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  • Title: [Sexually transmitted diseases (STD) in adolescent girls].
    Author: Henry-suchet J.
    Journal: Contracept Fertil Sex (Paris); 1987 Apr; 15(4):413-6. PubMed ID: 12315322.
    Abstract:
    Contraception has been a factor in lowering the age at 1st sexual intercourse, which is now about 15 years in France. At that age, changes of partners are frequent, placing sexually active adolescents at high risk of sexually transmitted diseases. 2 risks predominate, those of condyloma following infection with the papilloma virus which exposes patients to risk of dysplasia and cervical cancer, and that of salpingitis with its risk of sterility. Condyloma has become more frequent in adolescents in France in the past 5 years. A comparative study showed that the average age at diagnosis of intraepithelial epithelioma related to condyloma declined by 5 years between 1960-80. The average age of condyloma diagnosis is about 18 years. Condyloma in adolescents should be treated prudently. If resected too soon after the primary infection before formation of antibodies, there is a risk of propagating the virus. Adolescent condyloma represents the major indication for laser treatment after colposcopy and microhysteroscopy have been used to determine the exact limits of the lesion. Patients should be warned of the possibility of return and the need for regular monitoring. Partners should also be treated. Apart from barrier methods, no contraceptive methods are known to affect development of condyloma. Chronic and acute salpingitis are 2 different entities, but both can cause sterility. Of the 100,000 French women diagnosed with salpingitis each year, 1/2 are under 25 and 1/5 are under 20. Salpingitis multiplies the risk of extrauterine pregnancy by 6 and carries a 15% risk of sterility, which doubles with each new episode. 75% of cases of salpingitis are caused by sexually transmitted diseases, with chlamydia trachomatis responsible for about 1/2. The risk of salpingitis in oral contraceptive (OC) users is .2-.9 in relation to women not using contraception. The seriousness of salpingitis is significantly less for OC than for IUD users. On the other hand , various studies have shown pill use to be associated with an increased rate of cervical chlamydia infection in adolescents and adults. The risk of salpingitis is multiplied by 2.7-7.3 in IUD users in relation to women not using contraception and by 1.8-9.3 in relation to users of other methods. IUDs should therefore be avoided in adolescents. No significant study has been done on the protection against salpingitis probably offered by barrier methods. Different studies have shown that 80% of tubal sterility is of infectious origin, but in 1/2 of these cases there was no history of recognized salpingitis. The contraception consultation should be used to screen and treat sexually transmitted diseases among adolescents. An intensive information campaign to combat sexually transmitted diseases among adolescents should be mounted by the government, schools, and the media. Systematic screening and an intensive information campaign have dramatically reduced the rate of salpingitis among adolescents in Sweden.
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