What are the gynecological health examinations

Routinely, healthy women of childbearing age who are not pregnant undergo an annual gynecological physical examination. There are a total of 4 core items that must be checked. The remaining items are all added as needed according to your personal situation. There is no need to waste money by doing random things, and don’t delay problems by missing items.

Last week I saw a 27-year-old girl and asked about the company's physical examination package. In addition to the regular items, she was given HPV classification and quantification, colposcopy, and a full set of ovarian cancer tumor markers. The total was almost 2,000. When I asked her, she did TCT and HPV joint screening every year. She had been double negative for three consecutive years, and she did not have intercourse bleeding or abnormal leucorrhea. I just asked her to return all the extra items and just do the four basic items.

The "internal examination" that many people avoid when they come for a gynecological examination is actually the most underestimated of the four items. The doctor looks at the appearance of the vulva, vagina, and cervix with the naked eye, and then makes a bimanual examination to feel the size, position, and tenderness of the uterus and appendages. Sometimes, he can find out problems that may not be found in time even with ultrasound—there used to be a 32-year-old patient who only went to gynecology every year. Ultrasound results were normal every time. Last year, the physical examination at the unit was supplemented with internal examination. When I felt it, I found a small tender nodule in her sacral ligament. After further investigation, I found out that it was early-stage deep endometriosis. Early intervention would have saved me from having period dysmenorrhea that would make me unable to go to work.

During the internal examination, the doctor usually takes two samples to save you from having to lie on the examination bed alone. One is the routine leucorrhea test, which is to check for common vaginitis symptoms such as mold and trichomonas. If you often have vulvar itching and yellowish leucorrhea with a fishy smell, the doctor will additionally test for bacterial vaginosis or mycoplasma or chlamydia. If you don’t feel uncomfortable, a routine leucorrhea test will be enough. The other is a sample of cervical cancer screening. Different guidelines now have different recommendations on screening options: most guidelines for those under 25 years old recommend TCT alone, while those aged 25 to 64 years old prefer TCT+HPV combined screening. If they are double-negative for two or three consecutive years, it can be relaxed to It should be done once every 2-3 years. Some studies believe that HPV screening alone is enough for women under 30 years old without high-risk factors. You can choose based on your own living habits and doctor's advice. There is no need to blindly pursue expensive quantitative quantitative testing unless you have been found to be HPV positive and need follow-up evaluation.

Another option is gynecological ultrasound. If you have had sexual intercourse, transvaginal ultrasound is preferred. You don’t have to wait in a hurry to hold in your urine. Small uterine fibroids and ovarian cysts can be seen much more clearly than abdominal ultrasound. If you have not had sexual intercourse, choose abdominal ultrasound or transrectal ultrasound, which can also clearly see the condition of the pelvic cavity.

As for the six items of sex hormones, AMH ovarian function test, CA125 and other tumor markers that people often ask about, not everyone needs to do it: those with regular menstruation and long-term infertility can add sex hormones and AMH, and those with a family history of ovarian cancer and breast cancer can add tumor marker screening. There is no need to prescribe routine physical examinations for ordinary health. After all, menstrual periods, long cysts, and even some inflammation may cause these indicators to fluctuate. If they are found to be high, it will only increase anxiety.

By the way, a reminder, it is best to take a gynecological physical examination 3-7 days after the menstruation is clear. Do not have sex, do vaginal douching or insert medicine 3 days before the examination, otherwise it will affect the test results.