Chlamydia trachomatis in women with intermenstrual bleeding using different methods of contraception

ABSTRACT

Intermenstrual bleeding is a troublesome complaint in women using the oral contraceptives [OCs] or intrauterine devices [IUDs]. Traditionally, this bleeding was attributed to insufficient hormonal support in case of oral contraceptive or to local mechanical irritation in the case of IUDs. The endometritis may be the cause causing this bleeding. In this study 150 women were included. They were divided into five groups each consists of 30 women. The first group was women who are using IUDs for more than 3 months with complaining of intermenstrual bleeding in the previous 3 cycles at least, for which no probable cause could be detected. The second group was women who are using the same IUDs for more than 3 months without complaining of intermenstrual bleeding. The third group was women who were are using OCs for more than 3 months and having imtermenstrual bleeding in the previous 3 cycles at least, for which a probable cause could not be demonstrated. The fourth group was women who are using the same OCs for more than 3 months without complaining of intermenstrual bleeding. The last group was women who are not using a method of contraception in the previous 3 months considered as a control group. Endocervical and endometrial specimens were collected from studied women for detection of chlamydia trachomatis antigen by direct immunofluorescence [DIF] method. A significant increase in the incidence of detection of C. trachomatis from IUDs user 17/30 [56.7%] from Ocs user 9/30 [30%] with intermenstrual bleeding [p < 0.05]. Also, there is increase in the incidence of C. trachomatis from IUDs user 7/30 [23.3%] from Ocs user, 3/30 [10%] without intermenstrual bleeding but non-significant [p >0.05] We concluded that C. trachomatis could be the aetiological agent of intermenstrual bleeding in women using IUDs or Ocs