Morphologic aspects of the senescence processes in female genital system

Senescence is characterized by a gradual loss of the stem cells activity and an atrophy of all cells and tissues which lead to the deterioration of the functional activity. The senescence processes manifest also in the female genital organs, producing different morphologic alterations. For the evidentiation of these aspects we retrospectively analyze 75 cases, from menopausal and postmenopausal women, investigating the histerectomy specimens, bioptic curettages and cervico-vaginal smears. The specimens were paraffin-embeded and routinely fixed and stained with hematoxylin and eosin (H&E), and the smears were stained using Papanicolau technique. Histologic and cytologic alterations in uterus, ovaries and vagina were observed. There were seen changes of the endometrial glands and stroma, cystic atrophy. Also, it was emphasized the arteriosclerosis of myometrial arteries, with medial hypertrophy. The microscopic aspect of the atrophic endometrium is different in histerectomy specimens than in bioptic curettages. The endometrial cystic atrophy must be differentiated from glandulo-cystic hyperplasia with retrograde atrophy. The cervical squamous epithelium is atrophic, with little or no intracytoplasmic glycogen, and the endocervical glands developed small clusters called endocervical tunnel clusters. These histologic features must not be diagnosed as invasive well differentiated endocervical adenocarcinoma. It has been noticed the absence of primordial and maturing ovarian follicles, the absence of the luteal body (corpus luteum) and atretic follicles and the persistence of corpora albicantia, especially in medulla. In ovarian stroma, different proliferation degrees of the cortical and medular stromal cells were seen, with occasional luteinised stromal cells and cortical cysts. The cervico-vaginal smears presented atrophic features. The described cyto-morphologic aspects are due to insufficient estrogenic stimulation, as a consequence of the lack of ovarian hormone production