Pietro Motta's latest studies on the microanatomy of menopause: Revised concepts on the beauty of aging

Menopause signs a hallmark in women's life. When compared to traditional two-dimensional techniques, scanning electron microscopy (SEM) allows to discover the impressive microcosm of the human body and offers original views of the real three-dimensional ultrastructure of reproduction. On the basis of Prof. Motta's last and original book, herein we show a selection of microscopic images that characterize the 3D changes taking place on the surface epithelia of the aging woman's reproductive tract. Biopsies of ovaries, tubes, uteruses, cervices and vaginas were obtained from women (45-72 years old) during surgical or endoscopical procedures and after the informed consent of the patients. Samples were processed for SEM as reported elsewhere. Reproductive aging is associated to epithelial flatness, higher stromal density, absence of ovarian follicles, thickening of vascular walls and lack of glandular secretion. The uterus and the tube show a morphodynamic sequence of gradual microvilli shortening, patchy to complete deciliation and formation of microplicae like structures. The formation of microplicae like structures is interpreted as an adaptive mechanical response of the genital epithelia to the new microenvironment. We can propose that these structures may represent the initial stage of a physiologic metaplasia. In conclusion, imaging of menopause through the use of SEM allows a better understanding of the morphological and physiopathological bases of female aging and represents a perfect blend of art and aesthetics: a further confirmation of the endless beauty of our inner microscopic anatomy.