Evaluation of the impact of developing and maintaining hormone therapy on the cervix uteri of adolescent girls with primary estrogen deficiency

Objective. To evaluate the colposcopic, cytological, and immunocytochemical features of the cervix uteri in adolescent girls who have had no sexual intercourses, have primary estrogen def iciency, and have therapeutically taken a drug containing 17-ß-estradiol and dydrogesterone in the time-sequential mode. Subjects and methods. A comprehensive survey was conducted among 48 sexually inactive adolescent girls aged 15-18 years. Among them, 24 adolescents had primary estrogen deficiency, who were therapeutically given a two-phase estrogen-gestagen drug for developing and maintaining hormone therapy (DMHT) and 24 more healthy girls who formed a control group for colposcopy and cytology. Before and within 9 months of treatment, the cervix uteri was evaluated by the results of extended colposcopy, cytological and immunocytochemical examinations of impression smears from the exo- and endocervix. The expression of estrogen receptor-a (ER-a), progesterone receptor A and B, epidermal growth factor, Ki-67, TNF-a, and Cas (LabVision, R&D Systems, and Novocastra Lab Ltd.) was targetedly analyzed. Results. The use of 17ß-estradiol as part of 9-month DMHT contributes to a three-fold increase in the expression of ER-a and in the moderate activation of proliferation processes with unchanged apoptosis, which manifests itself as restoration of maturity of the cervical and vaginal epithelium and as normalization of vaginal microbiocenosis. Conclusion. The found changes suggest that the combination drug containing 17ß-estradiol and dydrogesterone has a positive effect on the vaginal epithelium and cervix uteri in adolescent girls with primary estrogen deficiency

adolescent girls, cervix uteri, primary estrogen deficiency, developing and maintaining hormone therapy