Gynecological health examination

It is enough for adult women who are sexually active to have a routine gynecological examination once a year. For women who are not sexually active, it is enough to have a basic gynecological ultrasound every 2-3 years. There is no need to pursue "luxury gynecological packages" that cost thousands. If you choose 3-4 core items, you can cover more than 90% of the risks of common gynecological diseases.

I just met a 27-year-old girl in my clinic last week. For the Internet company's welfare physical examination, she added an additional gynecological upgrade package worth 2999. She checked for full HPV classification, ovarian function assessment, and full spectrum of vaginal microecology. Finally, she came in crying with the report, saying that it said "mild imbalance of vaginal flora" and "HPV52 weak positivity", and she thought she was about to get cervical cancer. I did a new TCT on her, and the results were all good. She didn’t even need to prescribe medicine. She just had to come back for a follow-up checkup after three months of regular work and rest. It was just a waste of thousands of dollars and she was scared to death. There are really too many cases like this in our outpatient clinics. Eight out of ten gynecological abnormality reports from medical examination institutions are "pseudo-problems" caused by over-interpretation.

Having said this, someone must want to ask, which items must be checked? In fact, it’s really not much: if you are sexually active, a routine internal gynecological examination, leucorrhea routine, cervical TCT, and abdominal or vaginal ultrasound are enough. If you are over 30 years old, you can add HPV joint screening. The total cost of these items in a public tertiary hospital is only 500 to 600 yuan, which is completely enough. Oh, by the way, regarding the frequency of cervical cancer screening, there are actually two different recommendations in the industry. The USPSTF guidelines say that TCT every 3 years is enough for 21-29 year olds without the need for joint HPV testing. Joint screening can be done every 5 years for 30-65 year olds. This standard itself is okay, but in China Many clinicians will recommend an annual check-up, mainly based on national conditions - many people simply cannot do regular three-year physical check-ups, and the risk of missed diagnosis is higher. If you can guarantee that you can definitely arrange a check-up every three years, it is absolutely fine according to foreign standards. You don't have to worry about which is right and which is wrong, just follow up your habits.

Many people also ask, if I don’t have sex, I don’t need to have a gynecological examination at all? There are two things to say about this. If there are no special symptoms, there is no need to undergo invasive internal examinations and cervical cancer screenings. However, I once met a 19-year-old girl who suddenly suffered from abdominal pain during gym class and was sent to the emergency room. It was found that she had teratoma torsion and one ovary was necrotic. She had never had a gynecological ultrasound before. If she had done an abdominal B-ultrasound every year, the tumor would have been discovered long ago, and she would not have had to remove the ovaries. Therefore, if a girl who is not sexually active often has lower abdominal pain or abnormal menstruation, she should go for an abdominal ultrasound in time. If there are no symptoms, it can be done every two to three years without any worries, and it does not cost a hundred yuan.

Oh, by the way, there is another question that everyone is ashamed to ask: Will it be embarrassing and painful to have a gynecological examination? The most exaggerated patient I have ever encountered was a 32-year-old who had been married for 5 years and had never had a gynecological examination because she was afraid of taking off her pants or the doctor's rough movements. In fact, it’s really not that scary. As long as you relax during a normal gynecological examination, you will feel a little sore at most and not hurt at all. If you are really nervous, tell the doctor in advance that this is your first time, and we will take it easy. If you really can’t accept a male doctor, you can also ask for a female doctor in advance. Nowadays, the proportion of female doctors in most gynecological clinics in public hospitals is more than 80%, so there is no need to be embarrassed. By the way, a reminder: do not have sex, do not irrigate the vagina, and do not insert medicine 3 days before the examination, otherwise the results will be inaccurate and the trip will be in vain.

Don’t think that gynecological examinations are only for young people. Last year, I met a 48-year-old sister who had been menopausal for three years. She felt that she had “no menstruation and why should I check gynecology?” She had intercourse bleeding intermittently before, so she thought it was menopause. After a year of delay, she came back for a check-up, and it turned out to be stage II cervical cancer. In fact, it usually takes 5-10 years for cervical precancerous lesions to develop into invasive cancer. During this period, only one TCT can detect the problem. If it is treated early, there is no need to cut the uterus. If it is delayed, the only option is chemotherapy and surgery, which is a long-term sin.

As for those "ovarian age tests", "cervical cancer risk genetic screening" and "private toxin assessment", take my advice, they are all IQ taxes. The AMH indicator is originally used to evaluate ovarian function for people who are preparing for pregnancy or have abnormal menstruation. If you have good menstrual regularity, if it is found to be low, it does not mean that you are going to menopause. If it is high, it does not mean that you are fertile. It is just a waste of money. There are also various fancy tests for vaginal flora. As long as you don’t have symptoms of yellowish vaginal discharge, itching, or odor, even if it is found to be a bit “imbalanced”, you can adjust it by yourself without taking medication at all.

To be honest, gynecological physical examination is really not as complicated as everyone thinks, and there are not so many bells and whistles. Don't be overly anxious. If you find out some minor problem, just search it on Baidu to scare yourself. Don't be too arrogant and put off getting checked even though you have abnormal symptoms. Taking half an hour every year to choose the right items is much more reliable than buying thousands of dollars of private parts care products.