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Cervical CytologyContinuous Nine Months Oral Danazol | ||
| Al-Kindy College Medical Journal | ||
| Article 1, Volume 3, Issue 1, 2006, Pages 40-43 | ||
| Authors | ||
| Waffaa N Saieed; Inas T Al-Hamdani | ||
| Abstract | ||
| Background: Danazol is a synthetic steroid primarily used to treat endometriosis. Its effectivenessis due to reversible hypo-oestrogenic and hyper-androgenic state which leads to atrophy ofendometrial tissue. Its effect on cervical tissue has not yet been studied. Pap smear is a well knownmethod for cytomorphological evaluation of exfoliated or mechanically dislodged cervical cells. It candetect pathologic abnormalities as well as hormonal effects. An attempt to link prolonged danazoltherapy (leading to relief of symptoms of endometriosis) to changes in cervical cytology during thistherapy and trying to find a possible relationship between them was the main goal of this study.Objective: To study cervical cytological changes with continuous oral danazol useDesign: Prospective Study.Setting: Al-Elwiya Maternity Teaching Hospital and Central Health Laboratory/ Baghdad, Iraq.Methods: sixty eight cases of pelvic endometriosis with primary infertility, started oral danazolbetween Jan. 2002 and Nov. 2002, in doses of 200-800mg/day. Their ages were between 20-38y.The forty cases included in this study had the following criteria collectively:1-Cases with primary infertility and endometriosis irrespective to their age or stage of the disease.2-Normal cervical cytology prior to commencement of treatment.3-Amenorrheic and symptom free, during the period of treatment.4-Use of barrier method of contraception (condom).5-Monthly performed high vaginal swab, revealed normal flora.6-No biochemical evidence of impaired glucose metabolism.According to the American Fertility Society Score (AFSS), sixteen cases had stage II, twenty caseshad stage III, and four cases had stage IV. Non had stage I. Cervical cytology was repeated after ninemonths continuous oral danazol treatment.Results: The forty cases that fit the criteria of inclusion were divided into two groups; A & B; groupB included the 12 cases requiring equal to or less than 400mg/day oral danazol, while group Aincluded the twenty eight cases that required more than 400mg/day danazol. After the completion ofnine months treatment, group B showed cervical cytological changes of "squamous metaplasia", whilegroup A showed "androgenic" picture of cervical cytology i.e. proliferation of glycogen richintermediate cells with vesicular nuclei.Conclusion: Cervical cytology changes can be caused by continuous nine month oral danazoltherapy if we want to reach a symptom free state in patients with primary infertility and endometriosis.These changes were dose related, when the dose exceeded 400mg/day, the changes were mainlyandrogenic, while doses equal to or less than 400mg/day showed sqamous metaplasia. The changeswere irrespective to age and stage of the disease.Key Words: Danazol, cervical cytology ,endometriosis. | ||
| Keywords | ||
| Danazol; cervical sytology; endometriosis | ||
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