The "pill", promiscuity, and venereal disease.

The various factors responsible for this rise have been discussed by such authors as Morton (1966) and Ids0e and Guthe (1967). A more recent possible reason for the increased incidence of sexually transmissible diseases is the increasing use of the oral contraceptives (Ashworth, 1968). The doctor working in the venereal disease clinic is in the best position to note the changes in sexual habits and infection rates in his local population. The general practitioner does not as a rule see his own cases of venereal disease as his patients may not admit their promiscuous behaviour to him. In the past 3 years we have found that women from a much wider range of social groups have been attending our particular clinic than in the past. The predominant group is no longer that of Social Classes 4 and 5. The available diagnostic services for cases of vaginal discharge, for the study of cervical cytology, and for pure diagnostic work are encouraging many doctors to refer their patients to the 'Special Clinic', whereas in the past they would have sent them to the gynaecological out-patients department. For the past 5 years we have noted in all our cases the nature of any contraceptive used together with a full sexual history, so that we are now able to compare the changes in contraceptive habits in relation to the possible increase in promiscuity which may be due to the use of oral contraceptives. In order to do this, we compare the percentage of infected women in the total clinic population (Table II) with that of the patients taking oral contraceptives. The habits of the women taking the 'pill' are then further analysed. We have taken gonorrhoea as the criterion of venereal disease; it is by far the commonest of such diseases, and urethral, cervical, and rectal films and cultures taken at weekly intervals over a period of one month enable us to make an accurate diagnosis. Gonorrhoea is diagnosed only if the cultures grow oxidase-positive colonies which ferment glucose alone. Table II shows a sudden increase in cases of gonorrhoea in this area in the past 6 months.