Evidence map›Paper›PMID 42890951›Full record

Trial reportFrontiers in reproductive health2026

Impact of contraceptive initiation on the cervicovaginal mucosa: results from the UMPALA multicentre, partially randomized patient-preference interventional trial.

Betty Njoroge, Nelly Mugo, Carolina Herrera, Karen Dominguez, Louise A Ouattara, Nazita Yousefieh, Neelima Chandra, Agnieszka Kurczewska, Stephanie Nartey, Julie Lewis and 8 more

Registry-linked trialAbstract readClinical Trial
In one paragraph

Trial report in Frontiers in reproductive health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04814927 (The UMPALA Study), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04814927 phase4completednot on this map

The UMPALA Study: A Clinical Study to Assess the Impact of Contraceptives on the Cervico-Vaginal Mucosa

TypeinterventionalSponsorEastern Virginia Medical SchoolRan2021 to 2022Enrolled112ConditionsMucosal Inflammation, Contraceptive, Complications, IntrauterineArmsCopper IUD, Etonogestrel implant, Levonorgestrel IUS, DMPA Sub-cutaneous
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Betty Njoroge *Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
Nelly Mugo *Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
Carolina HerreraCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Karen DominguezCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Louise A OuattaraCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Nazita YousefiehCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Neelima ChandraCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Agnieszka KurczewskaCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Stephanie NarteyLaboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Julie LewisLaboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Andrea R ThurmanCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Matilda SainaCenter for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
Raina N FichorovaLaboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Jacques RavelCenter for Advanced Microbiome Research and Innovation, Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, United States.
Reem Sharaf AlddinCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.
Nicola Richardson-HarmanAlphaStat L.L.C., Damascus, MD, United States.
Kenneth NgureDepartment of Global Health, University of Washington, Seattle, WA, United States.
Gustavo F DoncelCONRAD, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States.

Funding

Upgrade of confocal microscopy at the Oregon National Primate Research CenterP51OD011092 · OD · OREGON HEALTH & SCIENCE UNIVERSITY · PI Bonnie J. Nagel · 2012 to 2026
$203.9M
NIH HHS P51 OD011092
6 · The paper itself

Abstract

Background: Long-acting contraceptives are widely used, providing superior efficacy and systemic safety; however, the impact of contraceptive initiation on female genital tract function and health has been understudied. Methods: Non-pregnant, HIV-uninfected women aged 18-50 years were enrolled in a dual-centre partially randomized patient-preference interventional trial (NCT04814927) and allowed to choose one of four contraceptive options, etonogestrel contraceptive implant, depot medroxyprogesterone acetate subcutaneous injection, levonorgestrel intrauterine device, and copper IUD, with a minimum target of 12 participants per arm and site. Sampling took place at baseline, 1 and 3 months after contraceptive initiation, and 1 month post-contraceptive discontinuation. Primary outcomes focused on mucosal function and health, while secondary and tertiary outcomes pertained to systemic and mucosal susceptibility to HIV-1 and HSV-2. Results: Cervicovaginal samples from 112 enrolled participants showed transient, statistically significant changes in endpoints comparing baseline vs. 1 and 3 months after contraceptive initiation. Changes in pH, epithelial thickness, E-cadherin expression, antimicrobial peptides, glycogen, and lactic acid varied with contraceptive type and were typically transient. Serum oestradiol level was correlated with cervicovaginal epithelial function and glycogen and lactic acid secretion. Contraceptive initiation did not result in detectable Conclusions: Contraceptive initiation during the first 3 months of use induced transient and variable changes in mucosal epithelial and immune markers, not leading to persistent alterations of the vaginal milieu or increased susceptibility to viral infections during the 3 months after contraception initiation. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT04814927?term=NCT04814927.&viewType=Card&rank=1, identifier NCT04814927.

Indexed as

cervicovaginalcopper intrauterine devicedepot medroxyprogesterone acetateetonogestrelHIVHSV-2levonorgestreloestrogen

Identifiers

PMID42890951
PMCPMC13672642

What OpenQuestion holds

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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.