Laryngeal cytological aspects in women with surgically induced menopause who were treated with transdermal estrogen replacement therapy

Objective: To investigate the effects of estrogen replacement therapy (ERT) on laryngeal cytology in postmenopausal women. Design: Prospective open clinical trial. Setting: Outpatient menopausal clinic in the Department of Gynecology, University of Catania, Catania, Italy. Patient(s): Eighty-four healthy, surgically postmenopausal women, of whom 48 were treated with ERT and 36 were considered as a control group. Intervention(s): Transdermal E-2 treatment by patches or gel, evaluation of laryngeal cytology with cytobrush by indirect laryngoscopy, and questionnaire for the voice history. Main Outcome Measure(s): Changes in cytologic aspects of laryngeal cells with respect to vaginal cytology by hematoxylin and eosin staining; subjective voice changes. Result(s): Sixty-seven women completed the study. Ten women from the ERT group and five from the control group dropped out because of the invasive laryngoscope method; two subjects in the control group were excluded because of pathologies of the vocal cord. Hematoxylin and eosin staining confirmed similar superficial-intermediate aspects of the cells between the laryngeal and the vaginal smears in ERT-treated women. In the control group, both smears showed aspects of atrophy-dystrophy. The ERT group had a subjectively better quality of voice than the control group. Conclusion(s): Our study confirms that the larynx is an estrogen target, as are vaginal cells. ERT may provide prevention and treatment of dystrophic pathologies of the vocal cords in postmenopausal women. (Fertil Steril(R) 2000;74:1073-79. (C) 2000 by American Society for Reproductive Medicine).