New research conducted by Besins Healthcare has revealed that one quarter of women (25%) aged 45 – 65 who are experiencing perimenopause or the menopause are not regularly attending cervical screening appointments.1 13% of women noted that participation in cervical screening actually reduced when going through the menopause. When asked why their participation decreased, 35% of women reported that they found their cervical screening to be more painful or uncomfortable as a result of changes in their vaginal health. 17% of menopausal women believe that they are no longer eligible to attend screenings and 12% believe that as they could no longer get pregnant, screening was not required – both of which are incorrect.1 These findings demonstrate that there are some misconceptions regarding the need for cervical screening when reaching the menopause and beyond.
Cervical screening is recommended for all women from 25 – 65. With the menopause occurring for women on average from age 45 plus, women should be attending cervical screening every five years in line with the recommendations of the Government screening programme.[ii] This research highlights that approximately 112,755 women aged 45 – 65 who have experienced perimenopause or the menopause may not be participating in the screening programme as they should be.[iii]
One of the main issues that effects more than 50% of women living through or post-menopause is vaginal atrophy, often known as vaginal dryness, where the vaginal walls become thinner, drier and less elastic which is caused by a reduction in oestrogen.[iv] The research showed that 35% of women have found their cervical screening to more painful or uncomfortable as a result of changes to their vaginal health another possible reason for less women presenting.1
There are several interventions that women can request or implement ahead of attending a cervical screening that can help to ease a cervical screening, yet the research showed that over half of women (58%) were unaware of these. For example:
- Request the use of a smaller speculum and/or ask the nurse if you can insert it yourself using a water-based lubricant.
- Choose a different position for the screening, for example it may be more comfortable lying on your side rather than on your back.
- Speak to your GP about options to relieve vaginal dryness in advance of your smear test.[v]
Dr Caoimhe Hartley, GP and owner of Menopause Health said, “The menopause brings about many changes for women and thankfully more awareness and understanding of these symptoms has come about in recent years. However, what this research serves to highlight is that the menopause is leading to a decline in regular cervical screening which could lead to increased mortality if they were to develop cervical cancer at this stage of life. With approximately half of women going through perimenopause or the menopause experiencing vaginal atrophy, and 35% of women claiming that the screening is more painful or uncomfortable as a result, it is understandable why they may decline to participate in a cervical screen, but there are a range of ways to make the experience more comfortable and the first port of call is to discuss this with your GP. There are many solutions available that can alleviate the problem of vaginal atrophy, enabling you to attend cervical screening which has the potential to save your life.”
In Ireland, about 300 women will be diagnosed with cervical cancer every year and 90 women will die from it.[vi] Yet, 90% of cases can be identified and treated in a simple outpatient procedure if caught early.7 This underlines the need for all women to participate in cervical screening at all stages of life, even post-menopause.