Understanding the physiologic process of cervical maturation
during adolescence and young adulthood may give us insight into
the epidemiologic observation that adolescents and young adults
appear vulnerable to certain pathogens. Women ages 15–24 years
have the highest age-specific rates of reportable sexually
transmitted infections (STIs) including Chlamydia trachomatis,
Neisseria gonorrhoeae, and human papillomavirus (HPV).(1 ) This
vulnerability is often attributed to risky sexual behaviors, but
biologic factors including the epithelial topography of the
cervix during this time period may also be contributory. During
fetal development, the cervical epithelium is composed of a
single layer of Mullerian columnar cells that are partially
replaced by urogenital stratified squamous epithelium.(3 ) An
abrupt squamo-columnar junction is seen on the neonatal
ectocervix. The epithelium remains relatively quiescent until
puberty, when uncommitted basal cells of the columnar epithelium
transform into squamous cells in