Antiprogestin-releasing intrauterine devices

a novel approach to endometrial contraception

Nihar R. Nayak, Ov Slayden, Kunie Mah, Kristof Chwalisz, Robert M. Brenner

    Research output: Contribution to journalArticle

    16 Citations (Scopus)

    Abstract

    Intrauterine devices (IUDs) that release progestins are highly effective contraceptives, but they induce breakthrough bleeding that some women find unacceptable. Because progesterone (P) antagonists [antiprogestins (APs)] are known to suppress the endometrium, induce amenorrhea and inhibit fertility, AP-releasing IUDs (AP-IUDs) may provide an effective contraceptive that also controls endometrial bleeding. Here, we assessed the effects of empty (blank) vs. AP-IUDs (ZK 230 211) on bleeding patterns and endometrial growth in ovariectomized, artificially cycled macaques. The AP-IUDs (but not the blank controls) induced extended, frank menstruation when inserted during the late luteal phase, an indication of local AP action. Over time, endometrial glandular and arterial proliferation were inhibited, steroid receptors were elevated, spiral arteries showed degenerative changes, P withdrawal bleeding was prevented, and estradiol (E2)-dependent proliferation was suppressed by the AP-IUDs. In sum, AP-IUDs suppressed the effects of P on endometrial progestational development and blocked the effects of E2 on endometrial proliferation, as previously shown for systemic treatment with APs. Therefore, AP IUDs may provide novel contraceptive devices with minimal breakthrough bleeding.

    Original languageEnglish (US)
    JournalContraception
    Volume75
    Issue number6 SUPPL.
    DOIs
    StatePublished - Jun 2007

    Fingerprint

    Intrauterine Devices
    Contraception
    Metrorrhagia
    Hemorrhage
    Contraceptive Agents
    Contraceptive Devices
    Menstruation
    Steroid Receptors
    Luteal Phase
    Amenorrhea
    Macaca
    Progestins
    Endometrium
    Progesterone
    Fertility
    Estradiol
    Arteries
    Growth

    Keywords

    • Antiprogestins
    • Endometrial changes
    • Macaque monkeys
    • Progesterone withdrawal
    • Uterine bleeding

    ASJC Scopus subject areas

    • Medicine(all)
    • Obstetrics and Gynecology

    Cite this

    Antiprogestin-releasing intrauterine devices : a novel approach to endometrial contraception. / Nayak, Nihar R.; Slayden, Ov; Mah, Kunie; Chwalisz, Kristof; Brenner, Robert M.

    In: Contraception, Vol. 75, No. 6 SUPPL., 06.2007.

    Research output: Contribution to journalArticle

    Nayak, Nihar R. ; Slayden, Ov ; Mah, Kunie ; Chwalisz, Kristof ; Brenner, Robert M. / Antiprogestin-releasing intrauterine devices : a novel approach to endometrial contraception. In: Contraception. 2007 ; Vol. 75, No. 6 SUPPL.
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