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Hum. Reprod. Advance Access published online on June 13, 2007
Human Reproduction, doi:10.1093/humrep/dem122
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The effect of oral contraceptives on uterine contractility and menstrual pain: an assessment with cine MR imaging

Aki Kido1,3, Kaori Togashi1, Masako Kataoka1, Yoji Maetani1, Asako Nakai1, Milliam L. Kataoka1, Takashi Koyama1 and Shingo Fujii2

1 Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan 2 Department of Obstetrics and Gynecology, Kyoto University, Kyoto, Japan

3 Correspondence address. Tel: +81-75-751-3419; Fax: +81-75-771-9709; E-mail: akikido{at}kuhp.kyoto-u.ac.jp

BACKGROUND: Low-dose oral contraceptives (OC) have been reported to control primary dysmenorrhea. Furthermore, a close relationship between dysmenorrhea and uterine contractions has been visualized with magnetic resonance imaging (MRI). This study aimed to use cine MR to demonstrate the effects of OC on myometrial contractility during menstruation and to associate the findings with dysmenorrhea.

METHODS: MR studies were obtained of 21 healthy female volunteers (22–47 years old) taking OC, and 20 control women (24–39 years old) not taking OC. Cine- and static MR images were obtained with a 1.5 T magnet during menstruation. Uterine contractility was assessed by the presence of endometrial distortion on cine MR, the area of the mid-sagittal uterine myometrium, and the thickness of the subendometrial low-intensity area on static images. Dysmenorrhea were assessed via a questionnaire.

RESULTS: A total of 21 OC users and 20 controls were included in the analysis. Endometrial distortion was significantly less prominent and the subendometrial low-intensity area was significantly thinner in the OC group. Furthermore in the OC group, the uterine myometrial area was larger (although not significantly) and the degree of assessed pain was significantly lower.

CONCLUSIONS: Both cine- and static MR images demonstrate that myometrial contractility was relatively suppressed in OC users, which may represent one of the reasons explaining the reduced menstrual pain experienced by OC users.

Key words: uterus/MR/oral contraceptives/uterine contraction

Submitted on June 2, 2006; resubmitted on February 25, 2007; accepted on April 17, 2007.


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