Occurrence of clue cells in the vaginal smears of postmenopausal women – an assessment under phase-contrast microscopy

Objective: This work was aimed at detecting the frequency of clue cells in the smears collected from postmenopausal women and establishing how easily they could be recognized under a phase-contrast microscope.
Material and methods: The examination was conducted among 1040 women aged over 50 years. The women had not menstruated for at least one year. The first group, called early postmenopausal, consisted of 660 women aged from 51 to 60 years. The second group, called late postmenopausal, was represented by 380 women aged from 61 to 83 years. Cytological smears from the uterine cervix collected at several outpatient clinics and fixed with Citofix were sent to the Department of Perinatology at the Faculty of Health Sciences of the Swiętokrzyska Academy in Kielce where they were prepared for inspection under phase-contrast microscopy. The fixed preparation was washed with 0.9% sodium chloride solution, covered with a cover glass and inspected under the microscope KFA P20 with a built-in phase-contrast device. After inspection under phase-contrast microscopy the smear was additionally fixed over a flame and stained with a Gram method. The stained smears were inspected under a regular optical microscope at magnification 100×, 400× and under immersion. The clue cells were searched for. Attention was also paid to the presence or lack of Döderlein bacilli (Lactobacillus vaginalis), multinuclear neutrophilic granulocytes and the presence of epithelial cell types.
Conclusions: Clue cells are present in women’s vaginal smears at any period after a menopause. The clue cells can easily be recognized in vaginal smears inspected under the phase-contrast microscope.