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.
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).
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