need to deal with the problem of osteoporosis. Ideally, we should identify the most vulnerable women at the menopause and reduce the physiological decline in bone mineral, without undue risk to other systems. There is interest in ultrasound screening.20 Further studies may show that measurement of ultrasonic attenuation through the os calcis, although lacking the precision of low dose radiation techniques, may be able to identify women at greatest risk of later sustaining a hip fracture.

The Ayre and the Armovical cervical spatulae were compared in a randomized trial involving 982 women of childbearing age. It was found that the Armovical spatula was slightly less effective than the Ayre spatula in obtaining adequate numbers of squamous cells. The Armovical spatula was, however, far better at providing a sample of endocervical or metaplastic cells and, as a result, yielded a substantially higher proportion of 'satisfactory' smears (54 per cent as against 39 per cent). Red blood cells were more often present in smears taken with the Armovical spatula than with the Ayre spatula, Although the data in the present study were too few to prove that the Armovical spatula is better than the Ayre spatula at detecting cellular abnormalities, it seems likely that this is so.