This is an expected finding among menopausal women not taking estrogen
- If this is the only abnormal finding and the patient has no symptoms, it
can be safely ignored.
- If the patient complains of vaginal dryness, irritation, painful
intercourse, vaginal discharge, odor, or other symptoms, then the Pap finding of atrophic
vaginitis is helpful in determining the cause.
- If the Pap smear has other abnormalities, treating the patient for 2-3
weeks with Premarin 0.625 mg PO daily and then repeating the Pap will often result in the
other abnormality disappearing.
This is also occasionally seen in women on long-term hormonal
contraception, whose circulating estradiol levels are quite low. If the
patient has no other symptoms, no treatment is needed.