Laryngeal cytological aspects in women with surgically induced menopause who were treated with transdermal estrogen replacement therapy

Objective: To investigate the effects of estrogen replacement therapy (ERT) on laryngeal cytology in postmenopausal women.

Design: Prospective open clinical trial.

Setting: Outpatient menopausal clinic in the Department of Gynecology, University of Catania, Catania, Italy.

Patient(s): Eighty-four healthy, surgically postmenopausal women, of whom 48 were treated with ERT and 36 were considered as a control group.

Intervention(s): Transdermal E₂ treatment by patches or gel, evaluation of laryngeal cytology with cytobrush by indirect laryngoscopy, and questionnaire for the voice history.

Main Outcome Measure(s): Changes in cytologic aspects of laryngeal cells with respect to vaginal cytology by hematoxylin and eosin staining; subjective voice changes.

Result(s): Sixty-seven women completed the study. Ten women from the ERT group and five from the control group dropped out because of the invasive laryngoscope method; two subjects in the control group were excluded because of pathologies of the vocal cord. Hematoxylin and eosin staining confirmed similar superficial-intermediate aspects of the cells between the laryngeal and the vaginal smears in ERT-treated women. In the control group, both smears showed aspects of atrophy-dystrophy. The ERT group had a subjectively better quality of voice than the control group.

Conclusion(s): Our study confirms that the larynx is an estrogen target, as are vaginal cells. ERT may provide prevention and treatment of dystrophic pathologies of the vocal cords in postmenopausal women.