Immunoreactive plasma estrogens and vaginal hormone cytology in postmenopausal women

The vaginal hormone cytology and the serum estrogen levels (as determined by radioimmunoassay) of 39 post-menopausal patients were compared. All cytologic parameters showed high statistical correlations with radioimmunoassay values, but these general associations could not be applied to individual patients. A more detailed analysis showed that an atrophic smear (eg, karyopyknotic index [KI], < 10%; parabasal level, > 20%; maturation value [MV], < 40%) indicate estrogen deficiency in the postmenopause. When the KI is 20%-40%, the parabasal cells less than 20% or the MV 40%-60%, the evaluation of estrogen status, on the basis of hormone cytology alone, is indeterminate. The three cytologic indices studied seem much more useful for detecting estrogen deficiency than estrogen excess in the postmenopause. The fact that immunochemical characteristics are not always related to biologic behavior must also be considered when interpreting these findings.