Cervical dysplasia in the postmenopausal female: diagnosis and treatment.

Thirty-two postmenopausal women, age 50 years or older, were colposcoped for abnormal Papanicolaou (PAP) smears. Sixteen had mild to moderate dysplasia, six severe dysplasia and the remainder had no dysplasia. Treatment included observation, topical estrogen, cryotherapy, conization or hysterectomy. Based upon our observations, satisfactory colposcopy can be performed in the majority of postmenopausal women. Oral or topical estrogen is a valuable adjunct in the initial evaluation and treatment of abnormal PAP smears in postmenopausal women. Criteria for adequate colposcopy in postmenopausal women are discussed and a management scheme is proposed.