HPV and Cervical Conization in Menopausal and Pre-Menopausal Women. What Happens after Two Years of Follow Up?

Introduction: HPV represent the most frequent sexual transmitted disease in women, with the maximum prevalence between the ages of 25-29. Studies show a reactivation of previously acquired HVP during menopause.

Methods: A retrospective study was conducted in a tertiary center with women with a conization from December 2013 to December 2014. We collected clinical data, histological analyses, treatment and follow-up variables, and compared them according to their menopausal status.

Results: 190 cases were collected, 19 of them were post-menopausal women (10%) and 171 were pre-menopausal women (90%). Among menopausal patients L- SIL was the most frequent cytology clesion (33,3%). The most common HPV in menopausal patients was the high risk (HR) genotype no 16/18 (47,4 %). Pre-menopausal patients presented similar HPV genotype: 44,4% of HR no 16/18, 16(28,7%) and 18 (2,3%). The definitive histological analysis in menopausal conizations revealed HSIL in 68,4% of thepatients and LSIL in 21,1%; 1 in situ carcinoma was diagnosed. In a menopausal group a consecutive operation was necessary in five women (33,3%).

After two years of follow-up only a menopausal woman presented an ASC-H conization. The analysis of the neutralization of the virus revealed similar results in both groups: 69,2% of menopausal women Vs. 53,6% of the pre-menopausal.

Conclusions: Menopausal women are a minority group of patients with conization. The cytologyc lesions and the prevalence of the VPH genotype is similar in menopausal women and no menopausal women. In histological analysis, premenopausal patients have more H-SIL. Results after two years of monitoring are similar in both groups.

Keywords: HPV, cervix cancer, menopausal, prevention, cervix neoplasms/epidemiology; risk factors; cervix neoplasms/prevention & control.