Pap Test After Menopause

Medically Reviewed by Traci C. Johnson, MD on September 02, 2022
Written by WebMD Editorial Contributors
3 min read

A Pap test looks for changes in the cells of the cervix that show cervical cancer or conditions that may develop into cancer.

Pap screen testing should begin at age 21. Routine screening is recommended every three years for women ages 21 to 65. You could also consider combining the Pap test with human papillomavirus screening or the HPV test alone every five years after the age of 30.

Testing is your best tool to detect pre-cancerous conditions that may lead to cervical cancer. If detected early, cervical cancer can be cured.

Even if you are menopausal or postmenopausal, you should continue to have Pap or HPV tests. Women who have had a total hysterectomy for a noncancerous condition and have not had a previous history of precancerous Pap tests may be able to stop Pap screening depending on their medical history and risk of contracting human papilloma virus (HPV). Screening may also be discontinued at ages 65 or 70 if women have had at least three normal Pap tests in a row and no abnormal Pap tests in the previous 10 years. 

You can get a Pap test every three years if both of these are true for you:

  1. Your last three pap cytology tests have been normal or you have had two negative paps with a co-test with HPV that have been normal within the past 10 years, with one being within the last 5 years.
  2. You have no history of a precancerous Pap test result, no HIV infection, no weakened immune system, and no history of in utero exposure to diethylstilbestrol

Women who have a higher risk of cancer may need a Pap test more often. Your doctor can recommend what is best for you.

Pap smears may be discontinued after a total hysterectomy unless the surgery was performed for cervical pre-invasive or invasive cancer or other uterine cancers, or if you are considered to be at high risk for other reasons; for example, if you are HIV positive (carry the virus that causes AIDS), or have a weakened immune system. In these situations, Pap smears should be continued as determined by your doctor. Women who have had a hysterectomy and no longer need Pap smears should continue to have routine pelvic exams performed by their doctor.

Pre-cancerous conditions of the cervix seldom cause symptoms. For problems to be detected, a pelvic examination and a Pap smear are usually required.

When cancer is present in the cervix, the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse or douching (although douching is not recommended). Abnormal vaginal discharge is another symptom. Pain is NOT an early warning sign of the disease. These symptoms can be caused by other conditions and are not sure signs of cancer; but be sure to see your doctor if any of these symptoms occur.