Post-termination contraception: use of the Multiload Cu250.

During a period of 27 months Multiload intrauterine devices were inserted immediately after suction evacuation of the uterus into 125 patients in two hospitals. Sixty-one patients were lost to follow-up despite careful explanation of the need to attend. The remaining 64 patients provided a total of 630 women months for analysis. Eleven patients requested removal of the Multiloads for various personal reasons. Four devices were spontaneously expelled, three in the first 2 months. Eight devices were removed on account of pain or bleeding and one because of infection. Five other patients were considered to have less severe uterine infection not requiring removal of the devices. These complications have to be viewed against those inherent in the procedure of termination: 4.4% pain or bleeding 3.6% uterine infection. Forty women are known to be continuing to wear the devices. They show no differences in terms of parity, gestation at the time of termination or degree of dilatation of the cervix at the time of termination from the other groups. One pregnancy occurred after 10 months of use. While acknowledging the deficiency of the study due to the high defaulter rate the immediate insertion of a Multiload at the time of termination of pregnancy can be considered as an acceptable method of contraception.

Vaginal microbial flora in normal young women.

Vaginal swabs were taken from 1498 women attending a family planning clinic. The flora was assessed in the absence of any information about the women to whom the swabs related. Yeasts and fungi were present in 311 women (21%) and were no more prevalent among "pill" users than others. Candida albicans was significantly associated with vulval itching and with a vaginal discharge described as heavier than normal or curdy on clinical examination, though these abnormalities were present in only a minority of women with the organism. Trichomonas vaginalis was found in 14 women (1%) and was associated with abnormalities of vaginal discharge in all but one. Gram-negative anaerobic bacilli were significantly more common in women with a troublesome vaginal discharge and those who used an intrauterine device than others. No associations were found between fungi other than C albicans or the other bacteria sought and either symptoms or clinical abnormalities of vaginal discharge.

Epidemiology and clinical significance of cervical erosion in women attending a family planning clinic.

Women attending a family planning clinic were studied to determine the relation between cervical erosion and clinical and social characteristics. The appearance of the cervix was recorded without knowledge of the women's symptoms. The prevalence of erosion increased with parity but, when the effects of other factors were controlled, decreased in women aged 35 and over. Erosion was significantly more common in women taking the "pill" and less common in women using barrier methods of contraception than in others. There was considerable variation between doctors in the reporting of erosion. No association was found between erosion and postcoital bleeding, dyspareunia, backache, or dysuria. There was a significant but modest association between erosion and vaginal discharge and a suggestion that erosion may sometimes be associated with nocturia and frequency of micturition. Vaginal flora was similar in women with and without erosion. Cervical erosion should not be regarded as pathological in asymptomatic women, nor should it be assumed necessarily to be the cause of symptoms in women with genitourinary complaints.