Factors influencing vaginal cytology, pH and bacterial flora in elderly women.
OBJECTIVE
To evaluate factors influencing the vaginal micro-environment in elderly women.


METHODS
Vaginal pH, cytology (Karyopyknotic index, KPI) and bacterial cultures were assessed in 350 women (age 72.2 +/- 1.4 years, range 65-84 years) who were not taking estrogens.


RESULTS
Vaginal pH was 6.5 +/- 0.1, KPI was 3.0 +/- 0.9% and bacteria of fecal type dominated. However, in some women the vaginal micro-environment resembled that of fertile women, with a predominance of lactobacilli (n = 68), low pH (n = 41) and an increased maturation index (n = 57). KPI was higher (p < 0.001) in women weighing > or = 85 kg, or with a body mass > or = 9th decentile or with a diastolic blood pressure > or = 100 mmHg and in women (p < 0.05) with a high menopausal age (> or = 53 years). Vaginal pH was lower (p < 0.001), KPI was higher (p < 0.01) and there was an increased (p < 0.05) presence of lactobacilli in smokers compared to non-smokers.


CONCLUSIONS
The latter finding is somewhat paradoxical as cigarette smoking has previously been shown to negatively influence estrogen metabolism. The influence of cigarette smoking on the vaginal micro-environment may be a direct local effect of nicotine.
Milsom
I
I
Department of Obstetrics & Gynecology, University of Göteborg, Sweden.
Arvidsson
L
L
Ekelund
P
P
Molander
U
U
Eriksson
O
O
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001835:Body Weight; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007778:Lactobacillus / Q000302:isolation & purification*; D008593:Menopause; D012044:Regression Analysis; D012907:Smoking; D014621:Vagina / Q000166:cytology / Q000378:metabolism / Q000382:microbiology; D014626:Vaginal Smears