Many women occasionally take a Pap smear or Pap test.
This is a study in which a smear test is taken from the vagina and cervix for oncocytology.
The diagnostic method is used for screening the detection of cancer, as well as precancerous conditions.
In the process of microscopic examination of the obtained clinical material specialist examines the cellular composition of the smear.
From it, he draws conclusions about whether atypical cells are present, whether there are signs of inflammation or atrophy of the genital epithelium.
Sometimes women, especially in old age, get a conclusion atrophic smear type.
What does this mean, and how dangerous is this condition?
Let’s talk about what is the atrophic type of smear in gynecology.
What is atrophy?
To understand what the atrophic type of smear means, you need to understand what the word atrophy itself means.
It is based on the word trophic, which means food.
Tissues that receive a sufficient amount of nutrients with blood develop normally.
If nutrition is not enough, they are degraded.
The prefix a in any medical term means the absence of something.
In our case, atrophy is the absence of trophism, that is, nutrition.
Blood supply of tissues in the genital area is impaired.
This leads to their degradation.
In fact, the body itself does this.
It saves its resources and reduces the blood supply of those organs that it does not use at the moment.
Most often, atrophic processes in the vagina occur in old age, when the genitals become unnecessary.
After all, their main purpose is to conceive, bear and give birth to a child.
Most postmenopausal women are not sexually active.
Their estrogen levels are low.
Therefore, the mucous membrane of the genital organs gradually atrophies – it becomes thinner and is no longer able to fully perform its functions.
This condition is considered normal if it occurs in old age, and does not require treatment.
With the exception of situations when a woman experiences discomfort due to atrophic processes, or they cause recurring inflammatory diseases of the vagina and cervix.
Atrophic smear type – what does it mean?
If you have taken a smear test for oncocytology, the atrophic type of smear may be indicated in the report.
Talk about what this means.
The mucous membrane of the genital tract consists of various cells.
They all have different degrees of maturity.
That is, one type of cells gradually turns into another.
All cells are divided into four types:
- superficial – large in size, with a small core, located separately, are determined in large numbers in the middle of the menstrual cycle;
- the intermediate ones are slightly smaller, have a large round core, are located mainly in layers;
- parabasal – small round cells with a large nucleus, normally found only during menstruation, and even then in a small amount (an increase in their number indicates atrophy);
- basal – even less parabasal, the nucleus occupies a third of the cytoplasm, appears only after menopause, and also after childbirth.
The superficial are located at the very top, while the basal ones are located deep in the mucosa.
Superficial have the greatest degree of maturity, and basal – the smallest.
Thus, if a large number of mature cells get into the smear, this means that they develop normally and trophic tissues are preserved.
If there are many immature cells in the smear, this indicates atrophic processes.
Atrophy is a relative concept, not an absolute one.
That is, it does not refer to those processes that are either there or not.
There is no clear boundary between the normal and intermediate type of smear, intermediate and atrophic.
These changes occur gradually.
There are more and more immature cells, and fewer mature ones.
The more pronounced atrophy, the more in the epithelium of the cervix contains parabasal cells.
As atrophy develops, the size of the nuclei in them also increases.
Causes of atrophic cervical smear
If you have an atrophic type of cytology smear, the reasons for this may be different.
The main ones are:
- age extinction of the reproductive function;
- an atrophic type of smear after delivery is often observed;
- estrogen deficiency at a young age;
- chronic inflammatory processes (colpitis).
Women of reproductive age may also have an atrophic type of smear.
This happens when:
- ovarian dysfunction;
- dysregulation of ovarian function with a decrease in estrogen production (this results from the pathology of other endocrine glands, for example, the hypothalamo-pituitary system).
Possible atrophic type of smear after removal of the uterus with appendages, for example, in the case of malignant tumors.
Ovaries may also be damaged during radiation therapy.
Young women sometimes develop emaciated ovary syndrome, which is characterized by anovulation and hypoestrogenemia.
Possible resistant ovarian syndrome, due to a violation of their receptor apparatus.
In this case, their full-fledged work is impossible due to the fact that the ovaries do not perceive the signals coming from other endocrine glands.
That is, they do not respond to changes in the level of other hormones that should stimulate the formation of estrogen.
Cytogram corresponds to the age, atrophic type of smear
With age, the atrophic type of cytology smear becomes the norm.
In menopause, the level of estrogen decreases.
This inevitably leads to a deterioration of the trophic genitals.
Atrophic processes gradually occur if the woman does not receive replacement therapy.
They progress over the years.
In this case, it is not so much age that is important, but the number of years that have passed since the menopause.
Menopause is the date of the last menstruation.
It is determined retrospectively (that is, in the past).
Because during menstrual bleeding a woman cannot know that they are the last.
But if 12 months have passed since the last menstrual period, it means that there will be no more.
Then the woman remembers when she had the last menstruation, and this date is considered the date of menopause.
5 years after the cessation of menstruation, an atrophic type of smear is already detected.
Age changes are still poorly pronounced.
In a smear, about 50% of intermediate cells are usually observed.
This is an atrophic type of uterine smear, but atrophy is still mild.
About deep atrophy says the appearance of parabasal cells.
Before the climacteric period, normally they should not be in a smear at all.
Even 5 years after menopause, only 17% of women are present.
Their presence indicates a pronounced atrophic processes with a sharp lack of estrogen.