الفهرس 
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Abstract
This work was done to study the effect of DMPA
use on the cervix and vagina, clinically,cytolo-
gically, colposcopically and histopathologically by doing two studies
A)Longitudinal study : this consisted of 50 females who received DMPA as a contraceptive, in a dose of 150 mg i.m. every 3 months for one year. Clinical, cytolo-gical, colposcopic and histopathological examination (punch biopsy from the ectocervix and endocervical curettage) was done before each injection.
B)Cross sectional study : this consisted of 100 DMPA users for at least one year (study group) and 100 controls (control group). Clinical, cytological, colposcopic and histopathological examinations, as done in the longitudinal study, were performed for each woman of the two groups.
Analysis of the clinical, cytological, colpo-scopic and histopathologic findings yielded the following results :
I. KPI : Both studies showed that the KPI decreases
significantly with DMPA use and this decrease
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increased with the duration of DMPA use. This denotes a progestational effect on the cervix and vagina.
II.Infections : There was no statistically significant increase or decrease in the incidence of non spe-cific and specific infections with DMPA or with the duration of its use.
III.Dyskaryosis and Dysplasia : There was no carcino-genic effect with DMPA use or with the duration of its use.
IV.Other Histopathologic Data : In the longitudinal study, there was no significant effect of DMPA use and various histopathological changes that occur in the ectocervical or endocervical tissue specimens. In the cross sectional study, normal histological findings in both tissue specimen were significantly more in the control group and some histological changes were significantly more with DMPA use.
V.Colposcopic Findings : The only colposcopic find- ings that were significantly more with DMPA were fine mosaic and epithelial atrophy. The incidence of undecissive colposcopies decreased with duration of DMPA use.
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CONCLUSIONS AND RECOMMENDATIONS
1.The use of DMPA, as a contraceptive, is apparently safe concerning cervical pathology.
2.Inspite of this apparent safety, check up of patients using DMPA, clinically, cytologically and colpo-scopically at appropriate intervals is recommended and if any revealed a suspicious area of the cervix histopathologic examination is mandatory.
3.The use of DMPA have some atrophic effects on cer-vical squamous epithelium, rather than a stimulatory effects.
4.Further studies and prolonged follow up of the patients are necessary before drawing any final conclusion regarding the carcinogenic effect of injectable contraceptives on the cervix uteri, as the period of one year might not have been enough to inflict cervical pathological changes.