Palavras-chave
Menopausa
Teste de Papanicolau
Colposcopia
Estrogênio
Como Citar
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Resumo
Objetivo: Verificar o efeito do estrogênio tópico na topografia da zona de transformação na colposcopia de pacientes hipoestrogênicas, e seu seu impacto na diferenciação entre alterações citológicas secundárias a atrofia e lesões intraepiteliais verdadeiras, visando melhorar o manejo das doenças cervicais na pós-menopausa. Métodos: Avaliação retrospectiva de mulheres climatéricas, com 50 anos ou mais com citologias cervicais anormais e colposcopia inicial negativa, que foram submetidas à terapia com estrogênio tópico conjugado e reavaliadas por nova citologia e colposcopia. Resultados: Foram incluídas 98 pacientes, com média de 57 anos e 9,5 anos de menopausa. Após 3 meses de estrogênio tópico conjugado, a taxa de colposcopia satisfatória aumentou de 20,4% para 32,7%. Das 78 pacientes com zona de transformação tipo 3 na colposcopia inicial, 66 mantiveram a mesma topografia. Além disso, 67 (68%) das 98 pacientes tiveram citologia negativa após o tratamento. A persistência de lesão intraepitelial de alto grau (HSIL) ocorreu em 33,3% dos casos, sendo que 16,7% desses foram diagnosticados com carcinoma microinvasor. Conclusão: O uso de estrogênio tópico conjugado melhorou a acurácia da citologia cervical em mulheres na pós menopausa tardia. Não houve melhora significativa na topografia da zona de transformação nem na taxa de colposcopias satisfatórias.
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