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    Closed cervix post menopause
    Leeella posted:
    I'm 62, way past menopause. Before menopause, I would receive abnormal pap smears, which when repeated would report normal. I went 3 years without a pap smear because of no insurance. When I did go, the gynecologist said he couldn't do one because my cervix was closed. He wanted to perform a procedure that I couldn't afford at the time. Now, it's 2 years later and I went back. He scheduled a LEEP for me. I don't have bleeding but also haven't had intercourse in 9 yrs. I read that the LEEP can cause stenosis, so I wonder if this is something I should have. I had a LEEP many years ago. My other question is, will it be possible for me to have intercourse if I decide I want it. In addition, I haven't taken any hormones for menopause. Thank you for any help you can give me.
    Mary Jane Minkin, MD responded:
    Dear Leeella,
    Yes of course you should be able to have intercourse is you would like to do so. You certainly could try some over the counter remedies like Replens, but given the changes in your cervix, I think you would do better with using either some vaginal estrogen (vaginal tablets or vaginal creams) or the new oral medication called Osphena (the Vagifem vaginal tablets, Estrace cream, or Osphena will have a more significant effect on the tissues themselves.) I would use one of the products for a couple of months, and then have you gyn reevaluate your cervix, to see with the improved tissue if he can do a real Pap smear. Often times when the cervical and vaginal tissues are really dry, it is hard for the pathologist to even read the Pap smear. So I'd suggest some medical intervention before proceeding to the LEEP; hopefully, you won't need it (And also hopefully, you'll be a lot more comfortable and able to have sex!)
    Good luck,
    Mary Jane
    Leeella replied to Mary Jane Minkin, MD's response:
    Thank you so much for responding and for the information. I have a LEEP scheduled but I'm going to ask about the tablets or creams you mentioned and see if he'll try that first.

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