Abstract
Background
Cyclooxygenase-2 (COX-2) is expressed in all female reproductive organs. Therefore,
inhibitors of COX-2 may affect reproductive function. We evaluated the effect of extended
administration of meloxicam on ovulation and the menstrual cycle. Our hypothesis was
that meloxicam administered from menstrual cycle day 5- 22 could interfere with follicular
rupture, without disrupting the menstrual cycle, and could be a potential non-hormonal
contraceptive method.
Methods
The study was conducted in 56 healthy sterilized women. Before the onset of treatment
and after the end of treatment, participants were observed during a control cycle
to ensure that they had progesterone (P4) serum levels (>12 nmol/l) consistent with ovulation. Participants were treated for 18 days, during
three consecutive cycles. They were randomized to 15 or 30 mg/day. The menstrual cycle
was monitored with serial ultrasound and hormone assays in blood.
Results
Fifty-six volunteers completed the study. In 55% of cycles treated with 15 mg/day
and in 78% of cycles treated with 30mg/day (p<0.001) we observed dysfunctional ovulation
defined as follicular rupture not preceded 24–48 h earlier by an LH peak or preceded
by a blunted LH peak (<21 IU/l) or not followed by an elevated serum P4 level >12 nmol/l. Ovulation was observed in 44.6% and in 21.7% of women in the lower dose
group and the higher dose group, respectively. There were no differences between the
two doses in other parameters measured. There were no serious adverse events and adverse
events were not different between doses or between control and treated cycles.
Conclusions
Although administration of meloxicam on menstrual cycle days 5- 22 resulted in a dose-dependent
inhibition of ovulation, more than 20% of subjects had normal ovulation with the highest
dose.
Implications
Previous studies have shown that oral meloxicam can delay follicle rupture. This study
investigated daily oral meloxicam as a non-hormonal contraceptive. Since ovulation
occurs in over 20% of cycles even with a high dose of 30 mg daily, it is not likely
that the approach would be a highly effective contraceptive strategy.
Keywords
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Article info
Publication history
Published online: May 03, 2014
Accepted:
April 19,
2014
Received in revised form:
April 17,
2014
Received:
October 16,
2013
Footnotes
☆The Eastern Virginia Medical School Institutional Review Board (IRB) in the United States and Comité Ético Científico del Servicio de Salud Metropolitano Central in Chile approved this clinical trial.
☆☆Funding: Support for this subproject (CIG-10-131) was provided by CONRAD, Eastern Virginia Medical School. The views expressed by the authors do not necessarily reflect the views Eastern Virginia Medical School.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
