We’re heading into the back-to-busy season, but don’t forget to prioritize YOU and your health — including preventative screenings, immunizations, and healthy habits. To kick off September, we’re talking cervical cancer.
What should women know about cervical cancer during the menopausal transition? What are symptoms to look out for? Risk factors to consider? How often should we get screened? When, if at all, can we stop screenings?
We’re covering it all below.
Cervical cancer 101
As the name suggests, cervical cancer develops in our cervix, which is the entrance from the vagina into the uterus. 99% of all cases are linked to prior HPV infections.
As a refresher, HPV = human papillomavirus, a common virus transmitted through sex. There is an HPV vaccine, which is usually administered around ages 11-12 in two doses. The vaccine is not generally recommended for adults older than 26 since most people in this age range have already been exposed to HPV. That said, if you’re between 27 and 45, it’s worth a discussion with your women’s health provider about your risk for HPV infection and potential benefits of vaccination. To learn more, visit cdc.gov.
While most HPV infections are asymptomatic and resolve on their own, repeat infections can increase our risk of developing this type of cancer, which happens to be the fourth most common among women.
RELATED: 10 Vaccines Recommended For Adults
Symptoms of cervical cancer
Early cervical cancer is hard to detect since it tends to be asymptomatic during this time. If early-stage symptoms DO occur, they may include:
- Abnormal vaginal bleeding post-sex, post-menopause, and/or between periods
- Vaginal discharge (watery, odorous, and/or contain blood)
- Pelvic pain
- Pain during sex
Symptoms of more advanced cervical cancer may include the warning signs listed above plus:
- Difficult urination or bowel movements that may include bleeding in urine or from the rectum
- Abdominal pain
Screenings for cervical cancer
To address the elephant in the room…no one (and we mean, no one) likes getting a pap smear — or any pelvic exam, for that matter. You have to put your feet up on those stirrups, and the speculum (the thing they stick up *there*) is cold, and there are probably 5,830,948,594,385,943 things you’d rather be doing instead, including watching paint dry. (Just us??!)
That said…and in all seriousness…with early detection, cervical cancer is one of THE most treatable cancers because abnormal cellular changes take place over several years. This is why it’s so, so important to stay on top of your screenings.
Type of cervical screenings available
There are a few screening tests available for cervical cancer, including:
- The HPV test, which screens for the HPV virus that can lead to the growth of cancer cells on the cervix.
- The pap test (aka pap smear or pap screening) tests for what’s called “pre-cancers” or changes to the cells of the cervix that, if untreated, put you at increased risk for cervical cancer. Pap smear results can either be normal, unclear, abnormal, or unsatisfactory.
“Normal” means no cell changes were identified on your cervix, so your cancer risk is low.
“Unclear” (or “inconclusive”) results means that your cells could be abnormal, but it may not be related to HPV — instead, it could be due to menopause, pregnancy, or another infection, in which case an HPV test may be warranted.
“Abnormal” pap test results mean that abnormal cells were found on the cervix, but this is NOT a cancer diagnosis. It could very well just be low-grade changes caused by HPV that will resolve on their own, but your doctor may recommend a colposcopy as a next step to more closely examine your cervix, vagina, and vulva.
Finally, “unsatisfactory” results mean there’s not enough cells in the sample collected, in case your healthcare provider will recommend a follow-up test.
How often to get screened during the menopause transition
Screening frequency differs by age, but it is not limited to younger people. According to a 2023 report published in Menopause: The Journal of The North American Menopause Society, HPV reactivation among postmenopausal women can pose an ongoing risk, even in the absence of sexual activity. This is why “age alone should not serve as a categorical indication for cessation of screening.”
And yet, the report revealed that, according to national claims data, 64.7% of people in the U.S. stop screenings before meeting the criteria to do so.
According to the American Cancer Society:
- Cervical cancer screenings should begin at age 25, with primary HPV testing every 5 years up until age 65
- Those who are older than 65 can discontinue cervical cancer screenings IF
– They have no history of cervical cervical intraepithelial neoplasia grade 2 (or a more serious diagnosis within the past 25 years)
– They have had adequate negative screenings in the 10-year period before age 65, which is usually defined as two consecutive negative HPV tests
There are some women who require more frequent testing, including those with:
- A history of cervical cancer
- A weakened immune system
Treatment options for cervical cancer
Cancer treatment protocols vary based on the type/stage of the disease and may include:
- Surgery (removal of the cancer tissue or a hysterectomy)
- Radiation therapy
There are various types of medical professionals who administer treatment, including:
- Gynecologic oncologists (specialists in gynecologic cancers, including cervical as well as uterine cancer, ovarian cancer, endometrial cancer, and vaginal/vulvar cancers)
- Medical oncologists
- Radiation oncologists
At the end of the day, cervical cancer screenings remain an important part of regular healthcare for women well past menopause. And while healthcare providers usually do a great job of keeping us up to date in our screenings, now is a great time to check when your last screening was. Can’t find that information? Give your healthcare provider a call!