Closed Cervix after menopause

My last period was at age 41, I am now 60. I was on oral HRT for about 10 years. My only complaint about menopause was severe vaginal dryness. Currently I am using vagifem tablets 3 x per week due to severy vaginal dryness. My last pap smear the Dr. was unable to open my cervix and will do so in hospital by dialation.  My question is a closed cervix normal for someone in my situation, age, is it dangerous?  Will dialation be permanent or will I have to go through this every so many years or every year?  Sexual relations vaginally is out of the question due to the pain.
thank you

[Machelle Seibel, MD]

The cervix is the opening of the uterus. It lets menstrual blood out (and a baby out if you are pregnant) and it lets sperm in so a person can get pregnant. If you aren't having periods and can't get pregnant, and the lining of your uterus is thin (which is typical in menopause and which you would know from an ultrasound) you don't absolutely have to have the cervix open. Ask you doctor about the dilation to understand more about what it will help for you. In general, having the cervix "closed" in menopause isn't dangerous unless blood can't get out. Even when it looks closed, it often isn't "water tight" and is open a small amount.

Try using Replens, an over the counter product, for your vaginal dryness along with the vagifem. Use Replens daily for one week then twice weekly after that. It has no hormones but increases moisture. If this doesn't work in a few weeks, talk to your doctor about a stronger vaginal estrogen for a short course to see if that will help and then going back to the vagifem and replens to sustain it.
Machelle M. Seibel, MD