Estrogenic type of stroke in postmenopausal what it is: the causes, varieties

Menopause entails multiple transformations in the female body. It is changing dramatically and the activities of the reproductive system. Thus there is a physiological alteration of the internal organs, accompanied by changes in the mucosa and endometrium. The nature of these changes may vary significantly. To diagnose the ongoing transformations are special survey methods to assess the state of hormonal women and to identify emerging disease processes. Since the main symptoms of menopause is triggered by a sharp decline in the level of female sex hormones, it is very revealing smear estrogen content.

What is it - the type of estrogen in menopausal smear?

For information about changing hormonal women during menopause, as well as the state of the cervix, using special cytological examination. For this material carried fence mucous from the cervical canal. This procedure is rather simple, it is performed under normal gynecological cabinet using mirrors and special blades intended for collecting mucus. This manipulation is not associated with damage to the mucosa and does not belong to the category of painful procedures. Particularly sensitive women may feel a slight discomfort during sample collection.

Cytological tests can assess the presence and the proportion of the elements identified in the smear woman, and on this basis to obtain information about the nature occurring in the reproductive organs processes. Analysis for cytology is the subsidiary diagnosis conducted in parallel with the ultrasound pelvic and direct inspection technician.

The normal mucosa of female genitalia consists of 5 varieties of cells: the surface, the stratum, intermediate, parabasal and basal.

Each of these species belong to different epithelial layers of the reproductive sphere. They are disposed sequentially from the surface to the basal. The cells of the basal layer have the ability to transform cells in subsequent layers, thereby providing update epithelium. For a complete fulfillment of the process responsible estrogens. When menopausal their number is reduced in women often recorded atrophic changes in the mucosa, as evidenced by the corresponding characteristics of smear.

types of strokes

Depending on the content of hormones and epithelial cell layer cytological analysis can show several types of strokes, in particular:

1. Estrogen. This consists of a flat smear surface of cells in which there is a degenerative change in the cytoplasm (vacuolization) and folding basal cell membranes. The material observed individual nuclei and cell fragments.
2. Progesterone. It shows a large number of elements of the intermediate layer, are prone to congestion.
3. Proliferative peculiar to the first five years of menopause. It is characterized by the separate provision of the surface epithelial cells and type low concentration of leukocytes. Such strokes are detected when progesterone production is reduced, and estrogen still synthesized in sufficient quantities.
4. Mixed combines approximately equal ratio of cells from the intermediate and surface layers. Often this type of stroke occurs in the initial stage of menopause.
5. Atrophic (regression). Characterized by a predominance of parabasal epithelial cells over the elements of the other layers of the epithelium. Very often this type occurs in postmenopausal women.
6. Androgenic. It is determined when the plurality of intermediate, parabasal and basal cells correlates with a small amount of surface. Such smear may indicate the development of tumors of the ovaries and the adrenal glands.
7. Inflammatory. This kind of smear indicates the presence of fungi, trichomonads, cocci leukocytes. In the smear dramatically reduced the number of skin cells.

During the menopausal changes, accompanied by a large-scale restructuring in the organs and systems in the hormonal background there is a certain bias. Very often, for its evaluation, as well as to eliminate the development of pathological changes necessary to carry out studies on the level of estrogen. Information about estrogen saturation gives estrogenic type of stroke.

Types of estrogenic response

Such smear to evaluate the state of the uterus and ovaries in four typical types of estrogenic response:

• the first type of reaction is observed bright lack of estrogen and an increased number of leukocytes and atrophic cells;
• the second characteristic is moderate estrogenic deficiency, and the presence of leukocytes and atrophic cells, but their concentration is lower than in the case of the first type;
• at the third characteristic equal ratio of all types of epithelial cells;
• at a fourth type of content is excessively estrogens.

Throughout premenopausal period smear with some increase in the content of estrogen can be considered a variant of the norm, because the reproductive system is not yet lost its fertility function and the amount of estrogen by the ovaries is synthesized in a sufficient amount, in addition, the influence of added common hormonal changes. In this matter, it means a lot quantitative characteristic indicators.

As the progression of menopausal changes in estrogen type smear reveals the high content of dead cells. It is noted considerably reducing the amount of progesterone.

By the time of the entry in postmenopausal smear is not detected the white blood cells and the cells that make up the basal layer. This period is characterized by the change in the structure of the cytoplasm (the internal environment of the cell) - observed heterogeneity and its granularity. This may be a sign of trouble, for example, indicate the development of inflammation.

Estrogenic type of stroke in postmenopausal most common in women who have a high body mass, which is likely to due to the fact that of adipose tissue cells are also capable of synthesizing estrogen par with the adrenal glands.

To determine the quantitative ratio of epithelial cells is used cariopyknotic index (CPI), which is calculated number ratio superficial cells with pyknotic nucleus (ie, wrinkled kernel having undergone the impact of pathological factor) to the total number of epithelial elements. That measure of the proportion of the elements helps to identify estrogenic saturation of the organism. For menopause KPI level must not be higher than 25%, during menopause its performance should fall within the scope of 10-20%.

What is the cause of the change?

Smear estrogen during menopause such as occurs quite often. Such a diagnosis scares women their uncertainty. What can cause this phenomenon?

The most serious cause of which is able to signal the type of the stroke, is a pathological process which occurs in the uterus or ovaries. This phenomenon can be inflammatory, as well as benign and malignant tumors. That's why when it detects an estrogen-type smear should immediately pass an additional examination in order to determine the source of provoking excessive estrogenic activity.

However not always this kind of analysis shows such serious ailments. Sometimes the cause of the estrogen excess become thickened wall ovarian preventing the release of mature ovum from the follicle. In this case, laparoscopic surgery may be necessary in order to eliminate this defect and the normalization of hormonal levels. This reason may be relevant premenopausalWhen the ovulation process has not stopped.

Often the reason for identifying estrogenic type of stroke may be a hormonal imbalance that accompanies menopause parish.

whether treatment is required?

Treatment depends on estrogen saturation provoked its causes. That definition of the source that caused the increase of estrogen concentrations in blood smears, and its elimination is the main focus of treatment.

If a serious disease of the reproductive organs are not supported by a comprehensive examination, then to stabilize hormonal levels, and also to prevent the development of pathological processes in the future, a woman may be assigned to hormone therapy. Often one of the treatment options may be the appointment of oral contraceptives. In this case, the selected drugs, allowing for the reconciliation of estrogen and progesterone ratio according to age characteristics. As a rule, they act by inhibiting the synthesis of estrogen and compensate for the deficiency of progesterone.

Cytological examination of mucous material from the cervix helps detect abnormal development processes in the early stages, allowing you to save time and ensure a more gentle treatment gynecological diseases. To make maximum use of the nature of this method of diagnosis, the woman should regularly visit their gynecologist: at least 1 time per year during the reproductive years, and after the entry into menopause - every six months. This need is due to the instability of hormonal background of women in menopause, which often becomes a provocateur of hormone-dependent diseases, including oncology character.