Cervical dysplasia in the postmenopausal female: diagnosis and treatment.

Thirty-two postmenopausal women, age 50 years or older, were colposcoped for abnormal Papanicolaou (PAP) smears. Sixteen had mild to moderate dysplasia, six severe dysplasia and the remainder had no dysplasia. Treatment included observation, topical estrogen, cryotherapy, conization or hysterectomy. Based upon our observations, satisfactory colposcopy can be performed in the majority of postmenopausal women. Oral or topical estrogen is a valuable adjunct in the initial evaluation and treatment of abnormal PAP smears in postmenopausal women. Criteria for adequate colposcopy in postmenopausal women are discussed and a management scheme is proposed.

Human granulosa-luteal cell response to vinblastine exposure in vitro.

We examined the response of isolated human granulosa-luteal cells (HGLCs) to a cancer chemotherapeutic agent, vinblastine (VLB), that has been implicated in ovarian failure during treatment for Hodgkin's disease. VLB doses of 1.0 micrograms/mL for 4 h or 0.1 micrograms/mL for 24 h reduced HGLC progesterone production during exposure. The effect of high doses (10.0 and 100.0 micrograms/mL) persisted for at least 1 day after exposure. Previous 24 h, but not 4 h, high-dose VLB exposure reduced subsequent progesterone release in response to 10 IU of human chorionic gonadotropin (hCG). Without hCG stimulation, only cells previously exposed to 100.0 micrograms/mL had persistently reduced progesterone release. We conclude that HGLCs can completely recover from a short exposure to VLB, but longer exposures to 10.0 and 100.0 micrograms/mL are detrimental to their hormone secreting capacity.

Vinblastine reduces progesterone and prostaglandin E production by rat granulosa cells in vitro.

To elucidate the possible mechanism(s) of vinblastine-induced premature ovarian failure, we studied the effect of vinblastine (VLB) on progesterone (P) and prostaglandin E (PGE) production by rat granulosa cells in vitro. Granulosa cells obtained from immature, pregnant mares' serum gonadotrophin-primed rats were incubated for 5 h in modified Medium 199 +/- LH (10 ng/mL) with varying concentrations of VLB (0.001 to 10.0 micrograms/mL) and cells plus media were assayed for total P and PGE. VLB reduced production of both basal and LH-stimulated P in granulosa cells, with VLB at a concentration of 0.1 micrograms/mL showing the first significant difference from control. This dose also suppressed basal and LH-stimulated PGE. Granulosa cell survival was similar for all groups. Thus VLB, an agent known to disrupt microtubular function, reduced granulosa cell production of both P and PGE. Our results suggest that at a concentration (0.1 micrograms/mL) lower than that routinely achieved during chemotherapy (0.3 micrograms/mL), VLB depresses rat granulosa cell function in vitro. This system appears to be a valid model for preliminary assessment of the cytotoxic effects of chemotherapy on an ovarian component.