*It is generally accepted that estrogen stimulates cell maturation at all levels of the squamous epithelium (from basal to superficial) while progesterone stimulates cell maturation only to the intermediate level (Naib ZM, 1976).  Contraceptive hormones and hormone replacement therapy (estrogen or  progesterone alone or in combination) can further increase cell division and maturation to various levels.  Depo-Provera (a progestin-only contraceptive) may only increase proliferation of parabasal cells (see Hormone Effect Illustration). Long-term use of steroid sex hormones can shorten the resting period of cells where micronutrient reserves are replenished for proper DNA synthesis and cell division.  Thus, overly stimulated cervical and vaginal cells by steroid hormones can exhaust key micronutrients, especially folic acid and the antioxidant vitamins, resulting in cervical "cell anemia" with characteristic changes in cell morphology of cytomegaly and early dysplastic change (see folic acid deficiency illustrations).  Micronutrient deficient DNA within the nuclei of these anemic cells is made highly vulnerable to viral, carcinogen, and mutagen insertion (see HPV).   Good nutrition is of paramount importance in keeping the cells of the cervix healthy and dividing and differentiating properly, especially when under the influence of powerful steroid sex hormones.

  *A healthy flora of doderlein bacteria (lactobacillus acidophilus) is what cytologists like to see in the cervical sample background. This type of natural flora is indicative of a strong acidic defense against invaders such as candida, trich, and other opportunistic and sexually transmitted agents.  Antibiotics often destroy doderlein bacilli.  After or during treatment, the common fungi, candida, may manifest as a result.  A good B-complex vitamin with plenty of folic acid helps protect and maintain the desired acidic pH and healthy doderlein bacterial flora. Streaks of normal occurring mucous may also be seen in the background of the cell specimen.