The importance of Annual Gynaecological Health Check-up

Introduction

Women’s health has got more complex over the years. Changes in lifestyle, diet, pollution in every sphere of life and microwave radiation are all causing several women’s health issues today. Girls are undergoing an early menarche, and women an early menopause. The incidences of breast, cervical and uterine cancers have also gone up over the years. One hears of them in friends’ and family circles all the time, in recent years. Changing attitudes towards lifestyle and freedom are also pushing more women in to casual sex and multiple partners. This exposes them to the risk of sexually transmitted diseases.

For all these reasons and more, it’s important that women get an annual gynaecological examination or screening done at a reputed hospital. This goes a long way in preventing disease or detecting them early, so that timely treatment can be provided.

Why Annual Gynaecological Health Check-up is important

In the past, gynaecological screenings were condition-specific, based on existing symptoms. Later on, PAP Smear Test (PST) was introduced. In this, sample cells from the cervix and vaginal fluid are collected and analysed for cervical cancer and certain other conditions. Even today, a lot of women have the wrong notion that gynaecological check-up equals PST and that is good enough. The reality is far from this. PST has a very specific application and does not catch a whole lot of women-health risks.

That is why, today, hospitals or OBGYN clinics offer a comprehensive health-check-up package that covers various women-health risks. This is a great value-add and a huge relief to women who do not have the necessary awareness about such risks. What these packages cover and why they are important is explained below.

1. Counselling and Guidance

Compared to doctors from other specialties or area of medicine, a gynaecologist needs to counsel their patients more often, and like a friend. One reason for this is the complexity of women-health issues, second is the lack of awareness, third is the taboo or discomfort associated with discussing women-health issues with a friend or family member. So, at every age, or for every age-group of girls/women, a gynaecologist is needed for counselling.

Teenager: The gynaecologist educates the girl on her menarche, imparts sex-education, how to handle menstruation and associated issues, lifestyle to adopt or avoid, and several tips and tricks.
Early adult-age: Single women who have an active sex-life must consult the gynaecologist on the risks involved. This includes HPV screening, safe sex and screening for STDs.
Childbirth: Women, who require family planning, or who are starting a family, need appropriate guidance on the right kind of contraception, the right time or conditions to start a family, and in case the women is finding it difficult to conceive, are there any fertility issues and what are the solutions or options available.
At any age: One may experience painful sex, pelvic pain, menstrual issues such as missed periods or heavy periods (excessive bleeding and pain). For all this, its important to avoid home remedies and consult a gynaecologist.
Middle-ages: Women who are able to notice signs of menopause should consult the gynaecologist on how to handle the upcoming phase of life, dos and don’ts associated with it, etc.
Life after menopause: Women who have crossed this phase could face several health issues or conditions.

2. Chlamydia and gonorrhoea screening

Sexually-transmitted diseases (STD) like chlamydia and gonorrhoea are complex. Not all women show symptoms in the early stages. So, if one or more of these conditions is/are detected late or not treated immediately, they can lead to serious complications like chronic pain, infertility and pelvic inflammatory disease. Sexually-active women under the age of 25 need an annual testing for the same. Women above 25 need frequent testing if they have been diagnosed with any STD before, or have a new partner, or multiple partners, or has had unprotected sex once or twice.

3. HIV and other STDs

In addition to the above-mentioned STDs, there are others such as trichomonas, syphilis, herpes simplex, hepatitis and AIDS. In addition to sex, there are other risk factors too. For example, using infected needles or syringes while tattooing can lead to Hepatitis or AIDS. Even blood transfusion from an infected donor can increase AIDS risk. Some of these actions which increase the risk may be considered harmless by the person, due to a lack of awareness. That is why, a gynaecologist will ask several questions to understand the woman’s lifestyle and certain actions in the last couple of weeks, to understand the risks. Thereafter he/she will do the required tests for these conditions.

4. Hepatitis C testing

Hepatitis C is an infection caused by the hepatitis C virus (HCV). If left untreated, it can lead to liver damage, liver cancer, cirrhosis, and even death in some cases. The difficult part is that one may be infected with hepatitis C and not show any symptoms at all. However, the damage will be happening internally. And there are various risk factors for the condition.

The woman is a nurse or works in a clinical environment, with constant exposure to infected blood, as in the case of an infected needle piercing her skin.
The woman has consumed illicit drugs by injection
Having HIV currently as that can lead to Hep C infection
Has had a body-piercing or tattoo done in a dirty environment using equipment that have not been sterilized
Received a blood transfusion or organ transplant before 1992 (30 years back)
Received clotting factor concentrates before 1987 (35 years back)
Has undergone hemodialysis treatment for a long stretch of time
Was born to a woman with hepatitis C infection
Was in prison for some time
Was born between 1945 and 1965, the age-group which shows the highest incidence of hep C infection

That is why, a gynaecologist will ask the required questions, and do this screening

5. HPV testing

One of the risk factors for cervical cancer is infection by the Human Papilloma Virus (HPV). There are 2 strains of the virus especially which increases the risk hugely. The HPV test is done to check for presence of this virus. If confirmed, the doctor will undertake the next steps to look for signs of cervical cancer.

Also Read: Why is Master Health Check up important and what is the duration?

6. Uterine cancer screening

There are several risk factors for uterine cancer, such as age, obesity, race, genes, type 2 diabetes, other cancers, drugs such as tamoxifen, radiation therapy for cancers in the pelvic area, a diet rich in red meat or full-fat dairy, and imbalance in estrogen levels. A doctor is best qualified to understand the risk factors and will conduct the necessary screening.

7. Pap smear test

As mentioned before, PST is undertaken to look for the presence of cervical cancer. Women in the age-group of 21-29 years should have this screening done every 3 years, while women over 30 years and above should have a PST plus HPV screening done every 5 years. Cervical cancer may not show obvious symptoms or its symptoms could be similar to that of other ailments, hence a PST is a must.

8. Clinical breast exam and Mammography

Both these look for the presence of breast cancer. In younger women, a simple clinical breast exam is enough to confirm breast cancer. Plus, the fact that mammography may not give accurate results in younger women. Mammography is done for women above 40 years of age. It’s recommended to have this diagnostic imaging test done every year or maximum once in 2 years.

9. Bone density testing

Post-menopausal women show alarming reduction in calcium levels in the body, which increases their risk for osteoporosis. This leads to brittle bones and fractures in the case of falls. A gynaecologist will do the required tests to check calcium levels in the blood, and then a bone-density testing to assess the risk. In case the condition is confirmed, he/she will counsel the woman on how to manage the same for the rest of her life (since the condition cannot be reversed). And in case the condition is ruled out, the doctor will educate the woman on preventive measures.

10. Diabetes testing and lipid (cholesterol) profile assessment

As mentioned earlier, diabetes and obesity increase the risk for various conditions including certain cancers, in women. That is why, a blood test will be done to determine if the woman’s blood sugar and cholesterol levels are within healthy limits, and if not, how to address them. The advice will be specific to women and are best given by a gynaecologist.

Outlook

As is evident from the above, there are umpteen health risk that women face all their life, right from menarche until old age. The only way to mitigate the risk is get an annual gynaecological screening done. This is as important as the general health check-up and should not be missed for any reason. In addition to screening, such check-ups help establish a good rapport with the gynaecologist who will provide relevant advice and guidance from time to time.

Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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