How to check women’s health

The core principle is actually "customized on demand". There has never been a unified checklist that applies to all women. Rather than following the trend and buying expensive physical examination packages, only by matching items based on your own age, living status, and past medical history can you truly pinpoint risks.

I have been in the gynecology clinic for almost 7 years, and I have seen too many patients who fell into the "universal package". A 28-year-old girl came to me a while ago. The annual routine physical examination in the unit reported that everything was normal, but the result was non-menstrual bleeding for two consecutive months. She came to check for HPV16 positivity and low-grade squamous intraepithelial lesions. Her previous unit package did not include joint screening of HPV and TCT, which in vain delayed the intervention time for less than half a year.

Speaking of which, I would like to mention the much-discussed issue of HPV screening frequency. There is indeed no completely unified standard in the industry. Foreign guidelines generally recommend that TCT screening be done alone if you have sexual intercourse after the age of 21, and then combined with HPV testing after the age of 30. Many domestic clinicians will recommend that if you start having sex early and your sexual partner is not fixed, you can do joint screening after the age of 25. If you have good immunity and have a regular sex partner, it is enough to check every 2-3 years before the age of 30. There is no need to waste money on excessive screening for peace of mind.

Many young girls always think that they don’t need gynecological examinations if they are not married and have no sex life. This is not true. I just received a 19-year-old college student last month. Her menstruation has been delayed for six months in a row, and the longest period has not come for more than three months. She also gained 10 pounds due to acne on her face. She had been going to the dermatology department for acid tests and taking diet pills. Finally, she went to have six hormone tests and abdominal B-ultrasound, and found out that she had polycystic ovary syndrome. If she had been checked earlier, she would not have suffered so much. If you are not sexually active and have abnormal menstruation, tell your doctor clearly that you can have a transabdominal B-ultrasound without any discomfort, so don’t be shy.

For female friends over the age of 35, in addition to the mandatory screening for cervical cancer and breast cancer, it is best to add bone density to the annual check-up list. The rate of bone loss in women begins to accelerate after the age of 35, and it jumps to 2-3 times that of men after menopause. Many people wait until they are in their 40s and 50s to have back pain and leg cramps before thinking about calcium supplements. In fact, checking bone density five or six years earlier and supplementing with vitamin D and calcium in advance can reduce the risk of osteoporosis and fractures in old age by more than 30%. My aunt had her bone density checked during her physical examination last year. It was found that the bone mass was close to the critical value of bone loss. After a year of supplementation, she was checked again this year and it fell back to the normal level.

There are also many postmenopausal aunts who always think that "they have stopped having sex and have no sex life, so they don't need to go for gynecological examinations." This misunderstanding has really harmed many people. There was a 62-year-old aunt who suddenly had a small amount of bleeding after 10 years of menopause. She thought it was the legendary "rejuvenation". It took half a year to find out that it was late-stage endometrial cancer. If she had a routine transvaginal B-ultrasound and cervical scraping every year, it would cost less than 200 yuan. If detected early, the cure rate can be over 90%.

By the way, when you go for a check-up, be sure not to hide your privacy, whether you have had sex, whether you have a history of miscarriage, whether you have relatives in your family who have suffered from gynecological cancer or breast cancer. This information may seem inconspicuous, but it can actually help doctors accurately provide you with targeted projects. For example, for people with a family history of ovarian cancer, additional CA125 and HE4 tumor marker tests are nearly 40% more sensitive than simple B-ultrasound screening. Oh, and here’s a little tip: don’t have sex three days before a gynecological examination, and don’t put vaginal medicine in, otherwise it will interfere with the examination results, and you’ll be in vain for a trip.