Regression of cervicovaginal abnormalities in DES-exposed women. A comparison of changes in sexually inactive women and the effects of the onset of sexual activity.

Sequential colpophotographs were reviewed from a group of 1,139 female progeny exposed to diethylstilbestrol (DES) in utero and who were not yet sexually active on initial examination. Forty had ectopy. For 27 the normalized yearly rate of squamous metaplasia (replacement of columnar epithelium) was 28.8 +/- 3.7% (SEM). For the 18 who became sexually active the normalized yearly rate of squamous metaplasia was 54.6 +/- 6.2%. Thus, the sexually active women demonstrated a more rapid rate of squamous metaplasia; that rate was statistically significant (T = 3.8, p less than 0.001). The cervicovaginal hood was observed to regress slowly, and no effect of sexual activity could be demonstrated. Cervical intraepithelial neoplasia 2 was found in three patients. It occurred only in those who became sexually active, and the incidence was significantly different from that in the group that remained sexually inactive. The development of a small cervical os was found in two of the sexually active women without any local therapy.