title: Endometrial histopathology, ovarian changes and bleeding patterns among users of long-acting progestin-only contraceptives in Egypt.
abstract: OBJECTIVE
  To evaluate endometrial and ovarian effects, and bleeding patterns, among users of Depo-Provera(®), Norplant(®), and Implanon(®).
  
  
  METHODS
  One-hundred and fifty women, who had been using one of these long-acting progestin-only contraceptives (LAPCs) for at least the previous six months, with fifty in each of the groups, were assessed.
  
  
  RESULTS
  All results are mentioned in the following sequence: (1) Depo-Provera(®), (2) Norplant(®), and (3) Implanon(®). Normal bleeding was reported by 0%, 52%, and 8%; amenorrhoea or infrequent bleeding by 68%, 24%, and 72%; and abnormal bleeding by 32%, 24%, and 20%, respectively (p < 0.001). Histological evaluation revealed an atrophic endometrium in 84%, 32%, and 28%, respectively (p < 0.0001); a progestin effect in 16%, 28%, and 62%, respectively (p < 0.0001), and a proliferative pattern in 0%, 40%, and 10%, respectively (p < 0.0001). Endometrial thickness was 3 ± 0.41 mm, 3.62 ± 0.65 mm, and 5.2 ± 0.84 mm, respectively (p < 0.0001). Follicular growth in the ovaries was observed at ultrasound in 12%, 40%, and 72%, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Bleeding patterns, endometrial thickness, ovarian activity, and endometrial histology among Egyptian users of LAPCs differed significantly depending on the nature of the contraceptive.
authors.affiliation: Department of Obstetrics & Gynaecology & Gynaecology, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Laban
authors.forename: Magda
authors.initials: M
authors.lastname: Abd Alhamid
authors.forename: Eman A
authors.initials: EA
authors.lastname: Ibrahim
authors.forename: Ali
authors.initials: A
authors.lastname: Elyan
authors.forename: Ahlam
authors.initials: A
authors.lastname: Ibrahim
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000097:blood / Q000453:epidemiology; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000097:blood; D017135:Desogestrel / Q000097:blood / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D004534:Egypt / Q000453:epidemiology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000097:blood / Q000494:pharmacology; D017258:Medroxyprogesterone Acetate / Q000097:blood / Q000494:pharmacology; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects / Q000254:growth & development*; D011372:Progestins / Q000097:blood / Q000494:pharmacology*; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D003271:Contraceptive Agents, Female; D011372:Progestins; D016912:Levonorgestrel; D017135:Desogestrel; D017258:Medroxyprogesterone Acetate