Jenny The core must-do items of a routine gynecological health examination are mainly four items: routine internal gynecological examination, vaginal secretion testing, cervical cancer screening, and pelvic ultrasound. The remaining items are added on demand based on personal age, medical history, and family history. There is no need to get a full package at the beginning. Spending money can lead to inexplicable anxiety.
I just met a 26-year-old girl last week. The physical examination only included basic internal examination. She said that she occasionally had bleeding in the same room, so she took the initiative to add TCT and HPV screening, and she was found to be positive for high-risk HPV18. Fortunately, there were no lesions on TCT, and a six-month follow-up was enough. If these two items were not included, it might not be discovered until high-grade lesions appeared, and she would have to suffer the consequences of surgery.
Let’s talk about the internal examination first. Many girls get discouraged when they hear that they have to take off their pants for a gynecological examination. In fact, this examination is very quick. The doctor can detect vulvar leukoplakia, vaginal wall growths, cervical polyps and other visible problems with the naked eye. The feeling of touching the uterine appendage during bimanual examination cannot be replaced by instruments. Many patients with chronic pelvic inflammatory disease have normal ultrasound results, but they are diagnosed only when the doctor feels tenderness when touching.
The next vaginal discharge test is what everyone often calls routine leucorrhea. If you always feel itchy in your private parts, or your leucorrhea is yellow, green, and smelly, this test will give you results in about ten minutes and can distinguish whether it is a mold, bacteria or trichomonas infection. Don’t blindly buy lotions on your own. The more you rinse, the more disordered the bacterial flora will be, and the recovery will be slower.
Cervical cancer screening is an item that all sexually active women must pay attention to. The current guideline recommends that TCT every 3 years between the ages of 21 and 29 is enough. Combined TCT and HPV screening is recommended for those over 30 years old. If there is no problem with both, it is enough to check once every 5 years. However, there are different clinical opinions here. If you usually have an irregular sexual partner or have an immune deficiency disease, many doctors will recommend shortening the screening interval, which is more secure. Girls who are not sexually active do not need to do this screening regularly, so there is no need to worry.
Pelvic ultrasound is divided into two types: abdominal ultrasound and transvaginal ultrasound. If you are not sexually active, you can choose abdominal ultrasound. Just hold your urine in advance. If you are sexually active, transvaginal ultrasound is recommended. You don’t have to hold your urine. You can see uterine fibroids, ovarian cysts, and endometrial thickness much more clearly than abdominal ultrasound. Last month, there was a 41-year-old sister who usually had no symptoms of abdominal pain and bloating. During her annual physical examination, she discovered a 2.8-cm ovarian chocolate cyst during a transvaginal ultrasound. With timely medication and intervention, she would not have to wait until the cyst grows to 5-6 cm, which would require surgery.
As for other items, they are all selected according to needs. For example, if you have irregular menstruation all year round and always have acne on your face, you can add six sex hormone tests. Remember to take it on an empty stomach in the morning on the 2nd to 4th day of menstruation. You don’t have to wait for menstruation to clear up.； If you are over 35 years old and worried about declining ovarian function, you can also add an AMH test. You don’t have to choose a time for this, you can check it anytime. ； If you have a family history of ovarian cancer or endometrial cancer, it is recommended to check the two tumor markers CA125 and HE4 every year. Early screening is of great significance.
By the way, a final reminder: 3 days before a gynecological examination, it is best not to have sex, do not use vaginal medicine, do not flush the vagina, and avoid the menstrual period, otherwise the accuracy of the examination results will be affected.
