For most women, having an OB/GYN exam can be embarrassing, even scary. So what exactly does a gynecological exam look for and is it really scary?
Gynecological examinations include the following.
First is the vulvar examination, which checks for swelling, inflammation, venereal disease and other skin changes in the vulva.
Next is the vaginal examination to check for vaginal abnormalities, vaginal inflammation, microscopic examination of the leukorrhea to determine the presence of vaginal trichomonas infection and fungal infection, and to determine vaginal cleanliness.
Cervical examination is performed to determine the presence of cervical inflammation, cervical erosion and superfluous organisms. To prevent the development of cervical cancer, a cervical smear should be performed, which means the doctor will use a wooden spatula or cervical brush to collect cells shed from the opening of the cervix. These cells are then smeared on a glass slide and/or stored directly in a special chemical solution for smear to observe any abnormalities in cell morphology. This method will detect almost 90% of precancerous cervical lesions. If the cervical smear is not normal, other further tests should be done under medical supervision.
Finally, the size, texture and position of the uterus, the size and shape of the ovaries, and the presence of tenderness and pressure pain in the pelvis should also be examined by touch. Uterine fibroids, ovarian tumors, endometriosis, pelvic inflammatory disease and other diseases can be detected through gynecological examinations.
The above examinations are the scope of routine gynecological examinations, which are generally painless and do not cause any harm to women’s bodies, so there is no need to be afraid. As many gynecological diseases have no early symptoms, such as ovarian tumor and cervical cancer, the incidence of which is high and seriously threatens women’s health, many women come to the hospital for checkups only when they feel unwell or even uncomfortable, at which time they are already in the late stage of tumor and lose the best treatment opportunity. It may be inevitable that you feel a little embarrassed, but when you think that ovarian tumor and cervical cancer are life-threatening diseases, this problem will seem insignificant. If you have had a good conversation with your gynecologist and can relax and cooperate with him or her, in most cases, the process will be a relaxing experience. In foreign countries, women take gynecological examinations seriously and have regular checkups whether they feel unwell or not. It is useful for early treatment and prevention of some gynecological diseases.
Therefore, it is recommended that women of childbearing age have regular gynecological checkups to detect diseases early and treat them in time.
An important part of the gynecological examination is the cervical smear. A cervical smear, also known as Pap Smear, involves taking a small sample of cells from the cervix, placing it on a glass slide, and then studying it under a microscope for abnormalities. With the untimely deaths of Yuan Yuan Li and Anita Mui, “cervical cancer” has become the most frightening word in the female world. Many women became scared, but also benefited from the health awareness. Cervical cancer, known as the second killer of women, has more than 400,000 new cases worldwide every year, and 130,000 new cervical cancer patients are diagnosed in China every year. As a result, there has been a sudden surge in the number of people getting cervical smears recently.
With a simple cervical smear, doctors can detect tiny, very early changes in cervical cells, which allows deadly cancers to be eliminated even before they actually occur, so medical experts believe that cervical cancer is a completely preventable disease.
In most cases, cervical cancer develops gradually over a period of about 6 to 10 years based on chronic inflammation of the cervix. There is a concept called “cervical epithelial sarcomatoid lesion” (CIN), which suggests a pathological change between chronic inflammation of the cervix and cancer, and its diagnosis and treatment can prevent the development of cervical lesions to cancer. Therefore, regular cervical smear examination can be expected to detect abnormal changes of the cervix early to prevent the occurrence of cervical cancer. Clinical data show that if cervical cancer is diagnosed and treated at an early stage, the 5-year survival rate can reach over 90%. For early stage cancer detected under microscope, the cure rate can be as high as 100%.
Precautions before having cervical smear test.
1. The examination should be scheduled during non-menstrual period.
2. If you have acute gynecological inflammation or infection (e.g. gonorrhea, trichomonas infection, chlamydia infection, etc.), you should treat the infection until the inflammation subsides before performing the scraping test to avoid interference with the results.
3. Do not douche the vagina or use suppositories placed in the vagina within 48 hours before the planned examination, and do not have sexual intercourse.
The commonly used methods of cervical smear examination are the traditional Pap smear examination method and new techniques such as liquid-based thin-layer cytology (TCT).
The Pap system classifies cervical lesions into 5 grades according to their degree.
Pap grade 1 Normal
Pap grade 2 Inflammatory
Pap grade 3 Nuclear heterogeneity
Pap grade 4 Suspected cancer
Pap 5 Cancer
TCT classifies cervical lesions according to their degree.
Normal range
Benign cellular changes
Low grade intraepithelial lesions
High grade intraepithelial lesions
If a cervical smear shows abnormalities, don’t be anxious and scared, abnormalities don’t mean cancer! Your doctor will often also need to do the following tests to determine the location and nature of the lesion
Colposcopy: This is an easy way to help your doctor decide if you need treatment. It is not surgical, does not require anesthesia, and takes little time to complete. The major difference between a biopsy and a Pap smear is that the former takes “living” rather than “shed” cells, and is more specific.
Diagnostic scraping of the cervical canal: Sometimes a Pap smear report will suggest that abnormal cells may be present above the “migratory zone” of the cervix, a part of the cervix that cannot be detected even with colposcopy, and your doctor will recommend this small procedure to complement the diagnosis. Simply put, a tiny spatula is used to scrape cells from the cervical canal for testing.
Conical hysterectomy: If the lesions are severe, your doctor will conically remove part of the cervix. If all the lesions are removed, no further treatment is needed.
After a lot of research by domestic and foreign scholars, it has been confirmed that HPV infection is necessary for the development of cervical cancer, and human papillomavirus (HPV) can be detected in 99.8% of cervical cancer patients, while HPV negative patients almost never develop cervical cancer. There are more than 80 known HPV species, of which 13 are high-risk HPV types associated with cervical cancer.
HPV infection is transmitted through sexual intercourse and is usually asymptomatic. HPV infection is very common in some countries, and the infection rate is highest among women aged 18 to 28 who are sexually active. In general, the body can clear the virus through its own immune response, but if the virus is not cleared and survives in the body, it becomes a persistent infection and will cause various precancerous lesions of cervical cancer. Most women with HPV infection have a short period of time, disappearing after 8 to 12 months, but 10% to 15% of women over 30 years old have persistent infection. These women with persistent HPV infection have a high risk of developing cancer.
The normal cervix is lesioned after HPV infection and it usually takes about 10 years to develop from precancerous cervical lesions to cervical cancer, so there is enough time to treat HPV infection and the key is to pay attention to this viral infection. If the lesions are detected and treated at an early stage, the cure rate is almost 100%.
Since HPV infection is the main cause of cervical cancer and precancerous lesions, along with routine screening for precancerous lesions, some large hospitals in the city have started to use hybridization capture method to detect high-risk HPV infection. This method is highly accurate and can be performed at the same time as a cervical smear without any pain or injury to the patient.
HPV infection is an important warning, and although not all HPV infections can develop into cervical cancer, it is important to give high priority to the management of HPV. A common response by physicians is to treat the disease as a virus, by treating the cervical lesions caused by HPV infection and removing the virus. If a middle-aged woman is tested negative for HPV infection and also does not have any cellular lesions, her doctor will confidently say that no similar tests will be needed for the next 5 years.
With the above introduction, we should clarify the concept that
Cervical cancer is a cancer that can be detected and treated early.
Cervical cancer is a cancer that can be expected to be completely eradicated.
Let’s fully enjoy the convenience brought by modern technology and protect our health.