Objective: The atrophic changes in menopause reflected in cytology is known, but relevance of other features in menopausal management is relatively unknown.  Present study was undertaken to evaluate the clinical profile and cervical cytomorphology in symptomatic postmenopausal woman.

Material and Methods: A total of 112 postmenopausal patients who presented with symptoms related to urogenital atrophy were studied. Adequacy, density of inflammation with numerical scoring, specific pathogens and predominant cell type were assessed in each smear and correlated with presenting symptoms and duration of menopause.

Result: The most Common presenting urinary symptom was dysuria, Increased frequency, Urgency and associated with fever and suprapubic pain. Smears of all patients showed inflammation, varying in intensity, irrespective of the presenting symptoms with a high incidence of candidiasis (12.5%). Two patients who had ASCUS (Atypical squamous cell of uncertain significance) on smears had carcinoma on follow up. 7 patients who opted for HRT were followed up with cytology.

Conclusion: Cytology (Pap Smear) in postmenopause can be used other than to assess hormonal status, to screen for malignancy, pathogens in inflammation and to monitor hormone replacement therapy.

Keywords: Postmenopause, Infections, Cytology, Urogenital Atrophy.

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Dr Soma Thakur

Tutor, Department of Pathology, Sri Krishna Medical College, Muzaffarpur