| Abstract: | ![]()
Over the 1969-1974 period a cytohormonal study was undertaken in 1200 menopausal women seen at the Cama Hospital, Bombay, India. Results are categorized under the following headings: postmenopausal endometrium - 104 cases; routine cytology in 1200 women; women with postmenopausal bleeding - 120 cases; women after hysterectomy and oophorectomy - 159 cases; and estrogen estimations in urine and correlation with cytology - 125 cases. Over 1961-1963, endometrium from 104 uteri removed for genital prolapse were studied and classified according to Parks et al. (1959). 9.6% were atrophic, 17.3% were inactive cystic glands, 2.8% were hyperplasia, 66.3% were proliferative, 2.8% were secretory, and 0.96% were polyps. There were only 297 normal smears in which cytohormonal evaluation could be done. Out of 215 cases in the 1st decade of menopause, 1/2 show some degree of estrogen activity and the other 1/2 show an atrophic pattern. Out of 76 cases in the 2nd decade only 24 show some degree of estrogen activity. Whereas 52 showed an atrophic pattern after 20 years of menopause only an occasional smear will show an estrogenic smear. Cytology has a definite place in the management of cases with menopausal bleeding and if used routinely will diagnose a few more cases which may be missed on biopsy, but routine cervico-vaginal smears should be supplemented with endocervical and endometrial aspiration smears. Vault smears from 159 hysterectomized women were studied. 71 had normal smears, 77 had inflammatory smears, 10 showed abnormal cells, and 1 smear was unsatisfactory. Cytohormonal evaluation was possible in 71 cases. 43 showed some degree of estrogen activity, whereas 28 smears were atrophic. When chemical estimation of urinary estrogen was done, it was found that the mean average value in the series was 7.6/mcgms. |
