Cytologic Effects of Estrogen Tests on Postmenopausal Vaginal and Cervical Epithelia

Abstract

The action of the follicle hormone on squamous epithelium and on glandular epithelium depends on its pharmacologic composition and on its dosage, and can best be measured on the atrophic epithelium of the female genitalia.

Four hundred and ninety-two postmenopausal women were treated for inflammatory or equivocal cell-pictures with low doses of estrogen preparations. The action ot estrogen on the squamous epithelium was characterized by the high build up of the epithelium and by the appearance of lipid granules in the cytoplasm of superficial cells.

Glandular epithelial cells from the endocervix were twice as common in the repeated smears and revealed large vesicular nuclei. In no instance did we detect endometrial cells in the smears after these low doses of estrogen.

Besides this evidence of regular cell proliferation there were also benign cellular alterations:

• 1. Nuclear enlargements, seen in 4% of the cases. These did not indicate dysplasia, however.

• 2. In 4% of the cases the cell picture was that typical of parakeratosis occurring after estrogen clearing in old women, but which may be confused with premalignant or malignant epithelial changes.

• 3. In some cases squamous epithelial cells were seen with single or double nuclei surrounded by large spaces, similar to those occurring in folic acid deficiency or in condylomata.

All of these benign changes disappeared after a few weeks, and at latest 3 months.