Abstract
To investigate the relationship between IUD-induced menorrhagia and spiral arteriolar function, we examined the endometrium under light and electron microscope on samples obtained within 24 hours after the onset of premenstrual spotting. These samples included an IUD bleeding group (20 cases), an IUD non-bleeding group (20 cases) and an IUD non-user group (10 cases) as controls. Compared with the IUD non-user group the degenerative changes of spiral arteriolar wall were more severe and dilation of the spiral arteriolar lumen was more obvious, especially in the spongeous layer. In the IUD non-user group these changes were mild, suggesting that IUD-induced menorrhagia might be correlated with poor contractility of spiral arterioles in the spongeous layer.
Resumé
Pour explorer la relation entre la ménorragie provoquée par les DIU et la fonction des artérioles spiralées, nous avons examiné l'endomètre aux microscopes polarisant et électronique sur des échantillons obtenus 24 heures après le début de la microrragie prémenstruelle. Ces échantillons provenaient d'un groupe d'utilisatrices de DIU présentant un écoulement sanguin (24 cas), d'un groupe sans écoulement sanguin (20 cas) et d'un groupe témoin n'utilisant pas de DIU (20 cas). Une comparaison avec le groupe témoin a permis de constater que la dégénérescence des parois des artérioles spiralées était plus accentuée et que la dilatation du lumen de ces artérioles était plus prononcée, particulièrement dans le tissu spongieux. Dans le groupe témoin, ces altérations étaient légères, ce qui laisse penser que la ménorragie provoquée par les DIU pourrait fort bien être associée à une faible contractilité des artérioles spiralées dans le tissu spongieux.
Resumen
A los efectos de investigar la relación existente entre la menorragia inducida por DIU y la función arteriolar espiral, examinamos el endometrio bajo microscopio óptico y electrónico en muestras obtenidas dentro de las 24 horas de iniciado el sangrado premenstrual. Estas muestras comprendían un grupo de sangrado con DIU (20 casos), un grupo de no sangrado con DIU (20 casos) y un grupo de no usuarias de DIU (10 casos) como control. En comparación con el grupo de no usuarias de DIU, los cambios degenerativos de la pared arteriolar espiral fueron más acentuados y la dilatación del lumen arteriolar espiral más evidente, especialmente en la capa esponjosa. Estos cambios fueron leves en el grupo de no usuarias de DIU, característica que sugiere que la menorragia inducida por DIU podría estar correlacionada con la contractilidad deficiente de las arteriolas espirales de la capa esponjosa.
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Pan, J.F., Yu, Y.L., Wang, L.J. et al. The morphologic changes of endometrial spiral arterioles in IUD-induced menorrhagia. Adv Contracept 10, 213–222 (1994). https://doi.org/10.1007/BF01983353
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DOI: https://doi.org/10.1007/BF01983353