A significant number of your cervical screening years will happen during the stages of menopause. But does menopause affect cervical screening – and if so, how?
Cervical screening checks your cervix for changes that can lead to cervical cancer. If you have a cervix and you’re between the ages of 25-70, cervical screening is recommended every 3 or 5 years.
There are two different types of cervical screening:
If your last cervical screening was before 2023, you would have had a cervical sample taken. This type of cervical screening is sometimes called a smear test or a pap smear. This is when a clinician opens your vagina with a speculum and takes a sample of cells from your cervix. These are then tested for abnormal cell changes.
The HPV self-test was introduced in 2023. You can do this test yourself – just swab the inside of your vagina with the long cotton bud that comes in your test kit. Or a nurse or doctor can do this for you. The swab is sent away to a lab to be tested for human papillomavirus (HPV). HPV is the virus that causes the cell changes in your cervix that may lead to cervical cancer.
If there is no HPV detected in your self-test, there’s no need for a cervical sample. If HPV is detected in your self-test, then you need to do a cervical sample to confirm if cell changes have occurred and decide next steps.
For many people who are experiencing the stages of menopause, the HPV self-test can make cervical screening easier and more comfortable. This is especially true if you’re experiencing vaginal dryness – a common symptom of menopause.
But the HPV self-test isn’t only more comfortable – it can also be more accurate for menopausal people.
In cervical samples, cells can look abnormal because of low oestrogen, not because of HPV. That means that some post-menopausal people who aren’t on hormone therapy can get abnormal results from a cervical sample, even if they don’t have HPV. This means they’d need more tests to investigate the abnormal cells. If these people were to take an HPV self-test instead, it would show no HPV, and they wouldn’t need to get further testing.
You can get the HPV self-test if you’ve never had an abnormal result before. That means either this is your first cervical screening, or you’ve been tested before and received normal results.
You can also get the HPV self-test if you’ve received an abnormal result before, but you’ve been told you can go back to regular screening.
The HPV self-test is great, but it isn’t right for everyone. You might need to have a cervical sample taken because of a positive HPV self-test, or because past cervical samples have shown abnormal cells.
Some people are eligible for free cervical screening.
For some people, a short prescription of vaginal oestrogen before your cervical sample appointment can make the procedure more comfortable and more accurate.
Vaginal oestrogen usually comes as a cream that’s applied inside your vagina. If you apply this for three weeks before your appointment, it can help relieve dryness and increase the oestrogen in your cervix, preventing cells from looking abnormal due to low oestrogen.
When used short-term, this form of oestrogen is suitable for most people, including people who can’t take other forms of oestrogen (for example, people with breast cancer).
Routine cervical screening stops at 70 for most people, because screening beyond this age hasn’t been shown to reduce the chances of cervical cancer. Even though routine screening stops at 70, some people are encouraged to get screened from the ages of 70-74, if they haven’t had normal screening results in their 60s. That could mean:
In these cases, you’ll continue getting cervical screening in your 70s.
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