Cervical mucus. Problems and opportunities for drug delivery via the vagina and cervix

The vagina has been targeted as the site for delivery of a variety of drugs, and several different delivery systems have been utilized for this purpose. The compounds have almost exclusively been delivered to the vaginal epithelium. The presence of a mucus-laden cervix in women provides an opportunity as an alternative, or conjoint site for such drug delivery. An obvious application is the delivery of drugs that destroy, or render dysfunctional, spermatozoa and pathogens such as viruses and bacteria. In principle, a reservoir of a compound in the cervical mucus could achieve other physiological goals, as well. This article reviews the biology of human cervical mucus and its interaction with spermatozoa. It then focuses upon the critical problem of understanding the mechanisms of drug entry and permeation through the cervical mucus. This problem is only partially understood at present, and salient biophysical concepts are presented which will aid in its further study. It is concluded that there are good prospects for improved utilization of the cervical mucus for drug delivery, but that their realization will require improved understanding of the mechanisms of drug transport and bioactivity within the mucus. © 1993.

Duke Scholars

Author David F. Katz Biomedical Engineering