Abstract
Women face two main health risks from the decision to be sexually active: unintended pregnancy and sexually transmitted diseases (STDs). Actions taken to prevent a pregnancy may also influence either the occurrence of STDs or their consequences. One contraceptive, the intrauterine device, promotes the development of pelvic inflammatory disease (PID).<sup>1</sup>However, all other contraceptives apparently confer some degree of protection from STDs. The condom, when used correctly, is highly effective in preventing transmission of many STDs.<sup>2</sup>The oral contraceptives reduce the risk of PID.<sup>1,3</sup>Other mechanical and chemical barrier methods may also protect against PID.<sup>4</sup> The results reported by Jick and colleagues (page 1619) provide additional epidemiologic support for some local antibacterial influence of vaginal contraception. Women classified as spermicide "users" had gonorrhea rates only one fourth those of women using either oral contraceptives or having undergone surgical sterilization. Their data also suggest that spermicides may
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