Keywords
Menopause
Papanicolaou Test
Colposcopy
Estrogen
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Abstract
Objective: To verify the effect of topical estrogen on the transformation zone topography in colposcopy of hypoestrogenic patients, and its impact on differentiating cytological changes due to atrophy from true intraepithelial lesions, aiming to improve the management of cervical diseases in postmenopausal women. Methods: A retrospective study was conducted with climacteric women aged 50 years or older, presenting abnormal cervical cytology and initial negative colposcopy. Patients underwent treatment with conjugated topical estrogen for three months and were subsequently reassessed through repeat cytology and colposcopy. Results: A total of 98 patients were included, with a mean age of 57 years and a mean of 9.5 years since menopause. The rate of satisfactory colposcopies increased from 20.4% to 32.7% after estrogen use. Of the 78 women with type 3 transformation zone at baseline, 66 maintained the same topography. After treatment, 68% had negative cytology. High-grade squamous intraepithelial lesion (HSIL) persisted in 33.3% of cases, with 16.7% of these being diagnosed with microinvasive carcinoma. Conclusion: Topical conjugated estrogen improved cervical cytology accuracy in late postmenopausal women. No significant improvement was observed in transformation zone topography or in the rate of satisfactory colposcopies.
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