CYTOKERATIN-8, CYTOKERATIN-18 AND CYTOKERATIN-19 IN ENDOMETRIAL EPITHELIUM OF NORPLANT(R) AND NORETHISTERONE ENANTHATE INJECTABLE PROGESTOGEN CONTRACEPTIVE USERS

Cytokeratins 8, 18 and 19 are members of the cytoskeletal intermediate filament family found in all simple epithelia, Intermediate filaments are dynamic intracytoplasmic structures that can be influenced by a n umber of external factors, Norethisterone enanthate (NET-EN) is a long -acting progestogen contraceptive that has been found to arrest endome trial growth in the rat. Both Norplant(R) and NET-EN cause bleeding pr oblems among users which are responsible for >50% of withdrawals with these methods, The aim of this study was to explore changes in the exp ression and distribution of cytokeratins 8, 18 and 19 in NET-EN- and N orplant-exposed endometrial epithelium which could be related to bleed ing disturbances, Seven NET-EN and 37 Norplant endometrial biopsies we re paraffin-embedded and stained immunohistochemically to evaluate cyt okeratin expression and distribution, The results shelved that women w ho had received NET-EN for 3-4 months had a cytokeratin distribution s imilar to that seen in the normal menstrual cycle. This is in contrast to endometrium from Norplant users in which cytokeratin expression na s reduced and the epithelial cells were more rounded, No relationship between cytokeratin expression and breakthrough bleeding pattern was f ound, NET-EN and Norplant may act differently on endometrial epithelia l cytokeratin.