Dear Dr. Gott: I am 62 years old and in good health. I work 37 to 40 hours per week, and take lisinopril, levothyroxine and an 81 mg aspirin daily.

I have two issues I would like your opinion on. In 2002, I was told that my cervix was closing, so I underwent a procedure to reopen it. I am looking at the same procedure again this year to get a good Pap smear. At my age, do you feel this is a necessary procedure?

I have a Pap smear every year and each is never bad.

There is a history of cancer on my mother's side of the family. My grandmother and one of my aunts had cancer.

I only have hospital coverage and will have to pay for the procedure. I have frequent hot flashes.

They only last about five minutes, but happen at all hours of the day and night. They are so bad I feel as if I am about to melt.

My face and neck get extremely red, my heart races, I feel nauseated, hear my pulse in my ears and sweat so profusely that my hair and clothing get soaked. My concern is if they can adversely affect my health.

Reply: I believe you are suffering from the ill effects of menopause. Hot flashes are harmless but annoying.

They often occur in women during and after menopause when the brain has trouble determining if the body is hot or cold.

It, therefore, dilates and constricts the blood vessels spontaneously (or after certain triggers, such as stress), which causes the symptoms you have experienced.

There are several treatment options for menopause-induced hot flashes, such as hormone replace therapy, black cohosh and more.

Speak to your gynaecologist about this.

As for your cervix closing, I believe this is also due to menopause. During menopause, some women experience a thickening of the cervix, which can lead to partial or complete closure.

In most instances it is harmless and needs no treatment. If pain, fever, bleeding/spotting or abnormal drainage occur, cervical dilation may be necessary to determine if there is another cause such as cancer, fibroids or other conditions.

Remember that a pelvic exam is a good test to have regularly. It can diagnose several types of reproductive cancers.

Since you have had consecutive normal Pap smears and are post-menopausal, you may not need to have yearly Pap tests. You do have a family history of close female relatives having cancer, but you fail to say what kind.

If it were cancer of the cervix, or other reproductive organ, perhaps you should have a Pap every two or three years. If not, talk to your gynaecologist about stopping them.

You will still need to be seen for any spotting, increasing abdominal girth, bleeding, abnormal discharge or other symptoms, but because you are otherwise healthy and have had no bad tests, I believe it is in your best interest to stop.

If your physician is unwilling, request a referral to another gynaecologist for a second opinion.

To give you related information, I am sending you a copy of my Health Report "Menopause''.

Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, Ohio 44092. Be sure to mention the title.

Dr. Gott is a retired physician and the author of 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook'. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.