What Is The Recommended Duration Of Estrogen Therapy Before Repeat Pap Smear?

Posted on Thu, 17 Jul 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 17 Jul 2014 Answered on

Wed, 6 Aug 2014 Last reviewed on

Question : HI, I am XXXX from XXXXXXX Software. My mom is 54 years old and has been advised local estrogen therapy twice a week for repeat pap smear test.She has done it for 10 daysbut has missed twice. What is the usual recommended duration for local estrogen therapy to be done before repeat pap smear. Her initial report was negative for intraepithelial lesion or malignancy but early atrophy changes and squamous metaplasia was found. Few squamous cells showed mild nuclear enlargement probably atrophy related.

Answered by Dr. Richa Agarwal (57 minutes later)

Brief Answer:
Vaginal atrophy.

Detailed Answer:
Hi,
Thanks for writing to us. XXXXXXX is your mom in pre or post menopausal state?
Usually local estrogen therapy is recommended for two weeks before repeat Pap smear usually in dose of 4-6 micro gram/ day.
Local estrogen therapy is recommended to treat atrophic changes which occurs during premenopausal and post menopausal stage and causes changes in Pap smear.
Usually few nuclear enlargement in squamous cells are common at this age.
In my opinion she should first treat her vaginal atrophic changes then only go for repeat Pap smear test.
She should go for colposcopy also because long term use of estrogen cream is not recommended because it may cause cancer. ( colposcopy rule out HPV infection also).
She should go for repeat Pap smear after 6 months.
I think I have answered your query if you have further questions I will be happy to help you.
Good luck.
Regards
Dr. Richa

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju