Relationship between Progesterone Receptor Level in
Endometrium and Bleeding Pattern in Depot Medroxy
progesterone Acetate Userst
PICHAI CHOTNOPPARATPATTARA, MD*, SURASAK TANEEPANICHSKUL, MD*,
SURANG TRERATANACHAT, MD*, NA V APUN CHARURUKS, MD**
Affiliation : * Department of Obstetrics and Gynaecology,
** Department of Clinical Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
t This study was supported by grant from Ratchadapiseksompotch Fund Faculty of Medicine# Grant number RA-21.
AbstractBleeding disturbance is the major reason for discontinuation among depot medroxyproges
terone acetate (DMPA) users. However, the causes of progestin-induced bleeding are not well under
stood. The aim of the study was to examine the correlation between the occurrence of uterine bleed
ing and progesterone receptor (PR) levels in the endometrium. Forty-five matched pairs of age and
body mass index in DMPA users with bleeding and amenorrhea were studied. The endometrial PR
levels were evaluated. The PR score was assessed semi-quantitatively. Forty-two subject pairs met the
criteria. There was no difference in serum estradiol and progesterone levels between the groups. No
correlation between the number of bleeding days and PR score nor between the number of bleeding
days and serum estradiol and progesterone level was detected. The stromal PR score in DMPA sub
jects with amenorrhea was significantly higher than those with bleeding (p < 0.05). By contrast, the PR
score in glandular endometrium was not significantly different between the groups (p > 0.05). In
conclusion, after a second dose of DMPA, subjects with amenorrhea had a higher stromal PR score
than those with uterine bleeding.
Keywords : DMPA, Endometrium, Uterine Bleeding, Progesterone Receptor, Amenorrhea, Stroma
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