engleski

PAP SMEAR SCREENING IN POSTMENOPAUSAL WOMEN WITH AND WITHOUTH HORMONE REPLACEMENT THERAPY

We evaluated the results of annual Pap smears in 100 patients from 1999 to 2003 in two groups of women. In the first group of 50 women they continualy used oral combined hormone replacement therapy (Trisequens or Activelle, Novo Nordisk A/S). The second group of 50 women did not ever use any hornone replacement therapy. The patients were healty at the time of the study that is they did not have any gynecological pathology and those on the continuos combined monophase therapy did not have any unexpected bleedings in 3 years time and they had normal cervical smears at the beginning of the study. The main age of the patients was 54 years.Cytologic abnormalities were defined by Bethesda system ( ASCUS, AGUS, SIL-low grade, SIL-high grade. In the group of postmenopausal women withouth oral terapy, incidence of abnormal cytologic findins in 3 years time was: 83% normal cervical smear, ASCUS 7%, low-grade SIL 12%. In the group of women with continuous hormone therapy, incidence of abnormale smears in 3 years time was: 58% normal findings, ASCUS 6%, low-grade SIL 34%, high-grade SIL 2%. Patients with SIL were in 68% high risk type HPV positive. Cervical smears in postmenopausal women reraly detect significant clinical cervical disease after 3 years time period. Sexual activity of women is the risk factor for the development of cytological abnormalities in smears. Most of sexual active women in this study used replacement therapy. Nevertheless, the annual Pap smear cytologic screening is still essential in postmenopausal patients with or without HRT.

pap smear; postmenopausis; HRT

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