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Topical oestrogen prior to smear

180 Posts

Posted:  02-May-2014 15:41
Hi just wondered if anyone knows of any guidelines or protocols for giving oestriol 0.01% before smear test for postmenopaul women who have very painful smears.Is it two weeks of use on alternate dates and then stopped for 2 weeks before smear? or can they have the smear test done earlier?



1126 Posts

Posted:  02-May-2014 18:13 Log in to like this post
We use vagisil pessaries one at night for 2 weeks then do smear 72 hours after. Often the patient then goes into maintenance dose of twice weekly for three months ( if they were having other problems like painful intercourse )
Many ladies hug you when they return for giving them their life back.
Obviously must be prescribed according to Bnf

5368 Posts

Posted:  02-May-2014 19:19 Log in to like this post
As per Tigger..I'd just like to prompt you " younger" nurses out there to discuss sex with menopausal ladies to see if they are avoiding it due to pain , and start a discussion about topical oestrogens ... Life enhancing for some

Please be informed that the above is personal opinion only.
iPhone App Posted on my iPad

425 Posts

Posted:  02-May-2014 22:48 Log in to like this post
Ditto nakrdnurse, had a pt in for asthma today who said the vaginal oestrogen I had prescribed her for difficult smear 3m ago then continued, had made such a massive improvement on her sex life! I'll be knocking on my gps door when my time comes!

180 Posts

Posted:  03-May-2014 20:41
Thanks for all your advice.I have been told that a patient must wait 1-2 weeks after using any vaginal cream or pessary before having smear test.I cannot see any official guidance about this.Maybe it is decided by the individual doctors?


1126 Posts

Posted:  03-May-2014 21:24
I have done them at this point for years and always state on the form that pessaries have been used and never had any problem, only reason I don't do them sooner is that the stuff does stay put and any sooner than three days and you tend to just get a vag full of chalky residue, much longer than 2 weeks and you tend to lose the benefit.


243 Posts

Posted:  06-May-2014 18:37
I was told on smear course that you have to wait 2 weeks following oestrogen pessaries - that said, not sure if its in the local guidelines, I'll check...

1126 Posts

Posted:  06-May-2014 22:29
Thanks I might give our lab a ring and see what they say, all I can say is they have never queried the timing and not had dodgy results, but the nurse I work with is doing the course now has been told. 2 weeks so I may be out of date. We live and learn.

18 Posts

Posted:  12-Jul-2016 22:33
I was told on a smear course that I attended last week that vaginal treatments... Vagifem was suggested, should be used for 6 weeks prior to a smear then should be stopped 2 days before the test.


165 Posts

Posted:  12-Jul-2016 22:37
Even as a short course it has to be discussed the same as HRT with usual cautions
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