The vagina is one of the main target organs of sex hormones. Its epithelium is squamous epithelium like skin, but it does not have hair follicles and does not grow hair. The vaginal epithelium is affected by estrogen and progesterone and undergoes corresponding changes, showing cyclic changes. From these changes, ovarian function can be glimpsed. Vaginal mucosal epithelial cells are also constantly renewed. After the shed epithelial cells are stained in smears, the morphology and mutual relationships of the cells, as well as the structural characteristics and subtle changes in the nucleus can be observed under a microscope to assist in clinical diagnosis.

For example, during acute inflammation, a large number of squamous epithelial cells fall off, the cell boundaries are unclear, dim and unclear, the nuclei are enlarged, and the structure is unclear. Cancer cells are mainly characterized by extremely enlarged cells and an abnormal ratio to the cytoplasm. The particles in the nucleus are thick and unevenly distributed. In some places, they are condensed into clumps. The outline of the nucleus is also uneven. The entire nucleus is deeply stained and varies in size. , easier to distinguish from non-cancer cells. Taking advantage of the changes in the sensitivity of vaginal epithelium to estrogen, and the morphology of exfoliated cells can reflect the characteristics of estrogen concentration in the body, vaginal cell smear examination has become one of the important endocrine examination methods.

It combines the daily recording of basal body temperature when you wake up in the morning, the measurement of the viscosity and amount of cervical fluid, and the crystallization status of cervical mucus smear, which can almost definitely determine when ovulation occurs or whether there is ovulation. Insufficient estrogen or progesterone. Menopausal women can use these methods to determine whether there is ovulation, or more simply, just use vaginal cell smear staining to check the changes in the amount of estrogen in the body to guide judgment and treatment. The estrogen concentration is judged from the ratio of surface, middle and bottom cells in the exfoliated cells. For example, if you count 100 cells, 60 of them are surface cells, which are in the shape of tiled polygonal blocks, thin, with small nuclei, and are stained light red or light blue; 40 are middle cells, which are spindle-shaped or boat-shaped, with sharp angles and There are vacuoles in the cytoplasm, which are rolled or wrinkled, and are stained light blue; there are no round or oval small bottom cells, which are stained dark blue.

The above changes indicate that the vaginal epithelium is moderately affected by estrogen. If the ratio of epi/middle cells is 40/60, then the effect of estrogen is mild. If the ratio is that in addition to the reduced ratio of surface and middle layer cells, there are also bottom cells, which means that the influence of estrogen is reduced. A severe depression occurs when more than 40% of the underlying cells appear. Therefore, we can make a clear diagnosis and determine the severity of the impact of estrogen through vaginal cell smears, combined with the patient's clinical symptoms and vaginal examination, and take corresponding treatment measures. During the treatment process, when the vaginal exfoliated cells are repeatedly taken to check the condition of the cervix, a special scraper is used to scrape the cells that are about to be exfoliated from the upper 1/3 of the side wall of the vagina. This will not harm any tissue or cause any complications. Any discomfort or peculiar sensations. The scraped cell smears are then stained and placed under a microscope for pathological examination. This is a very convenient, painless, cheap and valuable auxiliary diagnostic method.

Therefore, menopausal women should frequently review vaginal smears during treatment. If you have vaginal inflammation, or have used local drugs, or have had sexual intercourse on the same day or the day before, it is not advisable to perform this examination, because the above conditions will inevitably affect the smear results and lead to wrong conclusions. If the smear is too thick or cells smeared back and forth repeatedly will be curled or damaged; if the smear is not fixed in a fixative such as 95% alcohol in time, cells will also change and break. Therefore, doctors should take various factors into consideration when judging the results of the smear.

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