False Positive Cervical Dysplasia May Be an Early Sign of GSM

False positive cervical dysplasia during perimenopause may be an early sign of genitourinary syndrome of menopause (GSM), according to preliminary findings presented at the 2019 North American Menopause Society Annual Meeting.

Now, the authors of the study are proposing that abnormal Pap smears that turn out to be benign in women older than 40 years should be included as a potential symptom of GSM. According to the authors, this could potentially expedite proper treatment of GSM with estrogen therapy and help avoid unnecessary colposcopy, biopsy, and other procedures that follow in the event of subsequent persistent positive results, especially among women who have had a stable relationship with their partner and previous negative Pap smear results.

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Researchers arrived at their conclusion after performing a retrospective study of 400 women above age 40 years with abnormal Pap smears categorized as atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesions (HSIL), with or without human papillomavirus. All women in the study had been treated with a local estrogen course of at least 4 to 6 months with repeat Pap smears.

Of the 43 women assessed thus far, 29 (67%) have experienced improvement with 6-month use of estrogen vaginal cream and have had no abnormal pap smears since. Thirteen of 42 women (30.2%) discontinued treatment or switched providers due to insurance coverage issues, and 1 woman (2.3%) experienced no clinical improvement with treatment and underwent further testing.

“Having analyzed 43 of the 400 women up to now, we found 67.4% of the abnormal Pap smears were due to benign changes proper of [GSM],” the researchers wrote. “This approach prevents a lot of time, unnecessary procedures/treatments, and millions of dollars spent on what has been up to now, the normal guidelines to approach these kinds of problems.”

—Christina Vogt

Reference:
Bali D, Gollamudi S. Positive false cervical dysplasia in perimenopausal years: an early sign of genitourinary syndrome of menopause. Paper presented at: North American Menopause Society Annual Meeting; September 25-28, 2019; Chicago, IL.