This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Reproductive physiology and hormones in females, Subject name: Gynaecology & Obstetrics
The maturation index on vaginal cytology is a diagnostic method for evaluating : 
Select and explain. 
A. Adequacy of cytotoxic drug therapy, B. Gender of an anatomically abnormal child, C. Malignant change at squamocolumnar junction of cervix, D. Endocrine status of vagina
D: Endocrine status of vagina
Answer: D: Endocrine status of vagina 
Explanation: Maturation index of Vaginal cellsIt is a ratio of vaginal cellsThree major cell typesBasal and Parabasal cells: Least mature cells; Not influenced by hormonesIntermediate cells: Progesterone influences the maturation Superficial cells: Most matured cells; Estrogen affects the maturity Cell counts are expressed as a percentage; Basal/Intermediate/SuperficialUsed for hormonal evaluationPredominance of parabasal cells indicates absence of estrogen stimulationPredominance of Superfical cells indicates estrogen presenceMaturation index examplesMenstrual cycleProliferative phase: 0/40/60Secretory phase: 0/70/30Pregnancy: 0/90/10Menopause: 100/0/0Ref: D.C. Dutta&;s Textbook of Gynaecology, 6th edition, page no: 58