title: Chronic endometritis in DMPA users and Chlamydia trachomatis endometritis.
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.
authors.affiliation: Department of OBGYN, University of Texas Health Sciences Center San Antonio, San Antonio, TX 78229-3900, USA. thurmana@uthscsa.edu
authors.forename: Andrea Ries
authors.initials: AR
authors.lastname: Thurman
authors.forename: Charles H
authors.initials: CH
authors.lastname: Livengood
authors.forename: David E
authors.initials: DE
authors.lastname: Soper
mesh_terms: D001706:Biopsy; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D002908:Chronic Disease; D003271:Contraceptive Agents, Female; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis; D003692:Delayed-Action Preparations; D004716:Endometritis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate; D016133:Polymerase Chain Reaction; D015995:Prevalence; D013022:South Carolina / Q000453:epidemiology
chemical_list: D003271:Contraceptive Agents, Female; D004269:DNA, Bacterial; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate