What items need to be checked in women’s health examination?

There is really no need to pursue a comprehensive physical examination for women. In addition to basic items such as routine hematuria, liver and kidney function, chest X-ray, and electrocardiogram, which are required by everyone, the core items should cover the three directions of gynecology, breast, and endocrinology. It can be adjusted based on age, living conditions, and family history. There is no need to buy high-end packages that often cost tens of thousands. Last week, I treated a 26-year-old girl who had just gotten married and was preparing for pregnancy. She was told to buy the most expensive cancer prevention package from the very beginning. In the end, the program I adjusted for her was only in her early 2,000, and the risks that should be covered were not missed at all. The extra PET-CT and full tumor marker package were not necessary for her age. On the contrary, she would receive unnecessary radiation.

Many people are dazzled by the project list of the physical examination center. In fact, it is not difficult at all to choose according to their own situation. Girls in their early twenties who have not yet had sexual intercourse do not need to undergo internal gynecological examination, HPV and TCT screening. Instead, the hymen will be damaged. An abdominal gynecological ultrasound should be done every year to see if there are ovarian cysts and uterine fibroids, and a breast ultrasound should be performed. That's enough. I met a 22-year-old college student a few months ago. He felt a hard lump in his breast and didn't dare to come for a check-up. He waited for half a year before coming in. In the end, it was found to be a 2-centimeter fibroid. He could just cut it with minimally invasive surgery and it would be fine. If he delayed for a few more years, there might be changes.

Once you are sexually active, you need to add TCT and HPV combined screening. There is indeed a controversial point about this item: some European and American guidelines believe that women under 30 years old who have received the nine-valent vaccine, have a fixed sexual partner, and have no other high-risk factors can do a combined screening every three years without having to run every year. However, many domestic clinicians still recommend annual screening. After all, our screening costs are not high, and the loss outweighs the gain in case of missed diagnosis. My own advice to patients is to look at your own living habits. If you frequently use public bath towels on business trips and have irregular sexual partners, you should get tested every year regardless of whether you are vaccinated or not. If there are no high-risk factors, it is perfectly fine to do it once every three years. Don’t worry about it.

At the age of 30 to 45, it is the period of high incidence of breast and cervical lesions. In addition to the above-mentioned screening, if breast ultrasound detects three or more types of nodules, you must add a mammography. Don’t worry about the pain of the mammography. It is more sensitive to calcifications than ultrasonic The sound was too high. My female colleague in the same department had a physical examination last year. She only saw type 3 nodules on ultrasound. Thinking it was nothing, I persuaded her to do a mammography. It was found that there were small clusters of calcifications. The puncture result was carcinoma in situ. She was cured after the removal and did not even need chemotherapy. If you often suffer from aunt disorder, acne, and inexplicable weight gain, you can also add six sex hormones and thyroid function. Don’t take it seriously. Polycystic thyroiditis or hypothyroidism may not only affect your pregnancy, but also make your overall condition much worse.

When you are over 45 years old and before and after menopause, remember to add bone density to your regular items. This is an item that many people miss. My mother was found to have low bone mass during her physical examination last year. I watched her take calcium and vitamin D supplements for a year, and walked briskly with her for half an hour every day. This year, the bone mass increased back during the review. If I don't care, it is easy to break bones if I accidentally fall when I am older. Gynecological ultrasound in this age group should also focus on the thickness of the endometrium. If bleeding occurs again after menopause, don’t think that it is “rejuvenation”. Get the endometrium checked quickly to rule out the risk of endometrial cancer.

If there is a clear family history of gynecological tumors or breast tumors, for example, if the mother or grandmother has suffered from ovarian cancer or breast cancer, the screening time should be advanced by 5 to 10 years regardless of age. Don’t stick to the public age line. By the way, there is another pitfall that I would like to remind everyone. Don’t believe the “ovarian function maintenance screening” or “full set of genetic tests to detect breast cancer risk” that are included in the packages of Internet celebrities. The former is really about checking the ovarian function and drawing blood to check for AMH. The latter is unless you are a high-risk group with a clear family history, otherwise ordinary people do not need to spend that wasted money.