Intermenstrual bleeding is a troublesome complaint in women using the hormonal methods of contraception or the intrauterine contraceptive devices. This type of bleeding was traditionally attributed to the lack of sufficient hormonal support in case of hormonal contraceptions or to the local mechanical irritation in case of IUCDs. We postulated that endometritis may be the cause behind this bleeding and we enrolled 140 women in this study. They had been divided into 7 groups each consists of 20 women. The first group was women who are using combined contraceptive pills (COCs) for more than 3 months without complaining of intermenstrual bleeding. The second group was women who are using the same COC for more than 3 months and having intermenstrual bleeding in the previous 3 cycles at least, for which no probable cause could be detected. The third group was women who are using the progestogen-only pills for more than 3 months without intermenstrual bleeding. The forth group was women who are using the same mini-pills for more than 3 months and were having intermenstrual bleeding in the previous 3 cycles at least, for which a probable cause could not be demonstrated. The fifth group was women who are using copper IUDs for more than 3 months without intermenstrual bleeding. The sixth group was women who are using copper IUDs for more than 3 months and complaining of intermenstrual bleeding in the previous 3 cycles at least, for which a probable cause could not be detected. The last group was women who are not using a method of contraception in the previous 3 months considered as a control group. Chlamydia trachomatis (C. trachomatis) is one of the most prevalent sexually transmitted pathogen among reproductive age women. C. trachomatis antigen in both endocervical and endometrial samples was detected by: (1) Giemsa stain. (2) Direct immunoflourescence (DIMF) test. |
