Human Reproduction, Vol. 14, No. 8, 1974-1978,
August 1999
© 1999 European Society of Human Reproduction and Embryology
Variations in vaginal epithelial surface appearance determined by colposcopic inspection in healthy, sexually active women
1 Sydney Centre for Reproductive Health Research, Family Planning New South Wales, 328 Liverpool Road, Ashfield, NSW 2131, 2 Department of Obstetrics and Gynaecology, University of Sydney, NSW 2006, 3 Väestoliitto, Kalevankatu 16, 00100 Helsinki, Finland, 2K1, 4 Family Planning Research, Women's Hospital, University of Southern California, North Mission Road, Los Angeles, CA 90033, USA, 5 Profamilia, Apartado Postal 1053, Santo Domingo, Dominican Republic and 6 Center for Biomedical Research, The Population Council, 1230 York Avenue, New York, NY 10021, USA
A total of 107 sexually active women, aged 18–35 years, was recruited through family planning clinics in four centres in different countries. Each woman underwent two or three gentle but thorough and systematic vaginal inspections using a consistent technique with colposcopic magnification over a 4–6 month period to look for changes in vaginal and cervical appearance which might be related to sexual intercourse, tampon use, contraceptive method used, cigarette smoking or other environmental factors. Obvious changes in appearance were photographed at x10 magnification. These `appearances' or `conditions' were classified according to a modification of the recommendations of a workshop sponsored by the World Health Organization, the Population Council and the Conrad Program. Most of these alterations in the appearance of the vaginal epithelium were judged to be of such minor clinical importance that they have been termed `conditions' or `changes in appearance' rather than `lesions'. In all, 56 `conditions' or `appearances' were noted in 314 inspections, the commonest being petechiae (53.6%). Potentially significant conditions justifying the term `lesions' (three microulcerations, two ecchymoses, five abrasions and one mucosal tear; 3.5% of inspections) usually healed spontaneously and disappeared rapidly. The incidence of these conditions was highest when the inspections followed intercourse in the previous 24 h (25.2 versus 14.2%; P < 0.0008), or tampon use (32.4 versus 15.9%; P < 0.0001). These processes may be regarded as a reflection of regular minor trauma to the vaginal epithelium.
Key words: colposcopy/sexual intercourse/smoking/tampon use/vaginal epithelium
7 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, University of Sydney, NSW 2006, Australia
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