Hormonal effects of Depo-Provera in cervical smears

The Effect of Progesterone Only Contraception on the Accuracy of Cervical Cytologic interpretation

“…7,17 Cellular characteristics which have been associated with the effect of progesterone exposure include curling or crowding of squamous cells, destruction of cells, and unusual morphology to cells (navicular or classically called "boat shaped"). 16 This cellular phenomenon caused by progesterone has the potential to affect the cytological interpretation of the cells. Progesterone is thought to promote atrophy of the epithelial cells as well as to decrease the cellular maturation pattern.…”

“…Exogenous hormones affect cervical cellular characteristics. [15][16][17] Exogenous hormones include all hormones to which a woman is exposed to in addition to what she produces endogenously. 1,18 Exposure to exogenous hormones may occur in the course of a woman taking either contraception or hormone replacement therapy.…”

“…Cellular effects related to exogenous progesterone exposure include crowding of cells, curling of cells, and the presence of navicular cells (glycogen filled squamous cells with thickened borders). 16 These cellular alterations may lead to difficulty with cytologic interpretation, though little research has been conducted on the issue. [15][16][17] Progesterone only contraceptive methods are used by as many as 19% of women in the United States.…”

“…16 These cellular alterations may lead to difficulty with cytologic interpretation, though little research has been conducted on the issue. [15][16][17] Progesterone only contraceptive methods are used by as many as 19% of women in the United States. 19,20 This means that these women may potentially be affected by any phenomenon which exists between progesterone exposure and variation in cytologic interpretation.…”

“…Some studies demonstrate a greater number of false negative, 21 and some a greater number of false positive cervical changes. 16 Further research is needed to determine the relationship between cytology and histology in women using progesterone contraception and whether that relationship differs from women not using progesterone contraception. Interpretation rates will be affected if there is a difference in the relationship between cytology and histology results in women using progesterone contraception.…”