PAP Smears

By Dr. Pauline Cundill. Updated 13th Oct 2014

It is important to test regularly for cervical cancer if you have a uterus (womb). Transmen are at risk of cervical cancer, however may find PAP tests invasive and distressing.

Testosterone causes the lining of the vagina to atrophy (shrink and dry), which can make PAP tests uncomfortable. The hormonal changes can make interpretation of the PAP test difficult in the laboratory.

We recommend discussing your options with your GP. Some people use a topical vaginal oestrogen cream for 1-2 weeks prior to their PAP test. The oestrogen is not absorbed into the rest of the body, but works locally to lubricate the vaginal walls and cervix -this makes the PAP test more comfortable.

For people who cannot tolerate a vaginal speculum, another option is a self collected / physician collected HPV (human papilloma virus) swab. These are not covered by medicare and cost around $80. These can be collected every 5-6 years as an alternative to a PAP test.