Condoms can prevent pregnancy, protect you from sexually transmitted infections, and even save your life. But you may not know the role they play in protecting your fertility.

The mechanism for this protection comes from the condom's impressive ability to protect you from Gonorrhea and Chlamydia, two sexually transmitted diseases which are very common in women ages 15-24. While we have all heard of Gonorrhea, Chlamydia is almost seven times more commo than its more famous cousinn, and sneakier, because it causes fewer symptoms. About 75% of infected women and 50% of infected men have no symptoms during a Chlamydial infection. How common is Chlamydia? The Centers for Disease Control estimates around four million new cases in the United States each year. Approximately 10% of sexually active young men without symptoms are infected.

Both Chlamydia and Gonorrhea are spread primarily through sexual intercourse. During sex, the bacteria leave the man and attach to the cervix, the opening of the uterus inside the vagina, and then multiply there. At this point, the woman typically has no symptoms except perhaps a vaginal discharge or mild burning with urination. Treatment at this stage is very effective. Untreated, the infection can sit on the cervix, or it can climb up into the uterus and out the fallopian tubes. When the infection reaches the tubes, it causes inflammation, also called pelvic inflammatory disease or PID, which may lead to swelling of the tubes, tubo-ovarian abscess, scarring, and pain. If treated promptly, most women will still be able to conceive, although the chances of tubal ectopic pregnancy and infertility are greater than for women who never had this sort of infection. The more episodes of pelvic inflammatory disease, the more likely a woman is to become infertile.

To look at this from the other direction, a study of women who had trouble getting pregnant because of blocked fallopian tubes showed that almost 80% had evidence of old chlamydial infection; many of these women never had symptoms and were unaware of their infection.

So how can you protect yourself?

• Limit your number of lifetime partners: many women consider themselves monogamous because they only have one partner at a time, but exposures add up. Abstinence is the only totally effective prevention for STDs.
  
  
• Get screened for Chlamydia: your doctor or clinic can test for Chlamydia from your cervix (similar to a Pap test) or from your urine, but not all doctors test every time they do an exam. Sexually active women under age 25 are at greatest risk and should be tested every 6-12 months regardless of symptoms.
  
  
• Talk about symptoms, risks, and protection before you have sex: Ask your partner to be tested for Chlamydia. If your partner has had another partner treated for a sexually transmitted infection or if he has had penile discharge or burning with urination, don't have sexual contact with him until he is treated.
  
  
• Use condoms for every act of intercourse: condoms are estimated to decrease the transmission risk by 90%!