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Characteristics of nasal epithelial cells in naturally postmenopausal women receiving hormone therapy with 1 mg 17β-estradiol and 2 mg drospirenone: a prospective study

Caruso, Salvatore MD1,2; Serra, Agostino MD3; Grillo, Calogero MD3; Maiolino, Luigi MD3; Agnello, Carmela MD2; Di Mari, Lucia MD1,2; Cianci, Antonio MD1

doi: 10.1097/gme.0b013e3181612271

Objective: To investigate the effects of drospirenone on nasal respiratory epithelium in postmenopausal women who are treated with hormone therapy (HT).

Design: Thirty-five naturally postmenopausal women participated in the prospective study. Women received continuous-combined HT containing 1 mg 17β-estradiol and 2 mg drospirenone. Cytological changes of nasal middle and inferior turbinate respiratory epithelium were evaluated by using the maturation index, performed at baseline and on the sixth cycle of HT.

Results: Hematoxylin-eosin staining for the maturation index of the epithelial nasal cells of women reached better trophic aspects during 17β-estradiol/drospirenone intake with respect to those observed at baseline (P < 0.001). The smears during HT emphasized the superficial and the intermediate types of cells, with a ratio index greater than 2. The parabasal cell content was less than 20%, and the karyopyknotic index showed degenerative changes in superficial and intermediate cells.

Conclusions: Our study confirmed that the nasal respiratory epithelium is an ovarian steroid target. Drospirenone acts on nasal cells similarly to other progestogens.

Hormone therapy containing drospirenone may produce changes in nasal respiratory epithelium of postmenopausal women, improving the cellular maturation index.

From the 1Department of Microbiological and Gynecological Science, 2Research Group for Sexology, and 3Clinic of Otorhinolaryngology, University of Catania, Catania, Italy.

Received August 27, 2007; revised and accepted November 5, 2007.

Financial disclosure: None reported.

Address correspondence to: Salvatore Caruso, MD, Ospedale S. Bambino, Via Torre del Vescovo, 95124 Catania, Italy. E-mail:

©2008The North American Menopause Society