CYTOLOGIC CHANGES FOLLOWING USE OF ORAL CONTRACEPTIVES

Abstract

This is a cytologic study of 1000 consecutive patients, clinic and private, who were taking various oral contraceptives. While the incidence of uterine cancer among the study groups was unchanged as compared with the controls, the frequency of abnormal cells in the gynecologic smears was undoubtedly greater with the use of oral contraceptives. The cytologic changes included nuclear enlargement, hyperchromatism, irregularities in chromatin, vacuolation and increased secretory activity of the endocervical cells. Cytologic examination should be performed routinely before oral contraceptives are prescribed. Although clinically endometrial hyperplasia and breakthrough bleeding may occasionally complicate the use of oral contraceptives, the exfoliation of endometrial cells was essentially the same in oral contraceptive and control patients. No evidence of excessive stimulation of epithelial element in the endometrium accompanied the continued use of hormonal contraceptives. In general, the cytohormonal effect associated with the use of oral contraceptives showed a depressed superficial cell count in the vaginal smears. Teenagers using oral contraceptives constituted 2-3% of the surveyed groups. The long-term effects of anti-ovulatory drugs in young female population are yet to be observed.