DEAR DR. GOTT:
I am 62 years old, in good health, work 37-40 hours per week, take lisinopril, levothyroxine and an 81 mg aspirin daily. I have two issues about which I would like your opinion.
In 2002 I was told that my cervix was closing so I underwent a procedure to reopen it. I am looking at the same procedure again this year to get a good pap smear. At my age do you feel this is a necessary procedure? I have a pap smear every year and they are never bad. There is a history of cancer in my mother’s family. My grandmother and one of my aunts had cancer. I only have hospital coverage and will have to pay for the procedure.
I have frequent hot flashes. They only last about five minutes, but happen at all hours of the day and night. They are so bad I feel as if I am about to melt. My face and neck get extremely red, my heart races, I feel nauseated, hear my pulse in my ears and sweat so profusely that my hair and clothing get soaked. My concern is if they can adversely affect my health.
DEAR READER:
I believe you are suffering from the ill effects of menopause. Hot flashes are harmless but annoying. They often occur in women during and after menopause when the brain has trouble determining if the body is hot or cold. It, therefore, dilates and constricts the blood vessels spontaneously (or after certain triggers, such as stress) which causes the symptoms you have experienced. There are several treatment options for menopause-induced hot flashes, such as hormone replace therapy, black cohosh, and more. Speak to your gynecologist about this.
As for your cervix closing, I believe this is also due to menopause. During menopause, some women experience a thickening of the cervix (cervical stenosis) which can lead to partial or complete closure. In most instances it is harmless and needs no treatment. If pain, fever, bleeding/spotting or abnormal drainage occur, cervical dilation may be necessary to determine if there is another cause such as cancer, fibroids, or other conditions. Remember that a pelvic exam is a god test to have regularly. It can diagnose several types of reproductive cancers.
Since you have had consecutive normal pap smears and are post-menopausal, you may not need to have yearly pap tests. You do have a family history of close female relatives having cancer but you fail to say what kind. If it were cancer of the cervix, or other reproductive organ, perhaps you should have a pap every 2 or 3 years. If not, talk to your gynecologist about stopping them. You will still need to be seen for any spotting, increasing abdominal girth, bleeding, abnormal discharge or other symptoms but because you are otherwise healthy, have had no bad tests, I believe it is in your best interest to stop.
If your physician is unwilling, request a referral to another gynecologist for a second opinion.
To give you related information, I am sending you a copy of my Health Report “Menopause”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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