Routine gynecological exams aim to promote women’s intimate health, helping to identify changes and treat some gynecological conditions and diseases, such as endometriosis, HPV, infections or ovarian cyst syndrome, for example.
It is recommended to go to the gynecologist at least once a year, especially after the first menstruation, even if there are no symptoms or discomfort, as there are gynecological diseases that are asymptomatic, especially in the early stages.
From gynecological exams, the doctor can evaluate the woman’s pelvic region, including the vulva, vaginal canal, ovaries, uterus, and even the breasts, identifying some diseases early.
Main gynecological exams
The main routine gynecological exams are:
1. Physical examination
The physical examination consists of assessing the woman’s body as a whole, including assessment of the breasts, armpits and thyroid, in addition to a pelvic examination, to check for changes.
The physical examination is carried out after taking an anamnesis in which the doctor evaluates the health history, complaints and symptoms that the woman may present.
2. Pelvic exam
The pelvic examination is a routine gynecological examination, generally carried out from the age of 21, in which the gynecologist first observes the external genitals, such as the labia majora and minora, clitoris, urethral meatus, opening of the vaginal canal and pubis, to check whether there are signs of changes or illnesses.
During this examination, the doctor can also perform a vaginal examination in women who have already started their sexual life, as it allows them to feel the size, shape and position of the uterus and ovaries, helping to diagnose conditions such as endometriosis, fibroids or ovarian cysts, for example.
A vaginal examination is also an examination carried out during pregnancy, usually at the first prenatal consultation, or at other consultations if the woman has symptoms of uterine contractions, to check the dilation of the cervix.
Additionally, during this exam, the doctor may also perform a Pap smear.
3. Papanicolaou
The Pap smear, also known as a preventive exam, is done by scraping the cervix and the collected sample is sent to the laboratory for analysis, allowing the identification of vaginal infections and changes in the vagina and uterus that can be indicative of cancer.
The exam does not hurt, but there may be discomfort when the doctor scrapes the cells from the uterus.
The Pap smear must be carried out at least once a year and is recommended for all women who have already started their sexual life or who are over 25 years of age. Find out more about the Pap smear test and how it is done.
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4. Pelvic ultrasound
Pelvic ultrasound is an imaging test that allows you to observe the ovaries and uterus, helping in the early detection of some diseases, such as polycystic ovaries, enlarged uterus, endometriosis, vaginal bleeding, pelvic pain, ectopic pregnancy and infertility.
This exam is carried out by introducing a transducer into the belly or inside the vagina, and the exam is then called transvaginal ultrasound, which provides clear and detailed images of the female reproductive system, allowing the doctor to identify changes. Understand what transvaginal ultrasound is and when to do it.
5. Infectious screening
Infectious screening aims to identify the occurrence of infectious diseases that can be sexually transmitted, such as herpes, HIV, syphilis, chlamydia and gonorrhea, for example. Learn about the main sexually transmitted infections.
This infectious screening can be done through a blood test or through microbiological analysis of urine or vaginal secretion, which in addition to indicating whether or not there is an infection, also indicates which microorganism is responsible and the best treatment.
6. Colposcopy
Colposcopy allows direct observation of the cervix and other genital structures, such as the vulva and vagina, and can identify benign cellular changes, vaginal tumors and signs of infection or inflammation.
Colposcopy is normally requested by the gynecologist as part of a routine examination, but it is also indicated when the Pap smear test has abnormal results. This exam does not hurt, but it can cause some discomfort, usually burning, when the gynecologist applies a substance to visualize possible changes in the woman’s uterus, vagina or vulva. Understand how colposcopy is performed.
7. Histerossalpingografia
Hysterosalpingography is an X-ray exam in which contrast is used to observe the cervix and fallopian tubes, identifying possible causes of infertility, in addition to salpingitis, which is inflammation of the uterine tubes. See how salpingitis is treated.
This exam does not hurt, but it can cause discomfort, so the doctor may recommend painkillers or anti-inflammatories before and after the exam.
8. MRI
Magnetic resonance imaging allows us to observe, with good resolution, images of genital structures to detect malignant changes, such as fibroids, ovarian cysts, uterine and vaginal cancer. Furthermore, it is also used to monitor changes that may occur in the female reproductive system, to check whether or not there has been a response to treatment, or whether or not surgery should be performed.
This is an exam that does not use radiation and gadolinium can be used to perform the exam with contrast. Find out what MRI is for and how it is performed.
9. Diagnostic laparoscopy
Diagnostic laparoscopy or videolaparoscopy is an examination that, through the use of a thin tube with light, allows visualization of the reproductive organs inside the abdomen, allowing the identification of endometriosis, ectopic pregnancy, pelvic pain or causes of infertility.
Although this exam is considered the best technique for diagnosing endometriosis, it is not the first option, as it is an invasive technique that requires general anesthesia, with transvaginal ultrasound or magnetic resonance imaging being more recommended. Find out how diagnostic and surgical videolaparoscopy is performed.
10. Mammogram
Mammography is normally recommended by the Brazilian Society of Mastology for women over 40 years of age, however, women aged 35 who have a family history of breast cancer should also have a mammogram.
The Ministry of Health recommends mammography for breast cancer screening, from the age of 50, carried out every 2 years. See how a mammogram is done.
This exam allows you to check changes in the breast, calcifications, benign lesions or breast cancer, and may also be requested by the gynecologist when detecting the presence of lumps or other changes in the breast during the physical examination.
11. Breast ultrasound
Generally, a breast ultrasound exam is performed after feeling a lump during palpation of the breast or if the mammogram is inconclusive, especially in women who have large breasts and have cases of breast cancer in the family.
Ultrasonography should not be confused with mammography, nor does it replace this exam, being only capable of complementing breast assessment. Although this exam can also identify nodules that could indicate breast cancer, mammography is the most recommended exam to be performed on women suspected of having breast cancer.
To carry out the exam, the woman must lie down on a stretcher, without a blouse or bra, so that the doctor can apply a gel to her breasts and then apply the device, simultaneously observing on the computer screen if there are any changes.
12. Hormonal tests
Some hormonal tests may be requested by the gynecologist to assess the cause of late or absent menstruation, vaginal bleeding or low libido, for example, the most common being FSH, LH, estradiol, thyroid hormones or testosterone, for example.
These tests help diagnose health conditions, such as polycystic ovary syndrome or infertility, or to confirm menopause, for example. See other exams for menopause.
