Gynecology Diagnosis and Evaluation

Explore gynecology diagnostic tests and evaluations for accurate women health care.

Gynecology Diagnosis and Evaluation

Explore gynecology diagnostic tests and evaluations for accurate women health care.

Diagnosing gynecological issues requires specific tests like Pap smears and pelvic exams. Learn about gynecology diagnosis, preparation, and what results mean.

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Diagnosis and Evaluation

Diagnosing gynecological issues requires specific tests like Pap smears and pelvic exams. Learn about gynecology diagnosis, preparation, and what results mean.

At LIV Hospital, we understand that gynecological exams can feel vulnerable or uncomfortable for many women. Our diagnostic approach prioritizes your comfort, dignity, and privacy. We use the latest technology from high-resolution ultrasounds to genetic testing to provide clear answers. This section explains the common tests we perform, how they work, and exactly how to prepare so you can feel confident and relaxed during your visit.

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Common Screening Tests for Women

Gynecology

Routine screenings are “well-woman” checks. They are designed to monitor your reproductive health at different stages of life.

The Pelvic Examination

This is the physical checkup of your reproductive organs.

  • External Exam: The doctor visually checks the vulva for irritation, cysts, or abnormal discharge.
  • Internal Exam (Bimanual): The doctor inserts two gloved fingers into the vagina while pressing on your abdomen with the other hand. This allows them to feel the size and shape of the uterus and ovaries, checking for cysts or fibroids.

Pap Smear (Pap Test)

This is a screening test for cervical cancer.

  • What it does: It collects cells from the cervix (the opening of the uterus) to look for abnormal changes.
  • Timing: Women should start Pap smears at age 21. Between ages 21 and 29, it is recommended every 3 years.

HPV Test

  • What it does: It looks for the Human Papillomavirus (HPV), the virus that causes almost all cervical cancers.
  • Timing: For women aged 30 to 65, doctors often combine the Pap smear and HPV test (co-testing) every 5 years.

STD/STI Screening

  • Swabs and Urine: Tests for chlamydia and gonorrhea can be done with a urine sample or a vaginal swab.
  • Blood Tests: Used to check for syphilis, HIV, and sometimes herpes.
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Advanced Diagnostic Procedures

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If a screening test comes back abnormal, or if you have symptoms like heavy bleeding or pelvic pain, your gynecologist will move to diagnostic testing to find the root cause.

Colposcopy

If your Pap smear is abnormal, you may need a colposcopy. The doctor uses a special magnifying instrument (colposcope) to look very closely at your cervix. They may apply a vinegar solution that turns abnormal cells white, making them easier to see. If suspicious areas are found, a tiny biopsy is taken.

Endometrial Biopsy

This is used to investigate heavy or irregular bleeding, especially in women over 40. A very thin tube is inserted through the cervix into the uterus to take a small sample of the lining (endometrium). This sample is checked for cancer or hormonal imbalances. It causes a brief, strong cramp but is over quickly.

Sonohysterogram (Saline Infusion Sonogram)

This is a special ultrasound. Sterile saltwater (saline) is injected into the uterus through a catheter. The fluid expands the uterus like a balloon, allowing the ultrasound to show a clear outline of the uterine lining. It is excellent for finding polyps or scar tissue.

Imaging Techniques in Gynecology

Gynecologists frequently use imaging to look at the internal organs without surgery.

Transvaginal Ultrasound

This is the most common imaging test in gynecology.

  • How it works: Instead of a wand on your belly, a slim probe is inserted into the vagina.
  • Why it is used: It gets much closer to the reproductive organs than a regular ultrasound, providing high-definition images of the ovaries (to check for cysts) and the uterus (to measure fibroids or lining thickness).

Pelvic MRI

Magnetic Resonance Imaging provides detailed views of soft tissues. It is often used to map out the exact location and size of fibroids before surgery or to check for endometriosis implants deep in the pelvis.

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What to Expect During a Pelvic Exam

Knowing exactly what will happen can significantly reduce anxiety.

The Step-by-Step Procedure:

  1. Positioning: You will lie on the exam table and place your feet in footrests (stirrups). You will be asked to slide your hips down to the edge of the table.
  2. Speculum Insertion: The doctor will gently insert a speculum (a device made of plastic or metal) into the vagina. They open it slightly to separate the vaginal walls. You will feel pressure, but it should not be painful.
  3. Sample Collection: The doctor uses a small brush or spatula to quickly swipe cells from the cervix for the Pap test.
  4. Manual Check: The speculum is removed, and the doctor performs the bimanual exam to feel the ovaries and uterus.
  5. Completion: The exam usually takes less than 5 minutes. You can get dressed immediately after.

How to Prepare for Gynecological Tests

Proper preparation ensures your test results are accurate and prevents the need for a repeat visit.

Preparation Guidelines:

  • Schedule Wisely: Try to schedule your Pap smear or exam when you are not on your period. Heavy menstrual blood can obscure the cells and make the test results unclear.
  • Avoid Irritants: For 24 to 48 hours before a Pap smear, avoid intercourse, douching, or using vaginal medicines/creams. These can wash away or hide abnormal cells.
  • Empty Your Bladder: Urinate before the exam. A full bladder can make the bimanual exam uncomfortable and harder for the doctor to perform.
  • Track Your Cycle: Bring a record of the first day of your last period. Your doctor will almost always ask for this date.

Understanding Your Test Results

After your visit, you will receive results for tests like the Pap smear or biopsy.

Common Terms:

  • Normal / Negative: No abnormal cells were found. You can stick to the routine schedule.
  • ASC-US: “Atypical Squamous Cells of Undetermined Significance.” This is a common, slightly abnormal finding. It is often caused by inflammation or HPV. Doctors usually repeat the test in a year.
  • LSIL / HSIL: “Low-Grade” or “High-Grade” lesions. These indicate precancerous changes. Colposcopy is usually required.
  • Benign: Non-cancerous findings, such as benign cysts or fibroids.

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FREQUENTLY ASKED QUESTIONS

Is a Pap smear procedure painful?

Most women describe a Pap smear as uncomfortable but not painful. You may feel a brief pinch or pressure when the sample is taken. If you are very anxious or sensitive, tell your doctor. They can use a smaller speculum or guide you through relaxation techniques.

For a transvaginal ultrasound, you usually need to empty your bladder right before the test. For a pelvic (abdominal) ultrasound, you may be asked to drink water and hold it, as a full bladder helps sound waves travel better to create a clear picture.

Endometriosis is difficult to diagnose with standard tests. Ultrasounds can sometimes show large cysts (endometriomas), but they cannot see small implants of tissue. A definitive diagnosis usually requires a minor surgical procedure called laparoscopy to look inside the abdomen.

Pap smears and HPV tests are extremely accurate for cervical cancer screening. When used together, they detect the vast majority of abnormalities. However, no test is perfect. That is why regular testing is important if something is missed one year, it will likely be caught the next time.

You need a colposcopy if your Pap smear result is abnormal (showing precancerous changes) or if you have a positive HPV test with cell changes. It is a diagnostic step to look closer and confirm if treatment is needed.

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