0 Items £0.00

Let’s talk about… smear tests after menopause

Posted on: Tuesday, 15th October 2019 by Imogen Pinnell, Health Information Manager

This blog talks about cervical screening (smear tests) after the menopause, whether natural or triggered by treatment for cervical cancer.

Woman who has gone through menopauseIf you’ve had cervical cancer treatment and are currently going through the menopause or are post-menopausal, you may be having a different kind of test known as a vault smear. This blog post may be useful for you, but you may also need further support from your healthcare team.

The menopause, whether natural or triggered by treatment, can be difficult both physically and mentally. This is true no matter what age it happens. One thing which can become harder is cervical screening. We hear from lots of women who find that the menopause makes screening feel like a different experience to tests before it started, so if you feel this way, you’re not alone. 

Why might cervical screening become harder after the menopause?

When you go into the menopause, your body loses female sex hormones, oestrogen and progesterone, which are needed for things like periods and pregnancy. These hormones also help to lubricate your vagina and keep the tissue that makes up the vaginal walls stretchy. 

As these hormones decrease, your vagina may become drier and less stretchy, so when you try to put something like a speculum, used during cervical screening, into your vagina, it may be uncomfortable or even painful. But, thankfully, it’s often easy to treat – here are some of our top tips:

  • Ask the nurse to use a smaller speculum. Yes, speculums come in different sizes! As your vagina changes, a speculum that was fine before may no longer be right for you. You can ask to try out different sizes to find what works best.
  • Ask the nurse to use a water-based lubricant on the speculum. This can help the speculum go in more comfortably.
  • Try using a vaginal moisturiser before your appointment. A moisturiser is different to a lubricant – it can be applied regularly, sometimes daily, and goes into your vagina instead of onto whatever is being inserted. You can get vaginal moisturisers from most pharmacies, without a prescription however you can also ask your nurse or GP to prescribe it for you.
  • Ask your nurse or GP to prescribe you hormone replacement therapy (HRT) or local oestrogen. HRT replaces the hormones which are no longer made in your body, and can help with lots of the symptoms of the menopause, including vaginal dryness. HRT comes in many forms, such as a daily tablet or skin patch, but also as a gel or a cream, which you may see called local oestrogen. You apply the gel or cream to your vagina. Recently, there have been lots of news stories about HRT, which may have worried you, but often the benefits of the treatment outweigh any risks. You may want to speak with your nurse or GP to make a decision based on your situation. 

As well as vaginal dryness, the menopause can have other symptoms that may make cervical screening more difficult for you. Symptoms like mood changes – perhaps feeling more anxious or low – can make it hard to book and attend an appointment, while regular hot flushes may make you worry about managing one if it happens during the test. While none of these symptoms are pleasant, there are ways to deal with them and don’t forget there are lots of other women going through exactly the same thing so you are not alone in your experience. 

Read more about ways to manage menopausal symptoms >

What else can I do to make cervical screening better?

We know that cervical screening may also be difficult for reasons not related to the menopause, so here are some tips that might help: 

  • Remember that it’s your test - you’re in control and you can say stop at any time. 
  • Speak to your nurse before the test to let them know that you may need some help. Opening up to someone, especially if you don’t know them, may make you feel vulnerable, but if they know you need extra support, they will be able to give it. 
  • You may feel more comfortable in a different position, like lying on your left-hand side with your legs bent up. If you think this would help, you can speak with your nurse about the options. 
  • Ask your nurse if it’s possible for you to put the speculum into your vagina yourself. This can help you feel in control and make it more comfortable. 
  • Try wearing a skirt or dress to the appointment. You don’t have to take these off during the test, which may help you feel more covered. 

Read more about making cervical screening more comfortable >

Where can I get further support?

The Daisy Network

Provides support to women, along with their families and partners, who have been diagnosed with premature ovarian insufficiency.


Women’s Health Concern

The woman’s arm of the British Menopause Society (BMS). Provide information and support about the menopause, including benefits and risks.


Royal College of Obstetricians and Gynaecologists

Has an information hub about women’s health covering the menopause and beyond.


Categories: cervical screening