Contraception
Volume 76, Issue 1 , Pages 49-52, July 2007

Chronic endometritis in DMPA users and Chlamydia trachomatis endometritis

  • Andrea Ries Thurman

      Affiliations

    • Department of OBGYN, University of Texas Health Sciences Center San Antonio, San Antonio, TX 78229-3900, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 210 467 5080; fax: +1 210 467 5080.
    • ,
  • Charles H. Livengood

      Affiliations

    • Chlamydia Testing Laboratory, Department of Obstetrics and Gynecology, Duke University, Durham, NC 27710, USA
    • ,
  • David E. Soper

      Affiliations

    • Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA

Received 18 September 2006; received in revised form 21 March 2007; accepted 22 March 2007. published online 26 May 2007.

Abstract 

Objective

This study was conducted to determine the prevalence of Chlamydia trachomatis (CT) in the endometrium of depot medroxyprogesterone acetate (DMPA) users with and without breakthrough bleeding (BTB) (unscheduled bleeding) and/or chronic endometritis (CE).

Methods

Cross-sectional study. Endometrial biopsies were performed on 20 DMPA users who were having BTB and 20 DMPA users who were amenorrheic. The paraffin-embedded tissue sections were washed with xylene and ethanol to remove the paraffin. CT was identified in the endometrial samples using the COBAS AMPLICOR™ (Roche Diagnostics, Branchburg, NJ, USA) polymerase chain reaction (PCR) identification system.

Results

Chronic endometritis was the most common histologic finding (10/40, 25%) and occurred more often in women experiencing BTB (35% vs. 15%) (RR 1.62, CI 0.91–2.87). No patient with CE had CT infection of the endometrium or cervix.

Conclusions

CT was not a cause of CE in this population of at-risk patients using DMPA. It is possible that CE in DMPA users reflects an inflammatory state, a function of an atrophic endometrium. This points to the possibility of nonsteroidal anti-inflammatory drugs as therapy for CE in this population rather than antimicrobials or hormonal medication.

Keywords: Depot medroxyprogesterone acetate, Chlamydia, Chronic endometritis

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PII: S0010-7824(07)00143-6

doi:10.1016/j.contraception.2007.03.006

Contraception
Volume 76, Issue 1 , Pages 49-52, July 2007

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