Clinical profile and cervical cytomorphology in symptomatic postmenopausal women

The atrophic changes in menopause reflected in cytology is known, but relevance of other features in menopausal management is relatively unknown. One hundred postmenopausal patients who presented with symptoms related to urogenital atrophy were studied (September 1999 - March 2000). 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. The most common presenting urinary symptom was dysuria followed by frequency and UTI. Smears of all patients showed inflammation, varying in intensity, irrespective of the presenting symptoms with a high incidence of candidiasis (12%). Three patients who had ASCUS on smears had carcinoma on follow up. Six patients who opted for HRT were followed up with cytology. Cytology in postmenopause can be used other than to assess hormonal status, to screen for malignancy, pathogens in inflammation and to monitor hormone replacement therapy.