Cervical ectopy and the transformation zone measured by computerized planimetry in adolescents.
OBJECTIVE
To determine whether cervical ectopy and the transformation (T) zone were larger in adolescents using oral contraceptives (OCs) compared to depot medroxyprogesterone acetate (DMPA).


METHODS
Cervical photographs were taken on 91 adolescents in Baltimore, Maryland. Ectopy and T zone size were measured using computerized planimetry. Patients provided reproductive and sexual history. Correlates of ectopy and T zone size were identified by proportional odds and linear regression models, respectively.


RESULTS
Twenty-five women had no ectopy. Parity was independently associated with greater ectopy (OR 3.9, 95% CI 1.37-11.11). Predictors of smaller ectopy were douching (OR 0.23, 95% CI 0.09-0.65), and shorter sexual history (OR 0.20, 95% CI 0.05-0.74). Neither OC or DMPA were associated with ectopy. Predictors of greater T zone size were years since menarche (13.8 mm2/year, P = 0.003) and OCs (54.7 mm2, P = 0.05). DMPA predicted a smaller T zone (-67.0 mm2, P = 0.01).


CONCLUSIONS
Computerized planimetry provides standardized measurements. Douching and sexual activity may decrease ectopy through increased squamous metaplasia. Hormonal contraceptives were not associated with ectopy in adolescents. However, long-term progestin use may decrease T zone size.
Jacobson
D L
DL
Department of Epidemiology, The Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA.
Peralta
L
L
Farmer
M
M
Graham
N M
NM
Wright
T C
TC
Zenilman
J
J
D000293:Adolescent; D000704:Analysis of Variance; D002584:Cervix Uteri / Q000033:anatomy & histology / Q000187:drug effects*; D003271:Contraceptive Agents, Female / Q000494:pharmacology*; D003276:Contraceptives, Oral / Q000494:pharmacology*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D016015:Logistic Models; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology*; D007507:Therapeutic Irrigation
D003271:Contraceptive Agents, Female; D003276:Contraceptives, Oral; D017258:Medroxyprogesterone Acetate