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  • 1.
    Johannesson, Ulrika
    et al.
    Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
    Blomgren, Bo
    AstraZeneca, Södertälje, Sweden.
    Hilliges, Marita
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine.
    Rylander, Eva
    Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
    Bohm-Starke, Nina
    Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
    The vulval vestibular mucosa - morphological effects of oral contraceptives and menstrual cycle2007In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 157, no 3, p. 487-493Article in journal (Refereed)
    Abstract [en]

    Background

    An erythematous and hypersensitive vestibular mucosa has been observed during the use of combined oral contraceptives (COC). Hormonal effects on the vestibular morphology have not been studied.

    Objectives

    Our aim was to evaluate the morphology of the vulval vestibular mucosa during the influence of COC and during the menstrual cycle.

    Methods

    Forty-five healthy women (20 using COC and 25 not using COC) were included. A 6-mm punch biopsy was obtained from the right posterior vestibule on days 7-11 of the menstrual cycle. A corresponding biopsy was taken 2 weeks later in 16 women without COC. The epithelial morphology was estimated by measuring interdermal papilla distance, dermal papilla to surface, from basal layer to surface and width of dermal papillae. A histopathological assessment was made.

    Results

    The vulval vestibular mucosa of women using COC displayed a larger distance between the dermal papillae (P = 0·04) and a larger space from the dermal papillae to the epithelial surface (P = 0·03) compared with controls in the follicular phase. Women without COC displayed a larger interdermal papilla distance in the luteal phase compared with the follicular phase, P = 0·02. Histopathology showed more superficial blood vessels in the COC users (P < 0·01).

    Conclusions

    The vulval vestibular mucosa of women with COC display an altered morphological pattern with shallow and sparse dermal papillae compared with the follicular phase. Similar findings are seen in women without COC during the luteal phase which indicate a gestagenic effect on the mucosa. Associations between the morphological pattern and changes in mucosal mechanical sensitivity require further studies.

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