Cytological examinations of the uterine cervix in postmenopausal women. Is the diagnostic problem real or sham?

Scientific literature concerning cytodiagnostics of changes of the uterine cervix informs about a high rate of cytological diagnoses with false positive results in post – menopausal women. In most cases, these false diagnoses are connected with more frequent recognition of ASC in cytosmears. Conductive to these diagnoses are changes in atrophic epithelium of the uterine cervix induced by hormone deficiency and disturbances in biocenosis of the vagina which often appear after the menopause age. Opaque vaginal content, cell – cell adherence, inflammatory and degenerative changes in cells, cytolysis, presence of ”naked” cellular nuclei, cell cohesion, different sizes of cells and nuclei and hyperchromatosis of cellular nuclei – these are the causes making interpretation of cytosmears difficult. In order to avoid therapeutic dilemmas as regards diseases of the uterine cervix in post – menopausal women, clinicians should not be guided by cytological diagnoses only, instead the diagnostic procedure should include colposcopy diagnosis allows for correct qualification of changes of the uterine cervix for treatment and, first of all, distinguishing paraphisiological conditions from pathological ones.