Raised circulating levels of interleukin-6 in women with an intrauterine contraceptive device

Abstract

The aim of this study was to determine whether the presence of an intrauterine contraceptive device (IUCD) causes a systemic elevation of interleukin-6 (IL-6). The control group comprised 29 women with normal cycles and who were not using any form of contraception and the study group comprised 74 women who had had an IUCD in place for 10-24 months. Of these, 45 had intermenstrual bleeding. Systemic IL-6 was undetectable (minimum detection limit of the assay is 5 pg/ml) in the control but was raised in 20% of the women fitted with an IUCD (p < 0.01). There was no difference between IL-6 levels in IUCD users who had intermenstrual bleeding and those who did not. These results suggest that the effects of chronic IUCD usage may not be limited to the endometrium.

PIP: A case-control study indicated that IUD use causes a systemic elevation of interleukin-6 (IL-6) comparable to that observed in acute and chronic inflammatory conditions. The study group was comprised of 74 women who had had a Copper T-380A device in place for 10-24 months; 45 of these women reported IUD-related intermenstrual bleeding. 29 women with normal cycles who were not using any form of contraception served as controls. IL-6 levels were assessed through immunoradiometric assay. All 29 controls had undetectable circulating IL-6 levels, while 15 (20%) of cases had raised systemic levels of this cytokine. There were no differences in circulating IL-6 levels between cases who did and did not experience intermenstrual bleeding, nor was there a correlation between IL-6 levels and the day of the cycle on which a blood sample was randomly collected. It is unclear whether the circulating IL-6 observed in this study is an "overspill" from locally produced IL-6 or indicative of a more generalized systemic immunoactivation. Recommended are studies that monitor local and systemic production of IL-6 in IUD users in conjunction with other parameters of an inflammatory response, including C-reactive protein.