ArticleBMC women's health2026
The effect of estrogen and its receptors on the progression of cervical intraepithelial neoplasia in postmenopausal women through synergistic interaction with HPV.
Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo observe the progression of cervical intraepithelial neoplasia (CIN) in Human papillomavirus (HPV)-positive women receiving vaginal local estrogen therapy during the postmenopausal window period versus the non-window period, and to analyze differences in CIN progression across different stages of menopause. To compare differences in estrogen receptor (ER) expression across different postmenopausal stages and during the progression of CIN. To clarify that the use of local estrogen in postmenopausal women requires careful evaluation of benefits versus risks to avoid indiscriminate medication. To provide scientific evidence for clinical decision-making regarding estrogen use at different postmenopausal stages and for the prevention and control of CIN.
methodsThe study population consisted of postmenopausal women who were HPV-positive and had a first-time colposcopy diagnosis of cervicitis or CIN1. Follow-up examinations were conducted 6 months to 2 years later, with local vaginal estrogen application prior to follow-up. Participants were divided into a “window period” group and a “non-window period” group based on the timing of menopause, and colposcopy results were recorded and compared between the two groups. Additionally, normal cervical epithelial tissue samples were independently collected from both time periods. Cervical tissue samples from cases of cervicitis, CIN1, CIN2, and CIN3 were collected and categorized into cervicitis/CIN1 and CIN2/CIN3 groups. All specimens underwent ER immunohistochemistry, and differences in ER expression were compared across groups.
resultsThe window-period group included 44 participants, and the non-window-period group included 41 participants. Follow-up results showed that 7 patients (15.9%) in the window period group had CIN2 or higher, while 15 patients (36.6%) in the non-window period group had CIN2 or higher. Compared with the window period group, the progression rate was significantly higher in the non-window period group, with a statistically significant difference (P < 0.05). Ten cervical tissue samples were collected from each of the window period and non-window period groups, for a total of 20 samples. There were 5 cases each in the cervical inflammation, CIN1, CIN2, and CIN3 groups, totaling 20 cases. Immunohistochemical results indicated that ER levels in cervical epithelium were significantly higher in the window period group than in the non-window period group, with a statistically significant difference (P < 0.05). ER levels decreased significantly during the progression from cervical inflammation/CIN1 to CIN2/CIN3, and the difference was statistically significant (P < 0.05).
conclusionEstrogen and its receptors interact synergistically with HPV to influence CIN progression; compared to the window period, estrogen use during the non-window period may further accelerate CIN progression.
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