Skip Navigation LinksHome > January 2010 - Volume 14 - Issue 1 > Depot Medroxyprogesterone Acetate: A Risk Factor for Cervica...
Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e3181b0f73f
Original Articles

Depot Medroxyprogesterone Acetate: A Risk Factor for Cervical Stenosis After Loop Electrosurgical Excisional Procedure Management of Cervical Intraepithelial Neoplasia?

Martirosian, Tovia Elizabeth MD1; Smith, Steven Christopher MD, PhD2; Baras, Alexander Spyridon PhD3; Darracott, Mixon M. MD1

Spanish Translation
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Abstract

Objectives: In our anecdotal experience and sporadically in the literature, gynecologists have observed a connection between patient's use of depot medroxyprogesterone acetate (DMPA) and increased occurrence of cervical stenosis during follow-up after loop electrosurgical excisional procedure (LEEP). We decided to formally examine this association in our clinic population.

Materials and Methods: We performed a chart review, enrolling 257 patients and tabulating data on demography, use of hormonal contraceptives, characteristics of the LEEP, and presence or absence of cervical stenosis at 1- and 6-month follow-up evaluations. Univariate tests of association between the independent variables and the dependent variable of cervical stenosis were examined via the χ2 and Student t tests for discrete and continuous variables, respectively. To characterize the relative importance of independent variables significantly associated with cervical stenosis, logistic regression was performed.

Results: Of the 257 charts reviewed, 127 patients (49.4%) completed 1 and 6 months after LEEP follow-up appointments, providing adequate data for analysis. In this population, we observed 25 cases of cervical stenosis, or an overall rate of 19.7%. Of patients using DMPA at the time of LEEP or during the follow-up period, 9 (41.0%) of 22 developed stenosis, whereas of those who did not use DMPA, 16 (15.2%) of 105 developed stenosis, indicating a significant difference (odds ratio = 3.85, 95% CI = 1.41-10.50).

Conclusions: In our clinic population, use of DMPA was associated with higher rates of development of cervical stenosis, calling for larger studies of the association of DMPA in this LEEP complication.

©2010The American Society for Colposcopy and Cervical Pathology

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