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Closed Cervix Treatment
I am 57 years old and have not had a period for almost 3 years, never experience hot flashes or any menopausal effects. I've just been for my annual pap smear and was informed by my NP that my cervix is closed. Was prescripbed Vagifem tablets twice a week for 5 months and need to return for another pap so that cells can be taken from the cervix canal. I am concerned with using estrogen due to family history of breast cancer (my mother). The Vagifem literature indicates I should not use estrogen due to higher breast and/or uterin cancer risk. Is it safe to use Vagifem given my family history of breast cancer?
I was also told that I could be given a local anesthetic and that the cervix could then be dialated. Is this a drastic measure, or in my case, a better alternative to using Vagifem?  Thank you.
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I just had this procedure yesterday.  I'm 52 years old and have been post menopausal for about two years.  After my pap smear three weeks ago, the doctor's office called and said the sample they sent in did not contain and cells from the cervix.  Of course, my first question was - how did you miss locating my cervix?  As I understand, being post menopausal, lacking in Estrogen and I guess, my uterus is slightly tipped, the cervix is too high.  After several attempts yesterday to reach the cervix (I swear he was trying to find my belly button from the inside), he said he needed to do the dilation.  He said he would numb the area, dilate it, grab the cervix with an instrument and then be able to take the sample. I wasn't sure what I was in for, especially since the nurse kept apologizing.  They moved me to a different exam area in order to use a different type of exam table.  This special table moved up and down and tilted my head downward.  He used an injection of lidocaine.  This injection was really the most uncomfortable part of the procedure.  You know how they're always trying to convince you that you will feel a slight pinch?  This really did feel like a pinch.  Not even as painful as the injections the dentist uses.  He then proceeded with the dilation - I'm not sure exactly what that involved.  The rest of the exam seemed to proceed as one would expect.  He did decide to use a slightly longer speculum which I did feel.  They said I might experience some cramping and spotting the rest of the day, but nothing much happened.  I was pretty dizzy when they set the exam table back upright.  When all is said and done, it wasn't horrendous.  I had taken a vacation day from work and scheduled my annual mammogram for yesterday morning.  While at the original gynecologic appointment three weeks ago, we added on a bone density scan and then the call about the missing cervix sample came a week ago.  So, by the end of the day, I felt somewhat violated.  If taking the medication for five months is only to forego the cervix dilation - if all things are equal and there is no other reason for the meds - I would opt for the cervix dilation.  This is, of course, my unexpert, non-medical opinion.  If there are cons about the dilation, I was not made aware of them.  I was much more shocked to learn my body could change so much in what I feel is a very short period of time.  Our bodies are still such a mystery.  You remember, when we went through puberty, we were assured we were changing from girls to women.  When we go through menopause - the change of life - nobody tells us to what we are changing!
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Thank you for your story. I have not had a pap smear for several years because of the pain I suffered at the hands of the nurse when my gyno was on vacation. I have searched the internet to find any information about what can be done and what the experience would be like. For whatever reason, the experts have not replied.  Yours is the first answer I found. I wanted to let you know it is appreciated. Thank you for sharing. I will call my doctor tomorrow and ask about being dilation WITH medication.
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