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    difficulty performing a pap smear
    debraday1 posted:
    I had a pap smear and was told there was some blood in the way and therefore the test was inconclusive. The Dr wants me to use a vaginal hormone cream and return in two months. I have talked to friends who are also going through menopause and never had to go on hormones to have a pap smear. I am not a candidate for hormones as I lost my vision once when I tried to go on them, so I am reluctant. The Dr hurt somewhat when she did the test so I don't know if this coupled with my dryness is the cause of the blood. Do you think it prudent to ask her to be more gentle? Is it possible to perform the test without being rough and if so, will she be able to get a proper sample this way?
    Mary Jane Minkin, MD responded:
    Dear Debraday1,
    Most important question: are you uncomfortable with dryness? If you are, then you should use something -if Replens works, that's great-you can buy that over the counter, and works well for many women. If it doesn't relieve your dryness, you certainly can use vaginal estrogens; the amount absorbed is minuscule, so should not pose any problems. Unfortunately, if the vagina and cervix are really dry, even the most gentle exam can lead to some bleeding from the tissues.
    Occasionally severe dryness can actually lead to abnormal changes on a pap smear (not just difficulty reading secondary to blood, but actually cellular changes.)
    So why not start with something like Replens and see how you do?
    Good luck,
    Mary Jane

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