What are the items in gynecological health examination?

There is no one-size-fits-all fixed package for gynecological health examinations. The core is to conduct risk assessments in the areas of vulva, vagina, cervix, pelvic organs, and endocrine. The specific selection must be based on your age, sexual life history, daily symptoms, and past medical history. There is no need to pursue a "full package" at the beginning. On the contrary, it is easy to waste money and increase anxiety. Last week, a 23-year-old girl who had just been sexually active for a year came for a physical examination. As soon as she walked in, she was told that she wanted the most expensive comprehensive gynecological test. I screened her for basic tests and it was enough. I saved almost a thousand yuan.

A common gynecological examination that many people fear is embarrassing is actually the most basic screening item. The doctor will first visually observe the vulva for abnormal growths and mucosal damage, and then use a disposable speculum to check the condition of the vaginal wall and cervix. At the same time, a leucorrhea sample can be taken for routine testing to see if there are common inflammations such as mold, trichomoniasis, and bacterial vaginosis. There is also a point that has been debated in the industry for a long time: Should mycoplasma and chlamydia testing be added to routine physical examinations? Some institutions believe that routine screening can detect latent infections and avoid subsequent pelvic inflammatory disease. However, the current mainstream clinical consensus is that if you do not have recurrent vulvar itching, leucorrhea, or lower abdominal pain, and you do not need to prepare for pregnancy or have multiple sexual partners, there is no need for routine screening. If you find out positive, you may easily be over-treated.

As for the cervical screening that everyone has heard about the most, it is an early screening project for cervical cancer, that is, TCT liquid-based cytology test and HPV human papillomavirus test. Women who are sexually active are recommended to start after the age of 21. If two consecutive double screenings are negative, you can recheck again in 3-5 years. There is no need to do it every year, otherwise false positive results will easily make you worry. If you are a girl who has not had sex yet, you can just skip this item without having to do it forcefully.

The next pelvic ultrasound is also almost a must. Those who have had sexual intercourse prefer transvaginal ultrasound. There is no need to hold in the urine. The probe is extended into the vagina and close to the pelvic organs. The accuracy of detecting uterine fibroids, ovarian cysts, and endometrial thickness is much higher than abdominal B-ultrasound. I have seen many people hold back their urine until they become incontinent. Abdominal B-ultrasound still cannot be seen clearly. Switching to vaginal ultrasound can be done in five minutes, and many small cysts that cannot be seen with abdominal B-ultrasound have been detected. When postmenopausal women undergo ultrasound, they should focus on the endometrial thickness. If it exceeds 5mm, it is best to further investigate for endometrial lesions.

As for the six items of sex hormones, thyroid function, and tumor markers that everyone asks a lot about, they are not routine must-check items. For example, the six items of sex hormones only need to be checked if you have irregular menstruation, abnormal acne, hirsutism, or difficulty in preparing for pregnancy. If your menstrual cycle has always been regular and you have no related discomforts, it is a waste of money to draw several tubes of blood to check. There are also tumor markers such as SCC and CA125. Routine physical examinations for healthy people have a particularly high false positive rate. Previously, a girl found out that her CA125 was a little higher in her physical examination. She cried and thought she had ovarian cancer. The result was a physiological increase in her menstrual period, which was a waste of worry for half a month. Generally, these items only need to be added as needed for high-risk groups who have found abnormal masses or have a family history of related cancers.

By the way, remember to avoid the menstrual period before having a gynecological examination. Do not have sex, do not douche the vagina, and do not use vaginal suppositories in the first 2-3 days, otherwise it will easily affect the test results.