The glycogen index in the menopause: A study of certain estrogen functions based on a new method of staining vaginal smears

Abstract

The iodine vapor method of staining vaginal smears is presented as a rapid and simple means for determining the specific glycogen response to estrogen activity in the human subject. This method of clinical investigation is based upon observations that normal vaginal glycogen content parallels estrogen sufficiency, whereas diminution of glycogen (glycopenia) is indicative of estrogen deficiency.To determine the incidence of glycogen poverty in postmenopausal women, vaginal smears from 130 climacteric women (after staining by the iodine vapor procedure) were graded according to glycogen content. The incidence of the four glycogen grades was calculated according to age, duration of the menopause, and the nature of the climacteric, whether spontaneous or artificially induced. The significance of the findings, in terms of other reports of postmenopausal estrogen elaboration, is discussed. The possible “anti-hormonal” effects of various systemic and local disorders (febrile states and vaginitis) upon estrogenic activity, are suggested by observations in tuberculous women.Experience to date has established the usefulness of the glycogen index in estimating therapeutic response of estrogen therapy in juvenile gonorrheal and senile atrophic vaginitis. Evidence of its further value as a simple and sensitive indicator of estrogen activity in human subjects is presented in potency determinations of several commercial products.