Semmens J P, Tsai C C, Semmens E C, Loadholt C B
Obstet Gynecol. 1985 Jul;66(1):15-8.
Vaginal physiology was evaluated in 23 postmenopausal women before estrogen replacement therapy and at 1, 3, 6, 12, 18, and 24 months while receiving conjugated equine estrogens (Premarin). Reversal of hormonal levels (17 beta-estradiol, gonadotropins) and vaginal cytology occurred within one month. Vaginal pH levels significantly decreased from a baseline mean of 5.2 to a level of 4.2 at 24 months (P less than .05). Women who were sexually active showed a greater decline in pH levels than did women who were sexually inactive. Maximum increases in amount of vaginal fluid and potassium levels were observed after three months of therapy. Vaginal blood flow and vaginal electropotential difference were significantly increased over baseline values at one month and again at 12 months (P less than .05) with a slow progressive improvement continuing throughout 24 months of estrogen replacement therapy. This study provides documented laboratory evidence to suggest that restoration of vaginal tissue function requires 18 to 24 months and explains why dyspareunia may persist in the early months of replacement therapy despite hormonal and cytologic return to premenopausal values.
对23名绝经后女性在接受结合马雌激素（倍美力）进行雌激素替代治疗前以及治疗1、3、6、12、18和24个月时的阴道生理状况进行了评估。激素水平（17β - 雌二醇、促性腺激素）和阴道细胞学在1个月内发生了逆转。阴道pH值从基线平均值5.2显著下降至24个月时的4.2（P < 0.05）。有性生活的女性pH值下降幅度大于无性生活的女性。治疗3个月后观察到阴道液量和钾水平的最大增加。阴道血流量和阴道电位差在1个月时显著高于基线值，在12个月时再次显著升高（P < 0.05），在整个24个月的雌激素替代治疗过程中持续缓慢进展性改善。本研究提供了有记录的实验室证据，表明阴道组织功能的恢复需要18至24个月，并解释了为什么尽管激素和细胞学指标恢复到绝经前水平，但性交困难在替代治疗的最初几个月仍可能持续存在。
