Hormonally mediated disturbance of angiogenesis in the human endometrium after exposure to intrauterine levonorgestrel.

Abstract

BACKGROUND:

The levonorgestrel intrauterine system (LNG-IUS) is a contraceptive device that is used for treatment of menorrhagia. The system induces inter-menstrual bleeding within the first few months after insertion. We hypothesized that this bleeding might be associated with a change in vascular development.

METHODS:

A randomized, controlled study was undertaken on 48 women.

RESULTS:

Hysterectomy specimens were obtained and immunocytochemistry was carried out with antibodies to CD31, alpha-smooth muscle actin and myosin. Stereological measurement of blood vessels was also undertaken. Most vessels appeared normal, including the arterioles. Large thin-walled vessels were present in the superficial endometrium of the treated group but were almost completely absent in the controls. The distribution of cytoskeletal markers revealed well-formed basal arterioles with more widespread expression in the superficial stroma than was found in untreated tissue. The volume fraction of blood vessels (P = 0.0001), the number of vessel cross-sections per unit area (P = 0.0003) and the cross-sectional diameters of the largest vascular lumens (P = 0.0001) were significantly increased following treatment with LNG-IUS. However, there was no difference in the median values of vessel diameter or the vascular surface density.

CONCLUSION:

These findings suggest that the LNG has a localized effect on some vessels within the superficial endometrium.

• Authors: C Jay McGavigan, Peter Dockery, Vasiliki Metaxa-Mariatou, Dianne Campbell, Colin J R Stewart, Iain T Cameron, Steven Campbell
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 18 Issue 1 Pg. 77-84 (Jan 2003) ISSN: 0268-1161 [Print] England
• PMID: 12525444 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Actins
• Hormones
• Platelet Endothelial Cell Adhesion Molecule-1
• Levonorgestrel
• Myosins

Topics

• Actins (metabolism)
• Adult
• Arterioles (pathology)
• Blood Vessels (pathology)
• Endometrium (blood supply, metabolism)
• Female
• Hormones (physiology)
• Humans
• Immunohistochemistry
• Intrauterine Devices
• Levonorgestrel (administration & dosage, adverse effects)
• Muscle, Smooth (metabolism)
• Myosins (metabolism)
• Neovascularization, Physiologic (physiology)
• Platelet Endothelial Cell Adhesion Molecule-1 (metabolism)