ArticleMucosal immunology2016
Medroxyprogesterone acetate and levonorgestrel increase genital mucosal permeability and enhance susceptibility to genital herpes simplex virus type 2 infection.
Article in Mucosal immunology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02011711 (Modulation of Mucosal and Systemic Immunity by Hormonal Contraceptives), which is not on this map. Cited by 64 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Modulation of Mucosal and Systemic Immunity by Hormonal Contraceptives
Who cites it
64 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.
- Hormonal contraceptive use and the risk of sexually transmitted infections: a systematic review and meta-analysis.Scientific reports · 2022Pooled it
- Initiating Intramuscular Depot Medroxyprogesterone Acetate Increases Frequencies of Th17-like Human Immunodeficiency Virus Target Cells in the Genital Tract of Women in South Africa: A Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Genital inflammatory status and the innate immune response to contraceptive initiation.American journal of reproductive immunology (New York, N.Y. : 1989) · 2022Trial
- Behavioral effects of different contraceptive methods and HIV acquisition: an ancillary study of the ECHO randomized trial.Reproductive health · 2021Trial
- Use of contraceptive depot medroxyprogesterone acetate is associated with impaired cervicovaginal mucosal integrity.The Journal of clinical investigation · 2018Trial
- A randomized clinical trial on the effects of progestin contraception in the genital tract of HIV-infected and uninfected women in Lilongwe, Malawi: Addressing evolving research priorities.Contemporary clinical trials · 2017Trial
- Toxicants in sexual health products: highlighting a critical research gap.Journal of exposure science & environmental epidemiology · 2026Article
- A pilot study of re-purposing drugs to treat koalas with chlamydia.Scientific reports · 2025Article
- Epidemiological Characteristics of HSV-1 and HSV-2 in 177,599 Patients Based on PCR Testing in South Korea (2018-2022).Pathogens (Basel, Switzerland) · 2025Article
- Exogenous ephrin-A3 reverses loss of vaginal epithelial barrier protection in progestin-treated mice.Mucosal immunology · 2025Article
- Use of calibrated filter paper to evaluate vaginal moisture in mice.Scientific reports · 2025Article
- Ephrin-Eph signaling: an important regulator of epithelial integrity and barrier function.Tissue barriers · 2025Review
- Genital epithelial barrier function is conserved by intravaginal rings releasing etonogestrel and ethinyl estradiol.Tissue barriers · 2024Article
- Estradiol-mediated enhancement of the human ectocervical epithelial barrier correlates with desmoglein-1 expression in the follicular menstrual phase.Frontiers in endocrinology · 2024Article
- Article
- NET-EN treatment leads to delayed HSV-2 infection, enhanced mucin and T cell functions in the female genital tract when compared to DMPA in a preclinical mouse model.Frontiers in immunology · 2024Article
- Update on the Impact of Depot Medroxyprogesterone Acetate on Vaginal Mucosal Endpoints and Relevance to Sexually Transmitted Infections.Current HIV/AIDS reports · 2023Review
- Nonoptimal bacteria species induce neutrophil-driven inflammation and barrier disruption in the female genital tract.Mucosal immunology · 2023Article
- Commentary: Multipurpose prevention technologies-What about sexually transmitted infections?Frontiers in reproductive health · 2023Article
- Increased HIV-1 infection in PBMCs treated in vitro with menstrual cycle phase hormones or medroxyprogesterone acetate likely occurs via different mechanisms.American journal of reproductive immunology (New York, N.Y. : 1989) · 2022Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
Depot-medroxyprogesterone acetate (DMPA) is a hormonal contraceptive especially popular in areas with high prevalence of HIV and other sexually transmitted infections (STI). Although observational studies identify DMPA as an important STI risk factor, mechanisms underlying this connection are undefined. Levonorgestrel (LNG) is another progestin used for hormonal contraception, but its effect on STI susceptibility is much less explored. Using a mouse model of genital herpes simplex virus type 2 (HSV-2) infection, we herein found that DMPA and LNG similarly reduced genital expression of the desmosomal cadherin desmoglein-1α (DSG1α), enhanced access of inflammatory cells to genital tissue by increasing mucosal epithelial permeability, and increased susceptibility to viral infection. Additional studies with uninfected mice revealed that DMPA-mediated increases in mucosal permeability promoted tissue inflammation by facilitating endogenous vaginal microbiota invasion. Conversely, concomitant treatment of mice with DMPA and intravaginal estrogen restored mucosal barrier function and prevented HSV-2 infection. Evaluating ectocervical biopsy tissue from women before and 1 month after initiating DMPA remarkably revealed that inflammation and barrier protection were altered by treatment identically to changes seen in progestin-treated mice. Together, our work reveals DMPA and LNG diminish the genital mucosal barrier; a first-line defense against all STI, but may offer foundation for new contraceptive strategies less compromising of barrier protection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.