Endometrial histopathology, ovarian changes and bleeding patterns among users of long-acting progestin-only contraceptives in Egypt

Abstract

Bleeding patterns, endometrial thickness, ovarian activity, and endometrial histology among Egyptian users of LAPCs differed significantly depending on the nature of the contraceptive.

Effects of depot-medroxyprogesterone acetate on the immune microenvironment of the human cervix and endometrium: implications for HIV susceptibility

“…Comparison to samples from postmenopausal women, who are also atrophic but not exposed to DMPA, would address this issue, but was not a goal of this study. The median length of DMPA exposure was 13 months in our study, a time at which all our endometrial specimens would be predicted to be at least quiescent if not frankly atrophic 35, 36,37 .…”

“…Prolonged exposure to DMPA results in quiescence or atrophy of the endometrium, characterized by thinning of the epithelium, inactive widely-spaced glands, stromal edema, and pseudodecidualization 35,36,37 . These morphological changes may account for our observed alterations in cellular composition in DMPA users, rather than the hormonal effects of DMPA itself.…”

“…Further, age-adjusted analyses found that increased age is associated with lower levels of only three endocervical biomarkers, none of which differed significantly by study group. Another limitation is that prolonged exposure to DMPA results in endometrial epithelial thinning, resulting in small amounts or no tissue available for analyses 35, 36,37 .…”

A review of the endometrial histologic effects of progestins and progesterone receptor modulators in reproductive age women

“…A few tissue samples demonstrated early, mid or late secretory changes [31]. There is a lack of specific histologic effect between the progestins due to subjective interpretation of the endometrium and a lack of quantitative assessment of the endometrium [32]. Both etonogestrel and levonorgestrel have similar endometrial histologic findings after 12 months of use [33].…”

Bleeding profile in users of an etonogestrel sub-dermal implant: effects of anthropometric variables. An observational uncontrolled preliminary study in Italian population

“…Casey et al [14] and Blumenthal et al [8] report a removal rate for bleeding irregularities of 15% and 11%, respectively. Implanon Õ users report abnormal bleeding patterns less frequently in comparison with users of other progestin-only contraceptives [15]. This may be due to the fact that they show the highest rate of follicular growth, and have the thickest endometrium, showing signs of weak proliferative activity [15].…”