Serum and endometrial copper, zinc, iron and cobalt with inert and copper-containing IUCDs.

Serum and endometrial copper (Cu), zinc (Zn), iron (Fe) and serum cobalt (Co) were measured in the mid-follicular and mid-luteal phases of the menstrual cycles in 30 Lippes loops users, 30 CuT-200 IUCD users and 24 matched controls by atomic absorption spectrophotometry. In the control group, there was no statistically significant difference in mean mid-luteal, compared to mid-follicular, levels of serum Cu, Zn, Fe and Co and endometrial Zn. Mid-luteal endometrium contained significantly higher mean Cu, and lower mean Fe levels. In Lippes loop users, compared to controls, the only statistically significant differences were lower mean mid-follicular serum Zn, lower mean endometrial Zn and Fe, and higher mean mid-luteal endometrial Fe. In CuT-200 users, compared to controls, there was significantly higher mean mid-follicular serum Zn and lower mean mid-luteal serum Co, higher mean mid-follicular endometrial Cu and lower mean mid-follicular endometrial Fe levels. Compared to Lippes loop, CuT-200 users had significantly higher mean mid-follicular serum Co and endometrial Cu and Zn, and lower mean mid-follicular endometrial Fe.

PIP: Serum and endometrial copper (Cu), zinc (Zn), iron (Fe) and serum cobalt (Co) were determined on menstrual cycle Day 6-9 or 9-22 in 30 women with Lippes loops, 30 with CuT-200 IUDs, and 24 controls. The women were clients of the family planning and gynecology clinic of Benha University Hospital, Egypt. Endometrial samples were obtained with a fine Sharmans currette. In controls, the only differences between the mid-follicular and mid-luteal phase were higher Cu and lower Fe levels in the endometrium in the luteal phase. Lippes loop users had lower follicular serum Zn, lower mean endometrial Zn and Fe, and higher mid-luteal endometrial Fe than controls. The CuT-200 IUD group had higher follicular serum Zn and lower luteal serum Co and higher follicular endometrial Cu and lower follicular endometrial Fe levels. The CuT-200 group also had higher follicular serum Co and endometrial Cu and Zn and lower follicular endometrial Fe than did the Lippes loop group.

Serum and endometrial sodium and potassium levels with inert and copper-containing IUCDs and relation to serum steroid levels.

Serum and endometrial sodium (Na) and potassium (K) levels and serum estradiol, progesterone, testosterone and cortisol were measured in the mid-follicular and mid-luteal phases of the menstrual cycle in 20 Lippes loop and 20 CuT-200 IUCD users and 20 matched controls. Na and K were measured by atomic absorption spectrophotometry, while serum steroids were measured by RIA. Regarding steroids, the only significant difference between the three groups was a significantly lower mean mid-luteal serum estradiol in CuT-200 IUCD users compared to Lippes loop users (p less than 0.05). Regarding sodium in the control group, there was significantly lower mean mid-luteal serum and endometrial Na (p less than 0.01) that was not found in both groups of IUCD users. In the mid-follicular phase, there was significantly higher mean serum Na in both Lippes loop and CuT-200 groups compared to controls (p less than 0.05). Mean endometrial Na showed no significant difference between the three groups in both phases of the menstrual cycle. Regarding potassium in the control group, there was significantly lower mean levels in the mid-luteal-phase of the cycle (p less than 0.01) that was not seen with both groups of IUCD users. Serum K showed no significant difference in the three groups in both phases of the menstrual cycle. Endometrial K showed a significantly higher mean level in both Lippes loop and CuT-200 IUCD users compared to controls in the mid-luteal (p less than 0.01), but not in the mid-follicular phases of the cycle.

Levels of serum steroid hormones in intrauterine contraceptive device users.

Serum progesterone, estradiol, testosterone and cortisol were assayed in the mid-follicular and mid-luteal phases of the menstrual cycles in 30 Lippe's loop and 30 Cu T-200 IUCD users, compared to 24 controls. Mean serum progesterone and estradiol levels were significantly higher in the mid-luteal, compared to the mid-follicular phase in each group (p less than 0.01). There were no significant differences between the mean levels of progesterone, testosterone and cortisol in IUCD users and controls in both the mid-follicular and mid-luteal phases. IUCD users had significantly higher levels of estradiol (p less than 0.01) in the mid-luteal phase but not in the mid-follicular phase, compared to controls. There was hormonal evidence of corpus luteum insufficiency in 8.3%, 14.3% and 20% in the controls, Lippe's loop and Cu T-200 IUCD users, respectively.

PIP: Physicians divided 84 gynecologic patients aged 18-35 years who had not used any hormonal contraception or any drug that affects hormone homeostasis for at least 1 year at the outpatient clinic of Benha University Hospital in Egypt into 3 comparable groups to document the impact of IUDs on the human hypothalamic-pituitary-ovarian axis. Lippes loop users experienced a significantly shorter cycle length than either the copper T-200 IUD (Cu T-200) group or the control group (p.05). The Cu T-200 group had a significantly longer education duration of flow than did the other 2 groups (p.05). Neither the Lippes loop nor the Cu T-200 affected ovulation, except in 1 case of a Lippes loop user. Nevertheless, corpus luteum insufficiency did occur in 14.3% of Lippes loop cases, 205 of Cu T-200 cases, and in 8.3% of control group cases. The mean serum estradiol level in the midluteal phase stood significantly higher in the Lippes loop users than in both those using the Cu T-200 and no IUD (p.01). No significant differences existed, however, in mean serum progesterone, testosterone, and cortisol levels between IUD users and the control group during the midfollicular and midluteal phases. For all groups, the midluteal phase exhibited higher mean serum levels of estradiol and progesterone than the midfollicular phase (p.01), but no significant differences existed for testosterone and cortisol.

Postpartum colposcopy of the cervix: injury and healing.

Colposcopic examination was done in 189 successive parturients within 6-48 h of delivery for evidence of type, site, and extent of cervical trauma and its relation to various obstetric factors. There was trauma in 66% of cases, as erosion in 79%, as laceration in 56%, as bruising in 30%, and as yellow areas in 17%. In about two-thirds of cases, the diameter of cervical erosion, or the length of laceration did not exceed 5 mm and 81% of lacerations were of first degree. Cervical injury was significantly more frequent in primiparae, in the anterior cervical lip, in occipito-posterior positions, and with premature rupture of membranes. In 117 parturients with cervical injury another colposcopic examination was done 6-8 weeks postpartum. In 8% there was residual cervical damage.