Cervical ectopy and the transformation zone measured by computerized planimetry in adolescents

Objective: To determine whether cervical ectopy and the transformation (T) zone were larger in adolescents using oral contraceptives (OCs) compared to depot medroxyprogesterone acetate (DMPA). Method: Cervical photographs were taken on 91 adolescents in Baltimore, Maryland. Ectopy and T zone size were measured using computerized planimetry. Patients provided reproductive and sexual history. Correlates of ectopy and T zone size were identified by proportional odds and linear regression models, respectively. Result: Twenty-five women had no ectopy. Parity was independently associated with greater ectopy (OR 3.9, 95% CI 1.37-11.11). Predictors of smaller ectopy were douching (OR 0.23, 95% CI 0.09-0.65), and shorter sexual history (OR 0.20, 95% CI 0.05-0.74). Neither OC or DMPA were associated with ectopy. Predictors of greater T zone size were years since menarche (13.8 mm(2)/year, P = 0.003) and OCs (54.7 mm(2), P = 0.05). DMPA predicted a smaller T zone (-67.0 mm(2), P = 0.01). Conclusion: Computerized planimetry provides standardized measurements. Douching and sexual activity may decrease ectopy through increased squamous metaplasia. Hormonal contraceptives were not associated with ectopy in adolescents. However, long-term progestin use may decrease T zone size. (C) 1999 International Federation of Gynecology and Obstetrics.