Lactation Period in Indian Women: Duration of Amenorrhea and Vaginal and Cervical Cytology

Abstract

An investigation was undertaken to determine the time of the reappearance of menstruation in lactating women in India and the vaginal and cervical cytology during the lactation period. 272 lactating women seen as patients in a birth control clinic in Bombay made up the study sample. 15% of the women nursing babies 1-4 months old were menstruating as were 33% of those nursing infants between 5-8 months 57% of those nursing babies 9-12 months old 55% of those nursing babies 13-18 months old and 81% of those nursing babies older than 18 months. Only 1/3 of the women menstruated by the end of 8 months and just over 1/2 of them by the time the child was 1 year old. The lactation amenorrhea was longer in Indian women than that reported in women in the U.S. and Europe. Vaginal smears were taken in the postpartum period and compared with smears taken from the exocervix. From the smears it was determined that the cervical mucosa reacts less sensitively to hormone stimulation than the vaginal epithelium. Since the vaginal mucosa is more sensitive to the ovarian hormones than the endometrium and the exocervix is less sensitive than the vagina it would seem that the cervical smear would give a better indication of the functional state of the endometrium in the lactation period.