THE VAGINAL EPITHELIUM IN THE POSTMENOPAUSE - CYTOLOGY, HISTOLOGY ANDPH AS METHODS OF ASSESSMENT

In the study of postmenopausal vaginal oestrogen deficiency, an object ive assessment of the vaginal epithelium is necessary. The present stu dy was undertaken to evaluate different methods for assessing the vagi nal epithelium, during atrophic and mature conditions. The vaginal epi thelium was assessed by clinical examination, pH and vaginal cytology, including morphometric analysis, before and after oestrogen treatment . Biopsies of the vaginal wall were studied using descriptive histolog y and immunohistochemistry methods. The antigen Ki-67, a sensitive mar ker of cell proliferation, was detected using the monoclonal antibody MIB1. When comparing pre- and post-treatment values from the methods, a shift towards mature values was observed, but the magnitude of the s hift differed to a considerable extent. Vaginal cytology, expressed as mean maturation index (MI) shifted significantly from 94/6/0 to 0/65/ 35. Likewise, mean pH was significantly shifted from 6.2 to mean 4.5. The increased presence of Ki-67 positive cells could be demonstrated a fter oestrogen treatment, but the range of data was wide, which was al so found for the thickness of the epithelium and the number of cell la yers. For objective assessment of the vaginal epithelium maturation in dex and pH can be recommended.