorrhoeae from the Durham County Health Department were contacted by telephone informed that their culture was positive and asked to enter the study. Those who agreed were seen the next day in the Duke University Medical Center Womens Clinic. Pregnant women those felt to have active upper genital tract infection on pelvic examination and those with a known allergy to vaginal contraceptives were excluded. None of the patients were currently using topical vaginal agents for contraception. Endocervical swabbings for gonococcal culture were obtained. The patient was then given a steril disposable syringe containing 10 ml of a topical contraceptive gel the composition of which is highly representative of agents currently available in this class. Under the supervision of the nurse the patient injected the gel high into the vagina and mixed it vigorously with a finger to simulate coital events. She was instructed to remain in the area not to douche and to return to the clinic in 1 hour 2 hours and 4 hours for repeat culture from the endocervix for N. gonorrhoeae. In all 4 patients the baseline culture and all cultures at 1 hour 2 hours and 4 hours after insertion and mixing of the vaginal contraceptive agent were positive for N. gonorrhoeae from the endocervix. No patient experienced any adverse effects. Although the number of patients studied is small it is believed that the uniformity of results provides good preliminary evidence that the shortterm presence in the vagina of a contraceptive preparation has no effect on established gonorrhea or the ability to diagnose it by standard culture techniques. These data do not eliminate the possibility that the use of some other topical contraceptives may lower the sensitivity of endocervical culture for N. gonorrhoeae.