Chronic steroid overloadings and contraception. Importance of conjunctive changes in the corporeal human uterine mucosa

: In 1936 the author noted that the reticular fibers in the endometrium are hypertrophied during administration of high doses of estrogen. The fibers are visible by light microscopy after silver nitrate staining. Normal premenstrual endometrial biopsies show secretory glands (alcian blue positive) covering about 25% of the cut surface, with reticular threads surrounding them. In more recent studies, after 3 months of ingesting combined pills, premenstrual biopsies have small glands over only 10% of the surface, usually less than 100 mcm in diameter, which have no alcian blue positive secretion. The chorion, however, is dense with a particularly dense reticular network. It is suggested that this picture of "sclerotic" or "dystrophic" endometrium is probably responsible for amenorrhea in women who stop oral contraception.