When is it OK to stop getting Pap smears?
DEAR DR. ROACH: I am a widow in my early 70s and am not sexually active. I had my last Pap smear and complete gynecological and breast exam in 2014. My Pap smear was negative, and my gynecologist said she didn’t think I’d need Pap smears anymore since they had been negative for over 10 years. I was relieved to hear that, since I have vaginal atrophy and find the ovarian exam and Pap smears to be very painful.
In 2015 I returned for just the ovarian and breast exams. No problems were found.
Recently I received a letter from my gynecologist’s office saying I was due for a gynecological checkup and/or a Pap smear. I have scheduled an appointment for the gynecological checkup, but not the Pap smear. What is your opinion about a woman my age who is not sexually active needing Pap smears, especially if past Pap smears have been negative and the woman has vaginal atrophy? — J.P.
ANSWER: The guidelines are clear that women over 65, who have no history of abnormalities with their regular Pap smears and especially no history of gynecologic cancer, do not need further Pap smears. Their risk for developing cervical cancer is very, very small. However, I still think regular gynecologic care is appropriate. In fact, your gynecologist may have appropriate treatments for the vaginal atrophy. Not only can it cause symptoms, but it predisposes women to urine infections.