The cervix is the lower portion of the uterus. It protrudes into the upper end of the vagina and its opening connects the uterus to the vagina. The cervix is lined with a mucous membrane, but, unlike the vagina's membrane, the cervical mucous membrane is smooth. The cervix varies in size and shape depending on a woman's age and her menstrual or hormonal status. The cervix changes throughout a woman's life as she matures through the various stages of puberty, menstruation, pregnancy, childbirth, perimenopause, menopause and postmenopause.
Changes in Size
The uterus consists of the cervix and the corpus, the main body of the uterus, which is very muscular. During a woman's reproductive years, the corpus is twice as long as the cervix, but following menopause, the reverse is true, according to a Merck Manual article on women's internal genital organs by Dr. Peter L. Rosenblatt, a Massachusetts Obstetrics and Gynecology physician.
Cervical Cell Changes
A Pap smear is a test used to screen women for cervical cancer. The chance of developing cancer of the cervix increases with age and, when first diagnosed, cervical cancer in older women tends to be more advanced, according Cancerfacts.com. Because many cases of cervical cancer are diagnosed in women older than 50, Pap tests continue to be important after menopause.
Cervical cells go through many noncancerous changes that can be caused by hormone fluctuations that occur during menopause. Although many cervical cell changes are common and noncarcinogenic, they show up as abnormal cells on Pap tests, so health practitioners may advise repeating Pap smears or they may encourage patients to have other tests to be certain cell changes are not indicative of cancer.
Cervical Shape Changes
Some women complain of having a closed cervix because when a menopausal woman has a gynecological exam, it is sometimes more difficult to see the cervical opening due to dryness or shrinkage. During and after menopause, the cervix may become smaller, and a very elderly woman's cervix may be almost impossible to distinguish as separate from the vagina. General practitioner Dr. Roger Henderson, advisor and medical panel member for NetDoctor.co.uk, says the cervix does not actually change position or retract during menopause, but it can shrink slightly in size or atrophy.
Cervical Discharge
Vaginal and cervical discharge decreases in amount during menopause and may disappear completely after menopause, unless there is an infection.
Abnormal Bleeding
Vaginal bleeding after menopause is uncommon and usually abnormal. It may indicate the presence of a precancerous or cancerous condition of the cervix, vagina or uterus, specifically the endometrial lining. Memorial Hermann Baptist Beaumont Hospital in Maryland explains that up to 25 percent of postmenopausal bleeding is likely to be caused by cancer of the reproductive organs, with endometrial or uterine cancer being the most common.
Cervical irritation, infection or polyps may also cause vaginal bleeding, and bleeding may also result from thinning of the vagina or uterus, or hyperplasia, thickening, of the uterine lining.
Cervical polyps
If a doctor sees smooth purple or red fingerlike growths on the cervix, she may order a cervical biopsy that usually shows benign cervical polyps, according to MedlinePlus, a service of the National Institutes of Health. Polyps do not always cause symptoms in postmenopausal women, but some may experience abnormal vaginal bleeding or leucorrhea, a white or yellow mucous. The health care provider can remove most polyps during an outpatient procedure.
Cervical Stenosis
Cervical stenosis is the narrowing or closure of the passageway from the vagina through the cervix to the uterus. Some women are born with it, but it can be the result of a disorder or another condition such as menopause when the tissues in the cervix become thinner.
