Histological changes of the human endometrium by nortestosterone enanthate.

A long-acting progestagen SH 393 given parenterally in a single dose of 200 mg has been used to study the endometrial changes. Contraceptive effect of the drug lasts 12 weeks. 50 fertile patients selected by previous laboratory tests and hormonal assays were studied with periodical endometrial samples. Special technics were used to get information of the morphology; histochemical and enzymatic cell contents and ultrastructural patterns. Results obtained the first 4 weeks showed a distinct progestational effect of the drug with glandular regression early formation of the decidual reaction and its rapid involution with anomalous vascular patterns (atrophy of the functional arteries ectatic venous sinuses and hemorrhage with hemosiderin formation). Glycogen and mucopolysaccharides were present early but then depleted. Interstitial amorphous substance and fibers developed poorly. Cytoplasmic RNA was scanty. Nuclear DNA showed anomalous distribution varying in amount from cell to cell. Cell components had decreased amounts of oxidative and Krebs cycle enzymes. Regressive ultrastructural changes appeared in mitochondria endoplasmic reticulum and Golgi apparatus. Between Weeks 5 and 8 50% of the endometrium recovered its normal appearance. The rest showed either atrophy or the progestogenic effect similar to the first 4 weeks. Between Weeks 9 and 12 the endometrium recovered almost its normal patterns. Summary: During the first 4 weeks the drug was directly responsible for the regressive changes. From this moment on the mucosa gradually recovered in spite of a persisting contraceptive effect.(FULL TEXT)