Sex Steroids and Risk of Female Genital Tract Infection

Medroxyprogesterone Acetate Differentially Regulates Interleukin (IL)-12 and IL-10 in a Human Ectocervical Epithelial Cell Line in a Glucocorticoid Receptor (GR)-dependent Manner

“…Evidence in the literature suggests that high P 4 concentrations, such as those in the luteal phase and during pregnancy, are associated with increased HIV-1 shedding in cervical secretions (21,109,110) and increased susceptibility to HIV-1 infections (21,(111)(112)(113). Similarly, both human and animal studies suggest a link between high P 4 levels and increased risk of sexually transmitted diseases like HSV-2, Chlamydia, and Candidiasis (24,114). Considering that the concentrations of P 4 fluctuate due to reproductive processes (27,114,115), whereas the serum levels of MPA used as contraceptive peak after injection (4.5-65 nM) but then stay constant (ϳ 2.6 nM) for approximately 3 months, P 4 may induce transient inflammation of the ectocervical environment during times of high P 4 concentrations, although MPA may cause a more sustained inflammation.…”

“…Similarly, both human and animal studies suggest a link between high P 4 levels and increased risk of sexually transmitted diseases like HSV-2, Chlamydia, and Candidiasis (24,114). Considering that the concentrations of P 4 fluctuate due to reproductive processes (27,114,115), whereas the serum levels of MPA used as contraceptive peak after injection (4.5-65 nM) but then stay constant (ϳ 2.6 nM) for approximately 3 months, P 4 may induce transient inflammation of the ectocervical environment during times of high P 4 concentrations, although MPA may cause a more sustained inflammation. Our results are consistent with a model whereby pregnant and pre-menopausal nonpregnant women in the luteal phase could be vulnerable to sexually transmitted diseases due to proinflammatory actions of P 4 via the GR, although women on depo-medroxyprogesterone acetate could be vulnerable at all times, but especially after injection, via the same mechanism.…”