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Topical oestrogen prior to smear
Rosiem

148 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?

thankyou

rosie1
tigger1

1068 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
nakrdnurse

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
cloe

424 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!
Rosiem

148 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?

rosie1
tigger1

1068 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.

snoozybunny

237 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...
tigger1

1068 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.
Jan2312

10 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.

Jan
Prissy

158 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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