Effect of Testosterone Propionate on Glycogen Content of Human Vaginal Smears

Abstract

Summary

A method of demonstrating simultaneously the presence of glycogen and the morphologic characteristics of the desquamated cellular elements of the vaginal mucosa is presented. The glycogen in the desquamated vaginal epithelial cells of normally menstruating women can be made to disappear by administering adequate amounts of testosterone propionate. The disappearance of the glycogen is apparently dependent upon the production of atrophic changes in the vaginal mucosa since the first effect of the testosterone propionate is the disappearance of the squamous epithelial cells and their replacement by cells from the deeper layers of the mucous membrane. Coincident with this change in the size of the cells, the glycogen begins to decrease steadily and finally vanishes completely. Restoration of the glycogen in the smears parallels closely the reappearance of the normal vaginal epithelium.

The question arises as to the mechanism of this regression in the smear and the disappearance of the glycogen. There is experimental evidence indicating that androgens negate the biologic effect of estrogens. 1-3 It is, therefore, conceivable that the testosterone propionate in the cases reported here inactivated the estrogen formed in the individual and, as a result, atrophy of the vaginal mucosa occurred with loss of cornification and consequent disappearance of glycogen. It seems likely, however, that the regressive changes induced in the smear are also the end results of inhibition of the gonadotropic hormone formation of the hypophysis resulting in suppression of the follicular ovarian cycle. That the testosterone propionate probably inhibits the hypophysis is suggested by the following observations: (a) the excessive gonadotropic hormone excretion in a human female castrate can be suppressed with testosterone propionate; 5 (b) ovulation can be similarly inhibited in monkeys; 6 (c) menstruation can be inhibited and the estrogen and progesterone effects in the endometrium of cyclical human females can be suppressed by administering adequate amounts of testosterone propionate. 7