Gynecological health examination items

Gynecological routine physical examination, vaginal secretion examination, cervical cancer screening (TCT+HPV combined), transabdominal/transvaginal pelvic ultrasound. In addition, all the highly hyped "value-added projects" are all on-demand. It would be a waste of money to do them without instructions.

Last week, I met a young girl who had just graduated from the clinic. She came to me with a "goddess exclusive physical examination package" from a private institution and asked me if it was necessary. I looked through it and found 12 items including tumor markers, "premature ovarian failure screening" and "private anti-aging assessment". The whole package cost almost 3,000 yuan. When I asked the girl, she didn't even have sex, she had regular menstruation and no stomachache. Except for pelvic ultrasound and vulvar inspection, the rest of the items were really unnecessary.

Let’s talk about routine gynecological examinations first. Nowadays, many people are resistant to this and find it embarrassing and painful. Many people also say, "I don’t have to do this if I don’t have sex." In fact, there is no unified hard requirement in the academic world: if you don’t feel any discomfort or have no sexual intercourse, Women with a healthy life history can indeed skip the internal examination and go directly to a transabdominal pelvic ultrasound. However, if you have unexplained abdominal pain or abnormal vaginal bleeding, even if you have no sexual life, it is recommended to find an experienced doctor for an anal and abdominal examination to check the problem. Don’t hold on to the investigation and delay things. Oh, by the way, remember to empty your bladder before doing this project, otherwise you will cry in pain when the doctor presses on it. Don’t ask me how I know this.

Then there is the vaginal secretion examination, which is mainly to check whether there is vaginitis. Many people put medicine at home and wash the vagina with lotion when they feel itchy. When they think of a physical examination, they stop taking medicine for a day and come to check. The results are all normal and no problem can be found. Remember, if you want to check this, don't have sex, don't insert pills, and don't rinse your vagina for at least 3 days, otherwise the results will be completely inaccurate and you will be wasting your money.

Cervical cancer screening is now widely popularized, but there are still many misunderstandings. The first is the issue of screening age. The American ASCCP guideline recommends that women over 25 years old who have sexual intercourse should start screening. Domestic clinical guidelines are more conservative. Screening can start at the age of 21 if they have sexual intercourse. You can choose according to your own situation. Many people also ask, "If I take the nine-valent/four-valent vaccine, do I not need to be tested?" That's not true. The HPV subtypes covered by the vaccine are limited, and you still need to be screened regularly. If both TCT and HPV combined screening are normal, you can do it once every 3 to 5 years. You really don’t need to do it every year. Wouldn’t it be nice to drink milk tea with the money you save? Oh, by the way, many people are frightened to death when they see "HPV positive" on the screening report, thinking that they are going to get cervical cancer. It is really not the case. 80% of women will be infected with HPV once in their lives, most of which are transient. If the immunity is normal, it will become negative in 1 to 2 years. As long as the TCT is normal, regular re-examination will be enough. Don't buy any "HPV negative medicine" blindly. IQ tax comes from it.

Let’s talk about the pelvic ultrasound. This is divided into transabdominal and transvaginal ultrasound. If you are sexually active, you can choose vaginal ultrasound. You don’t have to hold in your urine and you can see clearly. If you are not sexually active, you can do transabdominal ultrasound. Remember to hold your urine in advance. Many people panic when they see the words "pelvic effusion" in the report and go to the doctor to prescribe medicine. In fact, most of them are physiological. They may occur after ovulation or just after menstruation. As long as there are no discomforts such as stomach pain and lumbosacral soreness, there is no need for treatment. Last month, I met a girl who was given a week of antibiotics at a small clinic because of a 1cm pelvic effusion. It was really unfair.

The remaining items need to be done only if there are real problems. Don't add them randomly if there is no indication. For example, if your menstruation is very irregular and only comes once every two to three months, and you still have acne and weight, then add six items of sex hormones. It is best to do the test on an empty stomach in the morning on the 2nd to 4th day of menstruation for the most accurate results. If you have a family history of ovarian cancer or endometrial cancer, or you suddenly have bleeding again after menopause, it is okay to add tumor markers such as CA125 and HE4, or perform hysteroscopy when necessary. As for the "antioxidant capacity test" and "private flora balance assessment" that those institutions are boasting about, listen to me, it's not necessary, there's nothing wrong with keeping the money.

I have been in gynecological clinics for almost 8 years and have seen too many extreme cases. Either they find gynecological examinations embarrassing and do not do them once for five or six years, and problems are discovered as soon as they come for examinations; In fact, gynecological physical examination is really not that complicated. Don’t believe those marketing words. Before going, check whether you have been feeling uncomfortable recently and whether you have any family history. Tell the doctor directly when you go. They will prescribe suitable items for you, which is a hundred times better than making blind choices on your own.