Hormonal patterns in vaginal smears from puerperal women

Maturation indices were determined for 1,000 vaginal smears from women three weeks to nine months postpartum. Atrophic smears predominated three to six weeks after delivery in women who were lactating, but only one-third of the non-lactators had an atrophic pattern during those weeks. There was a progressive increase in the incidence of estrogenic patterns observed beyond the sixth postpartum week, irrespective of the persistence of lactation. The incidence of mixed patterns (equal numbers of parabasal, intermediate and superficial cells) was remarkedly constant (about 5 per cent) regardless of lactation or time beyond delivery. This study confirms the traditional view of hormonally related puerperal vaginal cytologic patterns, and is at variance with recent claims that vaginal atrophy is unusual in the puerperium.