Abstract
Background
Endometrial spotting and/or bleeding (ESB) occurs in levonorgestrel subcutaneous implant
(LNG SI) users. Matrix metalloproteinases (MMPs) may play a role in ESB.
Study Design
Women between 18 and 40 years with regular menstrual cycles had a baseline evaluation
followed by LNG SI insertion and randomization to doxycycline (DOX; 20 mg) or placebo
(PL) twice a day. MMP-2, MMP-9 and tissue inhibitor of MMP-1 (TIMP-1) in serum and
the endometrium were estimated at baseline and at 1, 3 and 6 months after insertion.
Results
LNG increased serum MMP-9, while DOX decreased MMP-9 levels compared to PL after 1
month (p<.05). DOX decreased endometrial MMP-9 at 1 and 6 months compared to baseline
and PL (p<.05).
DOX increased endometrial TIMP-1 at 6 months compared with baseline and PL (p<.05).
MMP-2 levels were unchanged.
Conclusion
LNG SI increased serum MMP-9 and TIMP-1 levels, while DOX decreased both serum and
endometrial MMP-9 levels.
Keywords
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Article info
Publication history
Published online: February 09, 2009
Accepted:
December 23,
2008
Received in revised form:
December 22,
2008
Received:
November 5,
2008
Footnotes
���The research was supported by NIH Grant R01 HD43175-01.
������Dr. Shumei Zhao, Dr. Chainarong Choksuchat, Ms. Yueqin Zhao and Dr. George Kovalevsky have no conflicts of interest. Dr. David Archer is a paid consultant for Abbott Laboratories, Agile Therapeutics, Bayer Healthcare, Berlex, ConCert Pharmaceutical, Novo Nordisk, Radius, Schering Plough, Warner Chilcott and Wyeth Laboratories; he has Industry-Supported Research from Bayer Healthcare, Duramed, Organon-Schering Plough, Solvay, Warner Chilcott and Wyeth Laboratories; he receives Direct Industry Lecture Fees from Novo Nordisk, Organon, Schering Plough, Solvay, Upsher-Smith Laboratories and Wyeth Laboratories. Dr. Susan Ballagh is a paid consultant for Contraception Online, Gerson-Lehrman Group, Organon and Wyeth Laboratories; she has Industry-Support Research from Duramed Research, Bayer Healthcare, Conceptus, Pfizer, Organon, Warner-Chilcott and Wyeth Laboratories; she receives Direct Industry Lecture Fees from ARHP, Cardinal Health, Organon and Wyeth Laboratories.
Identification
Copyright
© 2009 Published by Elsevier Inc.
