Studies on the mucosa of postmenopausal oviducts: Surface appearance, ciliary activity, and the effect of estrogen treatment

Abstract

The epithelial lining of the human oviduct is known to be responsive to the fluctuating hormonal levels of the normal menstrual cycle, but its response to the changes in hormonal climate at the time of the menopause is not clearly defined. In this study the oviducts of nine postmenopausal patients were obtained at the time of abdominal hysterectomy, and the lining epithelium was studied by scanning electron microscopy. The activity of cilia on the fresh tissue was assessed by their ability to transport particulate matter applied to the epithelial surface. The fimbriae of oviducts from women who had received little or no estrogen treatment before surgery showed a significant deciliation of the epithelium, compared with specimens from premenopausal patients, and even showed some sloughing of cells from the surface. The secretory cells appeared inactive. However, the specimens from patients who had been treated with estrogen for periods of 1 year or more showed a remarkable maintenance of the epithelium, with the proportion of ciliated cells remaining almost as high as in premenopausal oviducts, even as late as 25 years after the menopause. The ampullar and isthmic portions showed less obvious changes. Cilia in oviducts from the former group (short-term or no treatment) were incapable of transporting 15-mum microspheres or lycopodium spores applied to the epithelial surface, whereas the oviductal cilia obtained from patients under long-term estrogen therapy showed efficient transport of particulate matter. The results are discussed in relation to earlier conflicting reports on the postmenopausal oviduct.