Abstract
This study attempted to establish a relationship between the dosage of ethynodiol diacetate used as an oral contraceptive and vaginal smear response. Examination of lateral vaginal wall smears showed a wide variation in response from strongly progestogenic to strongly estrogenic patterns. Changes in the smear pattern were noted when the dosage was altered. A high strength of the progestogen caused a reduction in the number of superficial cells reduction in the size of the intermediate cells and increase in clumping formation of the intermediate cells. A reduction in the pyknotic index was noted in all but 2 of 105 matched pairs of slides. Pyknotic indices showed a cyclic pattern and response corresponding to the dosage given. Doses varied from .1 mg to .5 mg of ethynodiol diacetate in several preparations and were adjusted to modify unwanted side-effects. This method provides a readily accessible clinical assessment of the patients predominant hormonal response to the dosage of the oral contraceptive and may assist in the management of the patients endocrine balance.
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