title: Cytologic findings in cervical smears in patients using intramuscular medroxyprogesterone acetate (Depo-provera) for contraception.
abstract: The purpose of the present study was to assess the findings in cervical smears associated with intramuscular depot medroxyprogesterone acetate (Depo-Provera) contraception. Seventy-four cervical smears of reproductive-age patients on Depo-Provera were reviewed for cytologic abnormalities, predominant cell type, and intermediate cell glycogenation (extensive (EGly) = navicular cells / glycogenation in 10 or more high-powered fields (hpf); moderate (MGly) = 5-10 hpf; and focal (FGly) = less than 5 hpf). A control group of 38 nonpregnant patients without hormonal therapy was reviewed. Study group patients' (SGP) age ranged from 16-44 years (average 28.1); control group patients (CGP) from 17-42 years (average 29.4). Time since last menstrual period (LMP) for the SGP was 16.9 months (range 1-96); LMP for CGP was 18.2 days (range 5-33). Four (5.4%) SGP had squamous intraepithelial lesions (SIL), four (5.4%) atypical squamous cells of undetermined significance (ASCUS), and one (1.4%) atypical repair. No CGP had SIL or ASCUS. Seventy-three (98.6%) SGP had intermediate cell (IC) predominance; one had parabasal cell predominance. Of the CGP, 28 (73.7%) had IC predominance, nine (23.7%) superficial cell (SC) predominance and one (2.6%) had near equal IC and SC. EGly was seen in 22 (29.7%) SGP; two (5.3%) in CGP (chi-square 7.53; 0.95 = 3.84). MGly was seen in 29 (39.2%) SGP; 10 (26.3%) in CG. FGly was seen in 17 (22.9%) SGP; 14 (36.8%) in CGP. No glycogenation was seen in six (8.1%) SGP; 12 (31.6%) in CGP. Time since LMP was inversely proportional to glycogenation in SGP: EGly-LMP 11.6 months; MGly-LMP 14.9 months; FGly-LMP 15.0 months; and no glycogenation-LMP 22.5 months. Glycogenation of IC appears inversely proportional to Depo-Provera effect. EGly due to recent Depo-Provera administration mimics changes associated with pregnancy.
authors.affiliation: Department of Pathology, St. John Hospital, Detroit, Michigan 48236, USA.
authors.forename: E E
authors.initials: EE
authors.lastname: Volk
authors.forename: J M
authors.initials: JM
authors.lastname: Jax
authors.forename: T J
authors.initials: TJ
authors.lastname: Kuntzman
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006003:Glycogen / Q000378:metabolism; D006801:Humans; D007273:Injections, Intramuscular; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D011230:Precancerous Conditions / Q000378:metabolism / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000473:pathology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000378:metabolism / Q000473:pathology
chemical_list: D003271:Contraceptive Agents, Female; D006003:Glycogen; D017258:Medroxyprogesterone Acetate