What are the gynecological health check-ups?

For ordinary healthy women of appropriate age and having sex, it is actually enough to do all four core items during annual routine gynecological examinations. There is no need to blindly add high-priced items and spend more money. Instead, they may be anxious because of false positive results.

Last week, I accompanied my 28-year-old Fa Xiao for a physical examination. She has a regular schedule and has no uncomfortable symptoms such as abnormal leucorrhea or dysmenorrhea, nor does she have a family history of malignant gynecological diseases. The doctor prescribed more than 2,000 additional items for her, including a colposcopy. I stopped and crossed out half of the unnecessary items. In the end, I didn't even spend 1,000 yuan, and all the indicators were normal.

Some people may think that I am too stingy to let her check. It is not true. Let’s follow the logic of the check and understand. The first thing that is usually done is what everyone often calls "routine gynecological examination". Many girls feel embarrassed and afraid of pain, and say they want to skip it as soon as it comes up. It is really unnecessary. The whole process only takes a minute or two, and there is basically no discomfort as long as you relax. The doctor can intuitively see whether there are any growths on the vulva and vagina, and whether the cervix is ​​in good condition. He can also feel the size and position of the uterus and appendages through palpation, and whether there are tenderness or abnormal masses. Many minor tenderness in chronic pelvic inflammatory disease may not be caught by ultrasound. Girls who have not had sexual intercourse can tell the doctor in advance, and they will switch to anal examination, so there is no need to worry about damaging the hymen.

The secretions you pick up easily can be used to treat leucorrhea. It costs more than ten yuan and is very cost-effective. If you have vulvar itching recently, or the leucorrhea is of wrong color or has a peculiar smell, this test can accurately distinguish whether it is a mold, bacteria or trichomonas infection. It is a hundred times more reliable than buying random lotions from Internet celebrities through short videos. Remember not to insert medicines or rinse the vagina 3 days before the test, otherwise the results will easily be inaccurate.

Cervical cancer screening is the most unavoidable of all items. After all, cervical cancer is currently the only cancer with a clear cause that can be screened and prevented early. There are quite a lot of controversies about this project. Some people say that you don’t need to check if you have been vaccinated against HPV. Some people say that you need to check once a year to feel at ease. In fact, according to the current authoritative guidelines, you can start screening after you have sexual intercourse at the age of 21. From 21 to 29 years old, you only need to do TCT every three years. After the age of 30, combined TCT and HPV screening is recommended, and it is enough to do it every five years. Even if you take the nine-valent vaccine, you still need to be screened on time. After all, the vaccine cannot cover all high-risk subtypes, and there is still a risk of missed protection. The reason why you don’t need to check every year is also very simple. Cervical lesions develop very slowly. Frequent screening may cause you to undergo a lot of unnecessary invasive tests due to transient HPV positivity, which will make you suffer instead.

The next gynecological ultrasound is also very practical. If you are sexually active, you can choose vaginal ultrasound. You don’t have to hold in your urine and you can see more clearly. If you are not sexually active, you can choose abdominal ultrasound. You can hold your urine in advance. This project can see clearly whether there are fibroids and adenomyosis in the uterus, whether there are cysts or polycystic changes in the ovaries, and whether the thickness of the endometrium is consistent with the current menstrual cycle. If you usually have worsening dysmenorrhea, heavy menstrual flow, or irregular menstrual cycles, this project can basically find out most of the reasons.

As for other gynecological examination items that everyone often sees, not everyone really needs to do them. For example, the six items of sex hormones can only be added if you have ridiculously irregular menstruation, serious acne and hirsuteness, or if you are trying to conceive or are unable to conceive and suspect endocrine problems. Routine physical examinations for healthy people have no reference value. There are also tumor markers such as CA125, which have a particularly high false-positive rate. If you happen to be in your menstrual period, have ordinary pelvic inflammatory disease, or even have a benign ovarian chocolate cyst, it will rise. Ordinary healthy people will be scared to death if they check it. Only people with a family history of ovarian cancer or abnormal masses detected by ultrasound need to do it. Colposcopy and hysteroscopy fall under the category of "further examination". Only if your cervical cancer screening or ultrasound results are abnormal, the doctor will recommend it. It is not a routine physical examination at all. Don't be fooled into doing it and suffer.

By the way, it is best to go for a gynecological physical examination during a period of 3 to 7 days when menstruation is clear. Do not have sex in the first 3 days, and do not flush the vagina deliberately. The results will be more accurate.