'Eosinophillic index' of the lateral vaginal wall cells indicates...
Basic: Estrogen Promotes, Progesterone inhibits Squamous cell maturation EOSINOPHILIC INDEX (EI) Ratio of eosinophillic cells to basophillic cells. This is given in a ratio. Parabasal cells not counted. (Students should not confuse that squamous cells sampled from the lateral vaginal wall is same as taking a paps smear from the cervix) This is Indicated for : Assessment of ovarian function. During pubey & reproductive, menopausal & post menopausal years Assesment of ovarian function in menstrual disorders Can also be used for diagnosing ovulation. Maturation Index (MI) The vaginal epithelium has Basal, Parabasal, Intermediate and Superficial cells. 100 exfoliated cells are counted and the MI is defined as ratio of parabasal to intermediate to superficial cells of vaginal epithelium. These cells are as presented as a 3 pa ratio with the Para basal cells staed 1st , intermediate cells 2nd & superficial cells 3rd. For eg: MI = 80 /20 / 0 Indicates :80 % - Parabasal cells 20 % - Intermediate cells 0 % - Superficial cells Increase in estrogen level enlarges the parabasal cells to become intermediate cells and then this will continue to enlarge & mature into keratinized superficial cells. The superficial cells are most abundant during proliferating phase. These cells are polygonal with abundant eosinophilic cytoplasm. There will be more deposition of glycogen in the vaginal epithelium. High estrogenic effect in a vaginal smear is recognized by a clean background & increased eosinophilic & karyopyknotic indices High progesterone levels promotes proliferation of intermediate squamous epithelium. These cells are polygonal in shape -with abundant bluish cytoplasm & seen during secretory phase. Parabasal cells are Immature squamous cell which are round to oval. Nucleus is relatively large. Hence, in a lateral vaginal wall smear, if the cells show... Shift to left - atrophic effect. Shift to right - Increased estrogen effect. More mid-zone cells - Progesterone effect
Effect of LH
Estrogenic effect
Progesterone effect
Prolactin effect
Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception