Genitourinary Syndrome of Menopause (GSM)- Pap Test and Gram Findings
International Journal of Research and Reports in Gynaecology,
The loss of ovarian function, prematurely or due to menopause, causes a decrease of the vaginal epithelium trophy. However, with the end of the menstrual cycle and the consequent hypoestrogenism, the epithelial thickness also decreases, with only the parabasal and basal layers remaining with low glycogen reserves. A thinner epithelial thickness associated with a pH greater than 4.5 and a microbiota without protective bacteria (Lactobacillus sp) can lead to an inflammatory condition not necessarily related to the action of a pathogen but mainly the atrophy itself. Atrophic vaginitis is often confused with genitourinary syndrome of menopause (GSM). Laboratory findings do not necessarily coincide with symptoms but could help in diagnosing. Examinations such as bacterioscopy of vaginal smear (Gram) and cytology (Pap test or cytology in liquid medium) have findings that may suggest a picture of intense hypoestrogenism. However, the clinical-laboratory correlation is essential.
- Genitourinary syndrome of menopause
- papanicolaou test
How to Cite
Phillips NA, Bachmann GA. Genitourinary syndrome of menopause: common problem, effective treatments. Cleve Clin J Med. 2018;85:390–398.
Angelou K, Grigoriadis T, Diakosavvas M, Zacharakis D, Athanasiou S. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data. Cureus. 2020;12(4): e7586.
Angelou K, Grigoriadis T, Diakosavvas M, et al. (April 08, 2020) The Genitourinary Syndrome of Menopause: An Overview of the Recent Data. Cureus 12(4): e7586.
Heller DS, Weiss G, Bittman S, Goldsmith L. Does a diagnosis of atrophic vaginitis on Papanicolaou test signify the presence of inflammation? Menopause. 2015;22(8): 814-5.
Kurita T. Developmental origin of vaginal epithelium. Differentiation. 2010;80(2-3):99-105.
DOI: 10.1016/j.diff.2010.06.007. Epub 2010 Jul 17.
Godha K, Tucker KM, Biehl C, Archer DF, Mirkin S. Human vaginal pH and microbiota: an update. Gynecol Endocrinol. 2018 Jun;34(6):451-455.
DOI: 10.1080/09513590.2017.1407753. Epub 2017 Dec 22
Brizzolara S, Killeen J, Severino R. Vaginal pH and parabasal cells in postmenopausal women. Obstet Gynecol. 1999 Nov;94(5 Pt 1):700-3.
Kim S, Seo H, Rahim MA, Lee S, Kim YS, Song HY. Changes in the microbiome of vaginal fluid after menopause in Korean women. Microbiol Biotechnol. 2021;31(1).
Wilbur DC, Nayar R. Bethesda 2014: improving on a paradigm shift. Cytopathology. 2015;26(6):339-42.
Solomon D, Nayar R (Eds). The Bethesda system for reporting cervical cytology. Definitions, criteria, and explanatory notes. 3rd Ed. New York: Springer; 2015.
Yakoushina TV, Medina IM, Hoda RS. "String of pearls" appearance of blue blobs in postmenopausal atrophy on ThinPrep Pap test. Diagn Cytopathol. 2009;37(10): 738-9.
Crothers BA, Booth CN, Darragh TM, Means MM, Souers RJ, Thomas N, Moriarty AT. Atrophic vaginitis: concordance and interpretation of slides in the College of American Pathologists Cervicovaginal Interlaboratory Comparison Program in Gynecologic Cytopathology. Arch Pathol Lab Med. 2012;136(11): 1332-8.
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