Abstract

Objective: The aim of present study was undertaken to evaluate the postmenopausal clinical complaint of women and cervical cytomorphology in symptomatic cases of postmenopausal woman.

Material and Methods: A total of 72 postmenopausal patients who presented with various postmenopausal clinical symptoms in GOPD or GIPD related to urogenital atrophy were included in the study. From all the patients smears were taken with cotton tipped swab stick from the cervix and from the vagina. Smears were fixed in alcohol and stained with Hemotoxylin & Eosin stain and Papanicolaou stain and seen under oil immersion field. Adequacy, density of inflammation with numerical scoring, specific pathogens and predominant cell type were assessed in each smear and correlated with presenting symptoms and duration of menopause.

Result: The age of the women ranged from 43 years to 75 years and the duration of the menopause ranged from one year to more than 20 years. 92 percent of the study group who initially presented with symptoms was in the age range of 48 to 62 years. The earliest age at menopause was 43 years. White discharge per vaginum was the most common cervico-vaginal presenting complaint while dysuria was the most Common presenting urinary symptoms. Smears of all patients showed inflammation, varying in intensity, irrespective of the presenting symptoms with a high incidence of candidiasis (13%). 01 patient showed atypical squamous cells of uncertain significance in the smears had carcinoma on follow up.

Conclusion: Cytology (Pap smear) in postmenopause can be used other than to assess hormonal status, to screen for malignancy, pathogens in inflammation and also to monitor hormone replacement therapy.

Keywords: Postmenopause, Infections, Cytology, Urogenital Atrophy, pap-smear.