title: Steroid receptor expression in vaginal epithelium of healthy fertile women and influences of hormonal contraceptive usage.
abstract: BACKGROUND
  The objective of this study was to evaluate whether long-term usage of hormonal contraceptives modifies the steroid receptor expression in the human vaginal epithelium of healthy young women.
  
  
  METHODS
  In a cross-sectional study, three groups of hormonal contraceptive users [combined oral contraceptives (COCs), levonorgestrel implants (LNG) and depot medroxyprogesterone acetate injections (DMPAs)] were compared to controls. Fifteen subjects (20-34 years) were enrolled to each group. Vaginal biopsies were collected at two occasions from each subject, and serum concentrations of E(2) and progesterone were measured. Monoclonal antibodies directed against progesterone receptors (PRs) and estrogen receptors (ERs) were used in immunohistochemistry on formalin-fixed tissue sections of vaginal mucosa. A program for immunohistomorphometric quantification was devised to estimate frequency of epithelial steroid receptor-expressing cells.
  
  
  RESULTS
  Progesterone receptor expression was markedly down-regulated and significantly reduced in DMPA users compared to controls, COC and LNG users. In DMPA users, the ER expression was significantly elevated in the first compared to the second sample, and significantly elevated compared to LNG users. Estradiol concentration in serum was significantly reduced in hormonal contraceptive users compared to controls.
  
  
  CONCLUSIONS
  Steroid receptor expression in human vaginal epithelium is altered by long-term use of DMPA compared to controls.
authors.affiliation: Department of Clinical Science, Obstetrics and Gynecology, Umeå University, S-90185 Umeå, Sweden. anna.ildgruben@climi.umu.se
authors.forename: Anna
authors.initials: A
authors.lastname: Ildgruben
authors.forename: Inga
authors.initials: I
authors.lastname: Sjöberg
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Hammarström
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Bäckström
mesh_terms: D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D003280:Contraceptives, Oral, Synthetic / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations; D004848:Epithelium / Q000378:metabolism; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007267:Injections; D016912:Levonorgestrel / Q000494:pharmacology*; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology*; D011374:Progesterone / Q000097:blood; D011960:Receptors, Estrogen / Q000276:immunology / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000276:immunology / Q000378:metabolism*; D014621:Vagina / Q000187:drug effects / Q000378:metabolism*
chemical_list: D003280:Contraceptives, Oral, Synthetic; D003692:Delayed-Action Preparations; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D011374:Progesterone; D004958:Estradiol; D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate