{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:04:29Z","timestamp":1778155469522,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,11,5]],"date-time":"2014-11-05T00:00:00Z","timestamp":1415145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the effectiveness of vaginal estrogen cream to improve the rate of satisfactory colposcopy and subsequent smear result in patients in a hypoestrogenic state and an abnormal Papanicolaou smear. To delineate between abnormal smears secondary to atrophy and inflammation from preneoplastic change and suggest an effective treatment strategy to deal with this challenging situation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with abnormal cervicovaginal smears who were in a low estrogen state (postmenopausal or amenorrheic postnatal) undergoing colposcopy were identified. All patients had an unsatisfactory colposcopy and were treated with vaginal estrogen cream twice per week for 6\u2009weeks and underwent repeat colposcopy, smear and targeted biopsy where required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010four patients had an abnormal smear and were clinically in a low estrogen state, with four having previously had a hysterectomy. After 6\u2009weeks of vaginal estrogen therapy, 32 out of 50 patients' colposcopic examinations were satisfactory. Also, 40 out of 54 patients' smears returned to normal after treatment. Of the 14 patients with persistent smear abnormalities, only three were diagnosed with true high\u2010grade pre\u2010invasive disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of vaginal estrogen cream for patients with smear abnormalities and a low estrogen status improves the satisfactory colposcopy rate and improves the accuracy of the prediction of true high\u2010grade pre\u2010invasive disease. This treatment may then reduce the number of patients that require definitive treatment for their screen\u2010detected abnormalities in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.12545","type":"journal-article","created":{"date-parts":[[2014,11,5]],"date-time":"2014-11-05T10:38:25Z","timestamp":1415183905000},"page":"440-444","source":"Crossref","is-referenced-by-count":18,"title":["Abnormal cervicovaginal cytology, unsatisfactory colposcopy and the use of vaginal estrogen cream: An observational study of clinical outcomes for women in low estrogen states"],"prefix":"10.1111","volume":"41","author":[{"given":"Anthony","family":"Richards","sequence":"first","affiliation":[{"name":"Sydney Gynaecology Oncology Group Sydney Cancer Centre Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Dalrymple","sequence":"additional","affiliation":[{"name":"Sydney Gynaecology Oncology Group Sydney Cancer Centre Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0339(200102)24:2<132::AID-DC1026>3.0.CO;2-N"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199707)17:1<14::AID-DC3>3.0.CO;2-P"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20475"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980825)84:4<218::AID-CNCR6>3.0.CO;2-I"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1309\/XVB01JQYQNM7MJXU"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23949"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(77)90722-0"},{"key":"e_1_2_6_9_1","first-page":"680","article-title":"Evaluation of colposcopic accuracy without endocervical curettage","volume":"63","author":"Swan RW","year":"1979","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_10_1","first-page":"131","article-title":"The \u2018unsatisfactory\u2019 colposcopic examination","volume":"28","author":"Rochelson B","year":"1983","journal-title":"J Reprod Med"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.16.2120"},{"key":"e_1_2_6_12_1","first-page":"829","article-title":"2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors","volume":"121","author":"Massad LS","year":"2013","journal-title":"J Low Genit Tract Dis"},{"key":"e_1_2_6_13_1","volume-title":"Screening to Prevent Cervical Cancer: Guidelines for the Management of Asymptomatic Women with Screen\u2010Detected Abnormalities","author":"National Health and Medical Research Council","year":"2005"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1986.tb07938.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1990.tb16248.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyp140"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000093623"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2008.05.007"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjog.12545","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjog.12545","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.12545","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T07:29:38Z","timestamp":1695540578000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.12545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,5]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1111\/jog.12545"],"URL":"https:\/\/doi.org\/10.1111\/jog.12545","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,5]]}}}