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Abnormal Pap Smears-Post Menopausal
Frances76114 posted:
I'm 56 and post menopausal. I had an very abnormal pap smear , a colposcopy and another pap test. The colposcopy didn't show up anything but the pap test was still very abnormal. I go back this week for a endo. biopsy and a biopsy of the inside of the cervix. The doctor thinks it is due to menopause but wanted to be sure. How often does this happen to post menopausal women? I haven't had any problems that I know of so I was very surprised and now I am very worried. If it is due to menopause, what would the next step most likely be? I have tried to find some answers but can't find very much info on this. Is there anyone out there with a similar problem? Thanks for your input. Frances
J_Harrison_Hohner responded:
Dear Frances: I can think of two specific situations where being postmenopausal can contribute to abnormal PAP smear results. 1. Low estrogen levels (ie not using hormone therapy) can prompt the cells in the vagina and on the face of the cervix to have some unusual appearances. Usually these are reported back on a PAP as atypical cells of undetermined significance. If the GYN suspects this is an issue the woman may be asked to use a vaginal estrogen cream/ring/pellet before the follow up PAP or colposcopy. 2. Abnormal cells from either the cervical canal or the lining of the uterus can "drift down" and be picked up on a PAP smear. In this instance the tie in to menopause is that one would not expect to see many endometrial (uterine lining) type cells in a non-estrogenized/postmenopausal woman. The usual procedure is to do an endometrial biopsy to check the lining of the uterus, and an endocervical canal curettage (scraping of the cervical canal) to look for abnormal cells in the lining of the canal. It sounds like your GYN is taking your PAP smear results very seriously--which is a good thing. Hopefully this is truly tied to either a too thick lining of the uterus (can happen even from being overweight) or from being so low in estrogen that the cells appear abnormal to the pathologist reading your PAP smear slides. Please write us back when you get your results and put my name in the subject line so I can find you. Yours, Jane

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