Effects of the climacteric and sequential mestranol and norethisterone on the cervix and genital tract

The effects of the climacteric and sequential mestranol and norethisterone on the epithelium of the cervix and genital tract were determined in 12 postmenopausal women. Before treatment the squamocolumnar junction was visible in only six of the 12 women, but after treatment with sequential mestranol and norethisterone the squamocolumnar junction became visible due to a minor degree of eversion. Mucus, which was always absent before therapy, was always seen afterwards and any atrophic effects were reversed by therapy within 3 months. The effects of oestrogen and progestogen deficiency were more easily seen by scanning electron microscopy (SEM) than with conventional histology. Before treatment six of the nine women studied by SEM had a cervix covered by mature squamous epithelium, but after therapy all the women had mature squamous epithelium. The pretreatment lateral vaginal wall and urinary sediment smears showed mainly immature squamous cells; this correlated poorly with the histology and SEM of the cervix. There was a good correlation between urinary sediment and lateral vaginal wall smears both before and after treatment.