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
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Article info
Publication history
Published online: May 26, 2007
Accepted:
March 22,
2007
Received in revised form:
March 21,
2007
Received:
September 18,
2006
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
