Characteristics of vaginal smears during anovulatory (single-phase) menstrual cycle
Before reading we encourage you to read: "The criteria for assessing the state of the vagina"
Anovulatory, or alyutealny, menstrual cycle (without ovulation and formation of the corpus luteum) may not differ clinically from normal, except, proceeding with shortening or lengthening of the cycle, as well as the decrease or increase in blood loss. Most often anovulatory cycles occur in the period of menstruation, during menopause and during breast-feeding (in 50 % nursing mothers). Sometimes anovulatory cycles alternate with ovulyator- governmental.
Anovulatory cycles may be due to a violation of the regulation gipotalamogipofizarnoy or ovarian failure. In cases of central origin anovulatory cycles marked insufficient supply of blood to lutropin (anterior pituitary luteinizing hormone), when ovarian failure (granulosa cells are not able to respond to stimulation lutropin) lutropin levels in the blood high. Production of estrogen during anovulatory cycles can be either low, and high, but in both cases it is monotonic, without peaks, characteristic of normal menstrual cycles.
Hyperestrogenia type
It is characterized by a high degree of proliferation of the vaginal epithelium in the second half of the menstrual cycle (P-4, II-5). The index ranges from maturing 0/40/60 to 0/0/100, ЭI and KI - from 50 to 100 %. These indicators are stored for a long time and sharply reduced for 1-2 days before menstruation.
In the absence of the luteal (progesterone) stimulation (as the corpus luteum is not functioning) Smear a light background, clear, the location of the cell separation. Anovulatory cycles occur hyperestrogenia type of infertility, hormone producing tumors of the ovary, dysfunctional uterine bleeding.
Gipoestrogeniya type
It features a low proliferation of the vaginal epithelium and low rates kariopiknoticheskogo and eosinophil indices throughout the cycle. Peak indexes, observed in the middle of the normal menstrual cycle, usually absent.
The sharp decline in estrogen production is accompanied by the emergence of smears the parabasal cells, as in the atrophy (A-1, A-2 or A-3), which is not the normal reproductive period. Sometimes midcycle number of superficial cells increased to 50 %, IS - up 0/50/50, and CI and EI - 20-30 %, but the maximum numbers of these indicators will never reach the level of the ovulatory peak.
As with type hyperestrogenia, luteal conversion, typical of ovulatory menstrual cycles, no. Before the onset of menses decrease in the indices is growing.
Anovulatory cycles gipoestrogeniya observed with ovarian hypofunction, infertility, gipomenstrual- Mr. syndrome, infantilism, various neuroendocrine syndromes, acute and chronic infections, beriberi and other pathological processes.
