title: Human vaginal histology in long-term users of the injectable contraceptive depot-medroxyprogesterone acetate.
abstract: OBJECTIVE
  Apparently, depot-medroxyprogesterone acetate (DMPA) increases a woman's risk of acquiring HIV. The objective of this study was to test whether the vaginal mucosal thickness and Langerhans cell counts were significantly different in long-term DMPA users compared with women users of an intrauterine device (IUD) who had never used DMPA.
  
  
  METHODS
  Cross-sectional study. Twenty-three DMPA users were matched with 23 nonusers controlled for age, body mass index (BMI; kg/m²), and duration of contraceptive use. Four groups of women were evaluated according to the duration of DMPA use: >1, <5; ≥5, <10; ≥10, <15 or ≥15 years. Estradiol (E₂) levels were compared between the two groups. Histologic sections of vaginal mucosal biopsies were evaluated to measure the mean epithelial thickness and S100 immunostained sections were used to count the number of Langerhans cells/mm.
  
  
  RESULTS
  Mean (±S.D.) E₂ levels were significantly lower in DMPA users (39.4±26.6 pg/mL) compared with nonusers (102.6±60.3 pg/mL) despite similar ages (42.3±7.4 and 42.4±7.4 years, respectively). Mean (±S.D.) vaginal thickness was 232.6±108.1 and 229.7±112.9 in DMPA users and nonusers, respectively. There were no differences in vaginal thickness or Langerhans cell count/mm between users and nonusers even after controlling for DMPA duration of use.
  
  
  CONCLUSIONS
  Vaginal epithelial thinning or Langerhans cell count was not different between long-term DMPA users and copper-IUD users who had never used DMPA.
  
  
  CONCLUSIONS
  No differences were found in vaginal epithelial thickness or in Langerhans cell count between long-term users of the injectable contraceptive DMPA and nonusers.
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, and National Institute of Hormones and Women's Health, Campinas, SP, Brazil.
authors.forename: M Valeria
authors.initials: MV
authors.lastname: Bahamondes
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, and National Institute of Hormones and Women's Health, Campinas, SP, Brazil.
authors.forename: Sara
authors.initials: S
authors.lastname: Castro
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, and National Institute of Hormones and Women's Health, Campinas, SP, Brazil.
authors.forename: Nadia M
authors.initials: NM
authors.lastname: Marchi
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, and National Institute of Hormones and Women's Health, Campinas, SP, Brazil.
authors.forename: Michele
authors.initials: M
authors.lastname: Marcovici
authors.affiliation: Department of Pathology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Liliana A L A
authors.initials: LA
authors.lastname: Andrade
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, and National Institute of Hormones and Women's Health, Campinas, SP, Brazil.
authors.forename: Arlete
authors.initials: A
authors.lastname: Fernandes
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, and National Institute of Hormones and Women's Health, Campinas, SP, Brazil. Electronic address: bahamond@caism.unicamp.br.
authors.forename: Luis
authors.initials: L
authors.lastname: Bahamondes
mesh_terms: D000328:Adult; D001938:Brazil; D002452:Cell Count; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000009:adverse effects; D004958:Estradiol / Q000097:blood; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects; D007801:Langerhans Cells / Q000166:cytology / Q000187:drug effects / Q000276:immunology; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009092:Mucous Membrane / Q000166:cytology / Q000187:drug effects* / Q000254:growth & development / Q000276:immunology; D009929:Organ Size / Q000187:drug effects; D010044:Outpatient Clinics, Hospital; D015203:Reproducibility of Results; D013997:Time Factors; D014621:Vagina / Q000166:cytology / Q000187:drug effects* / Q000254:growth & development / Q000276:immunology
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D004958:Estradiol; D017258:Medroxyprogesterone Acetate
keywords: Injectable contraceptive; Long-term users; Reproductive age; Vaginal histology