A single-blinded randomised controlled trial to evaluate the pre-treatment effect of two vaginal estradiol doses compared to no treatment on the quality of pap smears in post-menopausal women.

INTERVENTION: Post‐menopausal women presenting to two FPA Health centres for routine pap smears to be randomly assigned to a) Group 1: one tablet of estradiol to be inserted into the vagina 3 nights prior to the pap smear; b) Group 2: five tablets of estradiol to be inserted into the vagina on consecutive nights one week prior to the pap smear CONDITION: New health condition. Please modify. Quality of post‐menopausal pap smears PRIMARY OUTCOME: Pap smear quality ‐ defined as number of atrophic smears and number of smears with endocervical material absent according to established cytological criteria. SECONDARY OUTCOME: Subjective comfort level of pap smear procedure relative to previous smears using a Likert Scale at the conclusion of the smear. INCLUSION CRITERIA: Naturally menopausal women with no spontaneous menses for the past 12 months; surgically menopausal women aged 20 ‐ 70 years at least 12 months post‐menopause; women in general good health who require a pap smear according to current guidelines; women who are able to consent and provide contact details.