HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van der Laak, J A W M Articles by Hanselaar, A G J M Search for Related Content PubMed PubMed Citation Articles by van der Laak, J A W M Articles by Hanselaar, A G J M Pubmed/NCBI databases Substance via MeSH

The effect of Replens^® on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry

¹ Department of Pathology, University Medical Center, St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands
² Diagnostic Center Eindhoven, Stratumsedijk 28A, 5611 NE Eindhoven, The Netherlands

Correspondence to:
Dr J A W M van der Laak, Department of Pathology 437 PA, University Medical Center, St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands;
J.vanderlaak{at}pathol.azn.nl Background: After the menopause decreased concentrations of oestrogen may result in insufficient maturation of the vaginal epithelium, which can lead to a range of vaginal discomforts. This state of vaginal atrophy may be treated with oestrogen replacement treatment. Replens^TM, a non-hormonal alternative to oestrogen replacement treatment has been shown to be effective in relieving symptoms related to vaginal atrophy in previous studies.

Aims: To study the effect of Replens on the maturation of the vaginal epithelium and morphology of the vaginal cells and to compare the results of a recently developed cytomorphometric method with manual assessment of the degree of maturation in vaginal smears.

Methods: Vaginal smears from 38 postmenopausal women suffering from symptoms related to vaginal atrophy were analysed manually and by cytomorphometry. The maturation value (MV) and the percentages of (para)basal, intermediate, and superficial cells (maturation index; MI) were measured by both methods before and after treatment with Replens. Cytomorphometry also measured mean cellular area, mean nuclear area, and mean area ratio.

Results: A correlation was shown between the two methods in the assessment of percentages of (para) basal and intermediate cells and MV. Cytomorphometric data showed a significant increase in mean cellular area, indicating a positive effect of Replens on the maturation of the vaginal epithelium. Changes in nuclear area and ratio between nuclear and cellular areas were not significant. Treatment with Replens did not influence MI or MV, as assessed by the two methods.

Conclusions: Replens did have an effect on vaginal morphology. The automated procedure may be useful for the assessment of maturation in vaginal smears and is more sensitive to small (subvisual) changes.

Keywords: postmenopausal atrophy; vaginal maturation; maturation index; automated image analysis

Abbreviations: CMA, cytomorphometric analysis; H&E, haematoxylin and eosin; I, intermediate cells; MI, maturation index; MV, maturation value; P, (para)basal cells; S, superficial cells

This article has been cited by other articles:

				M. Trinkaus, S. Chin, W. Wolfman, C. Simmons, and M. Clemons Should Urogenital Atrophy in Breast Cancer Survivors Be Treated with Topical Estrogens? Oncologist, March 1, 2008; 13(3): 222 - 231. [Abstract] [Full Text] [PDF]