| The average number of mature crypts in
the cervix is 600-800. They are more abundant in
adolescence, about 1000, than in premenopause, when there
are about 500. The crypts do not live indefinitely,
usually only 3 years, at the most 10-15 years; they then
degenerate and new ones are formed. During adolescence
there occur many thousands of immature crypts, in
addition to about 1000 mature ones. Some crypts normally
disappear by cell apoptosis (programmed cell death) and
are progressively replaced by new crypts as the result of
crypt maturation. There is a continuous process of cell
desquamation and cell apoptosis with replacement of cells
in crypts of the different types. So the cervix is a very
dynamic organ. Bleeding
from the crypts may occur premenstrually usually between
1 and 8 days before the onset of menstruation,
predominantly in women who have borne children and are
older than the age of 30 years. These crypts have a
specific star-like vessel arrangement which can be seen
with the colposcope.
The symbol P2 refers to crystal
symmetry which is usually evident. The P6 mucus has
mucolytic activity which may not always be seen. The
possible immune properties of the P6 mucus sub-types are
presently the subject of detailed investigations.
Mucus is partially broken down
by one of several mucolytic enzymes during its passage in
the vagina. The molecular basis for linear, rectangular
or hexagonal crystal formations becomes partially or
completely destroyed. It should be noted that this
partial mucolysis is essential for the occurrence of the
sensation of wetness and slipperiness which so definitely
help define the Peak of the mucus symptom.
The early appearance of the
P-type mucus during lactation may imply some
antibacterial or antiviral protection until the G mucus
appears following the return of ovulation.
Ovarian follicles may grow to a
certain size before they become sensitive to FSH. Such
early growth of the follicles may occur, with a few
follicles developing FSH receptors even some time after
menopause, with decreasing frequency.
The study of the effects of
contraceptive pills on the cervix is a difficult task. A
considerable amount of work is required for each patient
and the time required spans many years, up to
10 years or more. Many women also want to change to
other pills or to other methods of contraception, or
perhaps now want to become pregnant. It also happens that
some pills are withdrawn from the market. To these
difficulties are added the normal age changes in the
cervix and the dynamic processes which are of constant
occurrence. After 3 and up to 15 months of contraceptive
pill use, there is a greater loss of the S crypt cells
than can be replaced.
There are comparable
difficulties in studying the capacity of the vulva to
perceive the mucus symptom. We also know that two
different types of mechano-receptors are present which
may change in response to contraceptive medication. Use
of the pill disturbs the woman's vulval sensations.
|
