Han Leo, Taub Rebecca, Jensen Jeffrey T
Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR.
Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR.
Contraception. 2017 Nov;96(5):310-321. doi: 10.1016/j.contraception.2017.07.168. Epub 2017 Aug 8.
Cervical mucus varies in response to both natural and artificial hormonal changes. It is commonly believed that cervical mucus thinning is associated with normal fertility and that progestogen-induced thickening is an essential contraceptive mechanism. This review aims to broadly summarize our current knowledge about cervical mucus from both a clinical and basic research perspective.
We reviewed published literature pertinent to cervical mucus and contraception across scientific disciplines. We first present the most current understanding of the composition of cervical mucus, how it is hormonally regulated, and examine the role of mucus as an immune barrier. We then critically assess the current clinical tests used as surrogate markers for a contraceptive effect. Finally, we review contraceptive studies that have specifically focused on cervical mucus changes.
Existing research suggests that cervical mucus has potential to be a contraceptive target with unique, multipurpose characteristics. However, methodologic limitations associated with clinical assessments of cervical mucus complicate our understanding of contraceptive treatment effects. Key pathways involved in cervical mucus production with potential as novel nonhormonal contraceptive targets have been identified.
More research is needed to clarify the role of cervical mucus in current hormonal contraceptives and to support the development of novel nonhormonal cervix-based methods.
宫颈黏液会因自然和人工激素变化而有所不同。人们普遍认为，宫颈黏液变薄与正常生育能力相关，而孕激素诱导的增厚是一种重要的避孕机制。本综述旨在从临床和基础研究角度广泛总结我们目前对宫颈黏液的认识。
我们检索了各科学领域中与宫颈黏液和避孕相关的已发表文献。我们首先阐述了目前对宫颈黏液成分、其激素调节方式的最新认识，并探讨了黏液作为免疫屏障的作用。然后，我们严格评估了目前用作避孕效果替代指标的临床试验。最后，我们回顾了专门关注宫颈黏液变化的避孕研究。
现有研究表明，宫颈黏液有可能成为具有独特多用途特性的避孕靶点。然而，与宫颈黏液临床评估相关的方法学局限性使我们对避孕治疗效果的理解变得复杂。已确定了参与宫颈黏液产生且有潜力成为新型非激素避孕靶点的关键途径。
需要更多研究来阐明宫颈黏液在当前激素避孕中的作用，并支持基于宫颈的新型非激素方法的开发。
