Published online by Cambridge University Press: 05 February 2014
William Ledger: Thank you both for excellent talks. That was fascinating. Gordon, could you just speculate on whether the cervix might be similarly affected as the uterus? Do we have any new information on that?
Gordon Smith: Cervical tissue is obviously much harder to get. It's relatively straightforward to obtain lower uterine segment at caesarean section. You can obtain cervical biopsies but it is tricky to do so.
Mandish Dhanjal: Did you look at the effect on women of the oral contraceptive pill?
Gordon Smith: We don't have that information. We only have basic information on contraception and not such that we could do an informative analysis on it. That is certainly intriguing. If we think again about the evolutionary idea, you would have gradual increases in estrogen and progesterone during pregnancy and then suppression of both during breastfeeding. It does raise a possibility that maybe something in the cyclical nature of both the ovarian cycle and combined oral contraception in stimulating the uterus, withdrawing, stimulating the uterus, withdrawing, could lead to an adverse effect. Hence, it is not clear that the combined pill would be all that different from the spontaneous ovarian cycle. The intriguing thing is that long-acting progestogens may have a pattern of stimulation that is closer to the physiological, and may have less of an effect. You can really only tell in animal studies, where you can study manipulations of the hormonal environment directly.