Menopause marks the end of your childbearing years, but it doesn’t mark the end for the need for a particular screening test.
Unless you’ve had your cervix surgically removed, such as part of a hysterectomy, you still need to get tested for cervical cancer until you reach age 65.
“Just because they’re not delivering children anymore doesn’t mean they can stop getting exams,” says Dr. Stephanie Faubion, MD, director of the Mayo Center Clinic for Women’s Health and medical director of the Menopause Society.
Here’s what you need to know.
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The Test You Still Need to Get After Menopause
Over the years, you’ve probably gotten Pap (Papanicolaou) smears or Pap tests as part of a well-woman exam or check-up that involved a pelvic exam.
The Pap test entails using a small spatula or brush to collect some cells from the cervix so they can be examined in the lab. The lab tech looks closely at the cells to see if they show any changes or signs of being abnormal, which can be an early sign of cervical cancer.
You probably have also gotten an HPV test at various times. In fact, a Pap test is often given along with a human papillomavirus (HPV) test, which is a test that looks at cells for signs of infection with HPV strains that are known to can cause cervical cancer. HPV causes most cases of cervical cancer, according to the National Cancer Institute, specifically two of the 12 strains that are considered high risk.
Sometimes healthcare practitioners will screen patients for cervical cancer by using a combined Pap/HPV test, sometimes called co-testing.
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Why You Need to Keep Up With Cervical Cancer Screenings
It might not occur to you that you could still benefit from a screening for cervical cancer after you’ve hit menopause.
“Even if you’re menopausal or post-menopausal, you need to be evaluated for whether you need to continue to have Pap and HPV tests,” says Dr. JoAnn Pinkerton, MD, an OB/GYN in Charlottesville, Virginia. “And regardless, you need to still have pelvic exams.”
The American College of Obstetricians and Gynecologists (ACOG) recommends that you continue getting screened until you turn 65. Specifically, ACOG’s current guidelines recommend that women between the ages of 30 and 65 choose one of these options for their screenings:
- Undergo co-testing every five years
- Get a Pap test every three years
- Get an HPV test every five years
Related: The No. 1 Lifestyle Change That Can Actually Lower Your Reproductive Cancer Risk, According to Oncologists
Even people who’ve had a hysterectomy but still have their cervix need to continue their screenings, according to the American Cancer Society. Also, women who had a hysterectomy due to cervical cancer or pre-cancer may still need to undergo screening.
“Anybody that still has a cervix is potentially at risk for getting cervical cancer,” says Dr. Monica Christmas, MD, an OB/GYN and director of the Menopause Program with the University of Chicago Medicine.
About 12,000 new cases of cervical cancer are diagnosed in the U.S. each year, and it occurs most often in people over 40. About 4,000 people die from cervical cancer annually, according to ACOG.
It is, however, easy to lose track of screening guidelines, especially if you don’t go to your OB/GYN as often anymore. Perhaps you’re finished having children or don’t have plans to have any more children. Plus, midlife is a busy time for many people, who are juggling many things, including children, aging parents, their careers, and other obligations. So many women just stop getting screened as they get older.
“They may not think about it or it may not have occurred to them,” says Dr. Faubion.
But it’s important to not forget about it. Routine screening can detect changes in your cervical cells before they develop into cancer.
If you see your doctor for a screening and a pelvic exam, your doctor can also check you out for genitourinary symptoms that sometimes accompany menopause, like vaginal dryness or irritation, or your risk for bone loss or heart disease. It also gives you the chance to ask questions about any issues you may have, like any pain during sex or urinary incontinence.
“A lot of people don’t want to talk about it, but they suffer from it,” Dr. Pinkerton says about the issue of bladder leakage. “And the risk increases with age.”
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Why Some People Need More Frequent Cervical Cancer Screenings
Some people do need to undergo cervical cancer screenings more often than the standard recommendations, however. According to the National Cancer Institute, your doctor may recommend more frequent screenings for you if you have:
- A weakened immune system
- HIV
- A history of cervical cancer
- A recent abnormal cervical cancer screening test (or biopsy results)
Also, you may need more frequent screenings if your biological mother took a medication called diethylstilbestrol (DES) when she was pregnant with you. Between 1940 and 1971, some women took DES, which was a type of synthetic estrogen, to prevent premature labor, miscarriage and other potential complications. Researchers eventually discovered that female babies exposed to DES in utero later grew up to have an increased risk for certain kinds of cancer, including a type of the cervix and vagina called clear cell adenocarcinoma, as well as cervical precancers.
It’s a good idea to talk to your doctor if you have any of those factors about how often and how long you need to get screened for cervical cancer.
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Sources:
- Dr. Monica Christmas, MD, OB/GYN and director of the Menopause Program with the University of Chicago Medicine
- Dr. Stephanie Faubion, MD, MBA, director of the Mayo Center Clinic for Women’s Health and medical director of the Menopause Society
- Dr. JoAnn Pinkerton, MD, OB/GYN and fellow in the American College of Obstetricians and Gynecologists (ACOG)
- The American Cancer Society guidelines for the prevention and early detection of cervical cancer, American Cancer Society
- Cervical cancer FAQs, American College of Obstetricians and Gynecologists (ACOG)
- Cervical cancer screening, ACOG
- Cervical cancer screening, National Cancer Institute
- Diethylstilbestrol (DES) exposure and cancer, National Cancer Institute
- Genitourinary syndrome of menopause, Brigham and Women’s Hospital
- HPV and cancer, National Cancer Institute
- Older women may not get needed cervical cancer screenings, Centers for Disease Control and Prevention (CDC)
- Pap smear, National Cancer Institute
- The Pap (Papanicolaou) test, American Cancer Society