Colposcopic picture and cytopathological changes in oral contraceptive pill users

Abstract EN

This study was done at Al-Hussein University Hospital.

Sixty women using low dose oral contraceptives for different periods (1-5, 5-10 and > 10 years), twenty women who used the pills for more than one year then discontinued it for no less than 6 months and twenty controls who did not use the pills were investigated cytologically and colposcopically.

Histopathology was done for selected cases who have atypical smear or suspicious colposopy.

It was found that pill use for different periods was associated with significantly increased incidence of inflammatory smears (45%, 50% and 56% in pill users and 15% in controls) while it was 35% in those who discontinued pill intake.

However, there was no increase in the risk of specific infections (monilia or trichomonas).

In all cases there was no atypical smears.

The cytohormonal pattern of smears was progestational (intermediate cells) in pill users and estrogenic (superficial cells) during the proliferative phase in controls and in those who discontinued the pills.

Colposcopically, there was a significantly increased incidence of cervical ectopy among pill users than controls and than those who discontinued the pills (P<0.01), but there was no difference in the incidence of unsatisfactory or abnormal transformation zone.

Only 2 cases using the pills for more than 10 years showed abnormal transformation zone in the form of fine punctations.

Their histopathology revealed chronic cervicitis without any suspicion of malignancy.

In conclusion, pill use is not associated with a higher risk of premalignant changes in the vagina or cervix.

It is only associated with a higher incidence of inflammation and ectopy which could be related to the progestagen content