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  • Title: [Morphofunctional features of the cervix uteri in women using hormonal contraception].
    Author: Prilepskaia VN, Kondrikov NI, Nazarova NM.
    Journal: Akush Ginekol (Mosk); 1991 Dec; (12):6-10. PubMed ID: 1789353.
    Abstract:
    The causes of precancerous and cancerous diseases of the cervix are disputed. In women with menstrual disorders usually benign cervical disease is 5 times higher. In the 1960s the theory of hormonal genesis of cervical disease was advanced as similar pathogenetic processes in the cervix, endometrium, myometrium, and breasts resulted in hyperplastic changes in these organs. Ectopia can occur during sexual maturation under the influence of sex hormones. The maximum frequency (65.5%) of ectopia occurred up to age 20. Cervical ectopia can occur under use of oral contraceptives (OCs) for 6-12 months but it vanishes after discontinuation. In a study of 17,942 women aged 18-58 increased risk of preinvasive carcinoma of the cervix was found under longterm use of OCs. Increased frequency of cervical intraepithelial neoplasm from .9/10,000 women/year to 2.2/10,000 women/year was found only under longterm (up to 8 years) of OC use. An epidemiological investigation of 47,000 women using OCs for up to 10 years concluded that there was significant increase of frequency of cervical cancer compared with nonusers. It was 4 times higher in those taking OCs for over 10 years, although longterm use reduced uterine and ovarian cancer. Adenomatous hyperplasia of the endocervix was 14 times more frequent in OC users. In a sample of 128 women, 44% of whom were OC users, 24% had microglandular hyperplasia. Under the use of the 3-phase preparation Trisiston for 6 months-1 year ectopia was diagnosed in 13.6% of women that disappeared after cessation of use. Early cancer and dysplasia disappeared in 1/3 of women taking Enovid for 6-30 months after diagnosis. OCs promote the prophylaxis against genital cancer because women taking OCs undergo gynecological and cytological examinations more often, thus precancerous changes can be diagnosed early. The optimal and the safest method of contraception has to be chosen to minimize the effect on the cervix.
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