Gynecological Health Checkup Guide

Regardless of whether you have sex or have obvious gynecological discomforts, by having a targeted gynecological examination at least once a year, you can avoid more than 90% of common serious gynecological risks in advance, including early asymptomatic cervical cancer, ovarian malignant tumors, endometrial lesions, etc.

Let me tell you a disturbing statistic. I have been in the gynecology clinic for almost 8 years. Among the patients with cervical precancerous lesions, 80% have never had routine gynecological screening. They either think "I am not married and don't need to check", or they think "I am usually clean and have nothing wrong with me." When the symptoms of intercourse bleeding and bloody leucorrhea occur, it has often been pushed to the point where surgery is needed. I just treated a 23-year-old girl a while ago. She had just graduated and started working. During the physical examination at her workplace, she took the initiative to cross out the gynecology section. She felt that she didn’t feel uncomfortable even if she didn’t have a sexual life. However, she couldn’t stand up for a check-up due to dysmenorrhea for three consecutive months. She found that the ovarian teratoma had grown to 6cm, and she almost had to remove one of her ovaries. It was a pity.

As for the most frequently asked question: If you don’t have sex, does it mean you don’t need to have a gynecological examination at all? There are indeed two views in the industry. One group believes that young women who have no sexual life, menstrual disorders, and severe dysmenorrhea do not need to undergo routine gynecological screening to avoid the discomfort caused by invasive procedures. ； However, in recent years, we have encountered more and more girls in their 20s suffering from ovarian teratoma and polycystic ovary syndrome in clinical practice. Therefore, it is generally recommended that even if they have not had sexual intercourse, if they have irregular menstruation for three consecutive months, the dysmenorrhea is getting worse, or there is a hard lump or inexplicable swelling in the lower abdomen, at least an abdominal B-ultrasound is done. There is no need to touch the private parts, just hold in the urine. There is no pain, and the condition of the pelvic cavity, ovaries, and uterus can be clearly seen.

If you are a girl who is already sexually active, don’t be put off by the online posts saying “gynecological examination is so painful that you want to die”. I have seen many girls lying on the examination bed with their legs stretched like wooden boards. In fact, the more tense the muscles are, the tighter the muscles will be, which will make them more uncomfortable. When you relax, you will usually only feel slight soreness. If you are really afraid, tell the doctor in advance to use a small dilator, and most doctors will agree. Nowadays, many brands have produced HPV self-sampling kits. You don’t need to go to the hospital. You can take samples for testing at home. The accuracy is about 4%-6% lower than that of a doctor’s consultation. It is suitable for girls who are really afraid of pain or can’t spare the time. However, if you already have symptoms such as intercourse bleeding and abnormal leucorrhea, it is still recommended to go to the hospital directly to see a doctor to take a sample. Don’t be too troublesome.

Don't listen to private hospitals tricking you into doing a full set of gynecological examinations and ovarian function screenings that cost thousands. Ordinary people really don't need physical examinations. If you have sex before the age of 29, a gynecological B-ultrasound + TCT is enough every year. If you are 30 to 65 years old, you can do TCT + HPV combined screening. It only needs to be done every 3 to 5 years. You don't need to check for HPV every year. Of course, if you don't have the money, there is nothing wrong with doing it every year. There is no mandatory requirement. By the way, during the annual gynecological examination, a breast B-ultrasound is added, and a mammogram is added when you are over 40 years old. Many people always count the breast examination and gynecology separately. In fact, breast problems are also a high health risk for women, so I can save myself two trips by doing the check-up.

Oh, yes, don’t go when your period has just started or is about to start. It is best to go 3 to 7 days after your period. At this time, the cervix is looser and there is less secretion. Both the cervical condition and the sampling are more accurate. Do not have sex or have sex 2 days before the test. Use medicine and don't rinse with those private parts care solutions. Last week, I met a girl who had just used lotion to clean her vaginal discharge the night before to check for leucorrhea. The result was that nothing abnormal was found. It was a waste of time. The itching returned within two days after returning, and she had to come again.

There is also a tumor marker called CA125 that people often ask about. Should I check it? There are currently two factions in the academic world. One faction believes that if ordinary healthy women have no family history, the false positive rate of this test is too high. For example, when menstruation or pelvic inflammatory disease occurs, the number will be high, which is a waste of money. ； But from the perspective of a clinician, I generally recommend that women over 35 years old should have CA125 and HE4 checked every year. The two items add up to more than 100 yuan. After all, there are almost no symptoms in the early stage of ovarian cancer, and 70% of patients are diagnosed in the late stage. These two indicators can help us screen out a large part of the early risks, and the price/performance ratio is really high.

In fact, in the final analysis, gynecological examination is really not as embarrassing as everyone thinks, nor is it a shameful examination. Many girls born after 95 and 00 around me now take the initiative to make appointments for gynecological examination every year. After all, the body is their own, and spending a few hundred to buy peace of mind is better than spending hundreds of thousands to treat the disease if something goes wrong, right? Oh, by the way, if you go for a check-up, remember to wear loose pants or a skirt to save you the trouble of taking off your clothes when the time comes. This is a little reminder from those who have experienced it.