Gynecological examination is an important and necessary examination item for women. Through gynecological examination, women can have a comprehensive understanding of their own situation, so as to achieve early detection and treatment, or to prevent problems before they occur. But many women neglect the importance of regular gynecological examinations because they do not experience relevant symptoms, feel troubled by examinations, and are shy.
Who needs to undergo gynecological examination?
It is generally believed that women of childbearing age (starting around 18 years old) and middle-aged and elderly women need to undergo gynecological examinations, regardless of sexual activity. The American College of Obstetricians and Gynecologists (ACOG) recommends that women start their first gynecological examination from the age of 13-15, and the scope of examination for adolescents depends on the patient's personalized needs. There are currently no recommendations in this area in our country. But personally, I believe that gynecological examinations should cover teenagers who have sexual activity before the age of 18.
What are the routine gynecological examination items?
1. Gynecological examination
Gynecological examination is a necessary item. Doctors conduct visual and internal examinations, as well as vaginal discharge sampling and testing to check for vaginal inflammation such as trichomonas, mold, or bacteria; More importantly, cervical cancer screening should be conducted, including two items: (1) cervical cytology examination (currently commonly used are TCT or LCT, previously performed as a Pap smear test for cervical exfoliated cells, but the accuracy of detection is not as good as TCT/LCT, so if possible, TCT/LCT should be performed as much as possible);
(2) Human papillomavirus (HPV) testing.
Every woman over the age of 18 who has had sexual intercourse should or must undergo TCT screening (cervical thin-layer liquid based cytology testing technology), also known as cervical scraping, which is currently one of the most advanced and effective techniques for screening female cervical cancer. By classifying and diagnosing the exfoliated cells at the cervical opening, it is possible to determine whether the cells are cancerous or infected by microorganisms. HPV (Human Papillomavirus, a high-risk type of persistent infection in the reproductive tract) is the main cause of cervical cancer and is usually tested together with TCT.
2. Vaginal ultrasound
Transvaginal ultrasound is also a necessary procedure, which can detect most lesions on the uterus, ovaries, or fallopian tubes. If there is no sexual history, it is also recommended to have a transrectal ultrasound, which can achieve similar accuracy and results as a negative ultrasound examination.
3. breast cancer Examination
According to the latest cancer data, female breast cancer will account for 11.7% of the world's new cancer patients in 2020, becoming the cancer with the largest number of new diagnoses in the world. Although the incidence rate of breast cancer is the highest, the mortality rate is slightly lower, suggesting that the treatment and prognosis of breast cancer are better. If scientific screening can be carried out and early detection can be made, the 5-year survival rate of early breast cancer patients can reach 95%. The standard suggests that people with high risk of breast cancer should be screened from the age of 40, and breast ultrasound combined with mammography should be performed once a year. Breast cancer screening should be carried out for the general risk population (all women of the right age except the high-risk population) between 45 and 70 years old. For the general risk population, it is recommended to undergo regular breast palpation and breast ultrasound examination every 1-2 years. Of course, for women who have the conditions, they can consider undergoing breast palpation, breast ultrasound, and mammography once a year after the age of 40.
What preparations need to be made before the inspection?
1. Prepare loose fitting clothes and pants that are easy to put on and take off, and consider skirts.
2. The emptying size before physical examination is convenient for pelvic examination and vaginal ultrasound examination (for asexual individuals, bladder filling is required for abdominal ultrasound). If necessary (for those who cannot urinate or defecate on their own), they need to undergo catheterization or enema before defecation.
3. Avoid gynecological examinations during menstruation. If there is abnormal vaginal bleeding, it must be checked. Three days before gynecological examination, sexual activity, vaginal medication, or vaginal cleaning are not allowed.
4. The most important thing is still mental preparation. Don't be afraid or nervous, try to relax as much as possible, and taking deep breaths is a good way.
Some concerns of female friends in gynecological examinations
1. Little girls who have not had sexual intercourse do not need gynecological examinations
Error. Some gynecological diseases such as ovarian tumors can occur at any age. Women who have not had sexual intercourse and experience lower abdominal pain or palpable lower abdominal masses should seek timely gynecological treatment and complete corresponding examinations to avoid delaying the condition.
2. No need for gynecological examination after menopause
Error. The average age of menopause for women is 46-50 years old, but menopause does not mean that they will not develop gynecological problems again. Many gynecological diseases, especially gynecological malignancies, have a high incidence after the age of 50. Gynecological examinations can detect and treat these gynecological diseases early.
3. Abdominal ultrasound/CT is equivalent to gynecological examination
incorrect. It is worth noting that many gynecological diseases such as cervical lesions require gynecologists to conduct detailed gynecological examinations to fully expose the cervix and combine them with cervical scraping to detect them in the early stage. Therefore, abdominal ultrasound/CT cannot replace gynecological examinations.
Have you learned the common knowledge about gynecological examinations?