Apart from sex, vaginal atrophy makes it pretty impossible for me to have a pap smear - inconclusive readings. I have been having ultrasounds instead, but of course that can't track any cell changes. "At my age" I am not supposed to need pap smears any more, but it's been a comforting thing to have the all clear in the past. "At my age" atrophy could have happened anyway, but going from normal to extremely painful vaginal intercourse in 6 months seems relatively conclusive to me. My partner and I are OK and adapting, but like Marg I find lotions and such irredeemably messy, and personally I'm not having laser treatment without some extremely good results about efficacy and safety first!