Anxious about smear post menopause... Please be kind

[omega4ever]

It's been 14 years since my last smear which was normal thankfully. I've put off having a, smear for years, but recently due to another health issue I'm considering having another one.... Hopefully my last.

I always attend mammograms when invited. No prob with them.

I have always found smears horrible, both ultra embarresing and painful and I get really stressed beforehand. I did in my early 20s have some abnormal cells and a LETZ proceedure which was so horrid it put me off having regular tests. I'm now 56 and post menopausal... Have been on Hrt for 5 years... . Rarely now have penetrative sex. Taking oestrogen and continuous ultrogestron.

Is it worth putting myself through another smear or should I just leave well alone now.... I always used to tell myself cervical cancer was most prevalent in younger women, so I'm maybe beyond the high risk stage and needn't worry.

Apparently screeing is offered untill 65 years!

Are smears more painful and embarresing post menopause? Anyone got any views or suggestions or experiences pls.

Please be kind with replies... Im trying to do the right thing and be logical and brave, but I'm terrified... Which is ridiculous.

Well....it is probably best to have it done. Assuming after your Letz all was ok and it has been treated fully?

I'm quite a bit older than you and carried on having them. My gynae (who I have seen for various issues including HRT) did them every 18-24 months rather than every 5 years NHS for women my age. I was advised to use vaginal estrogen for 2 weeks before a smear to help retrieve the amount of cells needed. Once that didn't work (not a large enough sample) and I needed it repeated after 3 months.

If you are worried about discomfort, talk to your GP beforehand and maybe ask for vaginal estrogen to use (anyway).

Nowadays they test for HPV as well and if they find none, you may not need another smear (unless you have sex with someone new, or your partner does as they could pass HPV back to you.)

In my area NW, a smear is now basically a test for HPV and if negative they no longer look at the actual cells. There seem to be lots of home HPV tests now, I think Superdrug does one. Could that be an option for you if you can't face a smear?

I'm the opposite to you, would rather have a smear than a mammogram although do attend both. I'm due a smear this year and have just had a mammogram.

I agree an HPV test could be your compromise. However I would be inclined to book the appointment and go along. Tell them your fears and reluctance and that you are undecided. Make the decision there and then. The last woman I had was born to do smears. So very reassuring and professional.

Tell them in advance. I suffered trauma in that area and it's quite difficult for me. They used a speculum designed for smaller and younger females and were extremely kind.

After 14 years with no smear, you could have changes that need identifying.

HPV can regress naturally (it does in the vast majority of women- like 80%) but if so, it won't be seen on a test (even a DIY one) but you could still have cellular changes that started years ago.

Please consider what I suggested, which is a chat with a dr or nurse and using vaginal estrogen (on prescription OR OTC - it's called Gina) for some time before the test. That will make it more comfortable and enable them to get a good sample.

Thank you all for comments and advice. I've made an appointment with the practice nurse for a smear... But will have a discussion with her first re pros and cons and pain / atrophy... And will let her know my fears and anxieties.... I know it's stupid and silly but can't help myself.

The appt is next week so not too long to dwell on it all.

I had no idea of the changes to hpv testing instead of normal cytology so will discuss this with her and consider a home test if available and practical.

It's not stupid or silly and nor are you. Appointment booked, you should be really proud of yourself. I know it's really hard but you are doing the right thing.

I was advised to take paracetamol or ibuprofen an hour before my appointment to have a Mirena coil fitted. Maybe you could try that. It might help?

Well done on booking the appointment. My tips would be to book it as early as possible to avoid dread. Also plan a treat afterwards - coffee and cake with someone, a magazine or a new lippy.

I'm sure the nurse will accommodate your natural anxiety.

i am sure it will be fine
they use ky jelly
and are well used to the procedure

Brilliant you've booked it.
Definitely ask for a smaller spectrum and tell them your anxieties.
You can do this.
It will be done in under 5 minutes.

I had an internal ultrasound a while after I'd been on some medication which brought on menopause and although the nurse was very gentle it was still sore. When I first started to use internal oestrogen pessaries they were sore to start and they are tiny.
I totally understand your fears @omega4ever and as good as ky jelly is it's not great for this case. I'm not sure how much ibuprofen or paracetamol would help, but they would be worth a try.
It's good you have booked an appointment but I would not feel pressured into having it done then if you don't feel comfortable. Speak to the nurse, they might be able to get a gp to prescribe some medication which will help.
I hope it goes well, and you are all clear💐

@omega4ever - well done for contacting her. Absolutely not stupid or silly. Not even a little bit. If you don't take care of you on this, who will?

I'm 55 and had mine on Monday, I barely even noticed her doing it and it was over in no time. I am sure that if you tell them you are anxious they will be reassuring and take care with the process to minimise any discomfort.

I was in the same situation and very anxious about it. I was given vagifem for a two week load up prior to the smear and told to book a double appointment. The nurse was wonderful and whilst it was still uncomfortable, it didn't hurt like my previous one and between us we managed. I had a great sense of relief afterwards and you will too, as we know we need to take advantage of these tests when they are offered x

I'm post menopausal and find these very painful now, with the atrophy and everything. I need the "extra long" speculum as my cervix is so very far away ... which is a bit embarrassing. I do go though. Take a painkiller an hour before. I hope it goes well and is over as quickly as possible.

I have psychological problems with any kind of intimate exam after being sexually assaulted during DV marriage.
Unfortunately having endometriosis any gynae exams are necessary and traumatic.
My GP is aware of this and before a smear/exam I am offered sedation, usually diazepam an hour before my appointment and can tolerate it better, the nurses (knowing my history) are very gentle and fast.
Discuss your fears with a sympathetic GP if you can.

Are you having treatment for the VA @RedRosie ?

It shouldn't be 'accepted'.

I am always advised to use vaginal estrogen for 14 days before a smear, and stop for 3 days before it's done (as well as using it on the normal regular basis .)

I'm on low dose HRT (Femoston Conti) @JinglingSpringbells ... And generally well. The smear test is the worst thing about the VA actually (although the colposcopy I had to have last year was gruesome for the same reason). Sex etc is still ok for now.

We should talk more about these things. But despite that, it's important to have the smear if you can OP. And I hope it goes ok.

@RedRosie Has anyone discussed your VA with you? One in 4 women (at least) need topical vaginal estrogen as well as full hrt.

Just because you are using Femoston doesn't mean it helps your VA.
If you feel you have VA, why not ask for Ovestin or Vagifem too?

Some GPs are unaware that it's perfectly safe to use both.

I nursed mil through a cancer death. It was a thousand times more painful and humiliating for her in her last weeks than a smear test could ever be.

I beg everyone, take the checks they give you.

Hey, OP.

I'm in my 50's & post-menopausal.

My smears were always fine until I reached mid-late 50's.

I'm not specially active either, so that doesn't help my confidence about "things" going inside.

I didn't find the speculum going in painful, it was the ratcheting bit which was excruciating & she had to stop.

What has helped is: shorter speculum & the very lovely practice nurse "ratcheting" it up in very small stages. Putting cushions & my hands under my bum. Trying to control my breathing.

I used to be so relaxed about it in my younger days!

Just want to thank you all for advice and sharing experiences.

I had my appt this morning and smear test done and hopefully out of the way.

It was pretty uncomfortable and took 3 attempts with a variety of speculum but the practice nurse was lovely and took lots of time and helped me through it.

So glad that's over!

You must feel delighted that it's out of the way and over with, well done!

Wow, fabulous - I hope you are very proud of yourself. Well done OP.