What screening tests do you need to track your gynaecological health?

Most women will require diagnostic screening for a gynecological condition at some point in their lives. It may be related to the reproductive system, breast health or pregnancy. But many are not aware of the exact tests to go for. Here’s a need-to-know by Dr Sunita Kapoor, Director and Consultant Pathologist at City X-Ray & Scan Clinic, New Delhi

In the case of women, who have symptoms related to the reproductive system (gynecologic symptoms), tests to identify the disorder causing them (diagnostic procedures) may need to be done. (Source: Freepik)

5 min readMar 10, 2023 04:30 PM IST First published on: Mar 10, 2023 at 04:30 PM IST

Written by Dr Sunita Kapoor

The screening tests that doctors recommend sometimes are done to look for disorders in people who have no symptoms. In the case of women, who have symptoms related to the reproductive system (gynecologic symptoms), tests to identify the disorder causing them (diagnostic procedures) may need to be done.

Most women will require diagnostic screening for a gynaecological condition at some point in their lives. It may be related to the reproductive system, breast health or pregnancy. But many are not aware of the exact tests to go for. Here are a few of the key ones:

Cervical cell (cytology) testing: Cervical cell testing, such as Papanicolau (Pap) test, or a human papillomavirus (HPV) test is done to check for cancer of the cervix (the lower part of the uterus).

Mammography: It is done to check for breast cancer.

Papanicolaou (Pap) test: Cells from the cervix are examined under a microscope to determine whether any are cancerous or abnormal and may, without treatment, progress to cancer (precancerous cells).

Human papillomavirus (HPV) test: In this test, a sample from the cervix is examined to determine whether HPV is present. HPV can lead to cervical cancer.

Occasionally, more extensive diagnostic procedures are needed. These include the following:

Cervical Biopsy: It is a procedure to remove tissue from the cervix to test for abnormal or precancerous conditions or cervical cancer. Cervical biopsies can be done in a number of ways. For testing purposes, the biopsy can remove a sample of tissue. Abnormal tissue can also be completely taken out through this biopsy. A cervical biopsy can also treat cells that may turn into cancer.

Endometrial Biopsy: The doctor can do an endometrial biopsy to take a small tissue sample from the lining of the uterus (endometrium) for study. The endometrial tissue is viewed under a microscope to look for abnormal cells. Your doctor can also check the effects of hormones on the endometrium.

Your healthcare provider may suggest an endometrial biopsy if you have abnormal menstrual bleeding, bleeding after menopause, and absence of uterine bleeding. Cell changes linked to hormone levels, or abnormal tissues, such as fibroids or polyps may show in biopsy results. These can lead to abnormal bleeding. An endometrial biopsy can also be used to check for uterine infections, such as endometritis.

Colposcopy: It is used to view the opening to the uterus (the cervix) and the vagina. The test uses an instrument with a magnifying lens and a light called a colposcope. It magnifies the image many times. The doctor sees the tissues on the cervix and vaginal walls more clearly. In some cases, your doctor will take a small sample of tissue for examination in the lab. This is called a cervical biopsy.

The doctor may do a colposcopy if he or she finds problems or abnormal cells during a pelvic exam or Pap test. The healthcare provider can see certain changes in cervical and vaginal tissues through the colposcope. These changes include abnormal blood vessels, tissue structure, color, and patterns.

Breast Biopsy: A breast biopsy is checked to see if cancer or other abnormal cells are present. Breast biopsies may be done to screen for several issues like checking a lump or mass that can be felt in the breast, to check a problem seen on a mammogram, such as small calcium deposits in breast tissue or a fluid-filled mass (cyst). The biopsy is also done to evaluate nipple problems, such as a bloody discharge from the nipple. Apart from that, it is done to find out if a breast lump or mass is cancer (malignant) or not cancer (benign).

Hysteroscopy: It is the exam of the inside of the cervix and uterus using a thin, lighted, flexible tube called a hysteroscope. The device is inserted through the vagina. Hysteroscopy is conducted to take a tissue sample (biopsy), remove polyps or fibroid tumors, and prevent bleeding by destroying tissue using electric current, freezing, heat or chemicals.

Sonohystography: Also called saline sonography, in this test, fluid is placed in the uterus through a thin tube (catheter) that is inserted through the vagina and then the cervix. After that, ultrasonography is done. The fluid fills and stretches the uterus so that abnormalities inside the uterus, such as polyps or fibroids, can be more easily detected.

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Pelvic Ultrasound: The test uses sound waves to make pictures of the organs inside your pelvis. A doctor might order this test to diagnose a condition or to check the health of your baby while still in the womb. In women, a pelvic ultrasound is used to view the cervix, fallopian tubes, ovaries, uterus, vagina, and bladder.