Screening for Women’s Gynecologic Health - An Oveview

Introduction

There is a saying prevention is better than cure, and it is a well-established fact regarding human health. Female genital health is one of the important aspects of the healthcare system. In developing countries, female gynecological health is highly neglected. As a result, these are associated with infertility, pregnancy complications, and even death. Use of proper screening methods can help diagnose pathological changes early.

What Is Gynecological Health?

Gynecological health means the assessment of well being of the female sex organs. Screening tests evaluate the early detection of pathological disorders associated with female sexual organs. These disorders can be infectious, can be hormonal, or can be cancerous. But proper screening and early diagnosis can be very helpful. If not diagnosed properly, this may cause infertility or even death.

What is Breast Screening?

In today’s world, breast screening is one of the most crucial aspects of gynecological screening procedures. It is the most common female cancer worldwide. Every one out of eight women in the world is suffering from breast cancer. Among women, breast cancer is responsible for 15.5 % of cancer deaths. But regular breast cancer screening has shown a 20 % reduction in mortality related to it.

The cause of breast cancer is unknown but related to the BRCA1 and BRCA2 gene mutation and hormonal imbalance. As it is not directly related to any carcinogenic agency or external tissue changes like ulcers, it is difficult to diagnose in the early stage. Self-screening in this condition can be very useful:

Self-Screening of Breast Cancer:

The self-screening method for breast cancer patients should stand in front of the mirror and should examine their breasts. This includes:

1. Any change in the shape and size of the breast.

2. Patients should press their breasts around the nipple and look for the presence of any hard mass.

3. Presence of redness, swelling, and ulcer.

4. Change in the shape and size of the nipples, often nipples are inverted is the positive case.

5. Look for any short discharge coming out from the nipple.

6. After raising their hands' patients can check for the presence of any lump present in the armpit region.

7. While lying down left hand can be used to examine the right breast and vice versa. In this technique, fingers are firmly placed over the breast and moved firmly to check for any lump.

Screening Tests For Breast Cancer:

The diagnostic screening test for breast cancer are:

1. Mammogram

A mammogram is a specialized low-dose X-ray imaging method to detect breast cancer. This can be two-dimensional or three-dimensional, known as breast tomosynthesis or digital breast tomosynthesis (DBT). Contrast-enhanced digital mammography is a method in which a breast radiograph is taken after injecting a dye.

2. Breast Ultrasound:

This technique uses high-frequency sound waves to create breast images.

3. Breast MRI (Magnetic Resonance Imaging):

The process is known as dynamic contrast-enhanced breast MRI (DCE-MRI). This technique uses radio waves and a powerful magnet for cancer detection and tissue characterization.

What Is Gynecological Cancer Screening?

Gynecological cancers are five types these are - cervical, ovarian, uterine, vaginal, and vulvar cancer. A sixth type of gynecologic cancer is also present: fallopian tube cancer. The annual incidence of gynecological cancers is 3.6 million. These cancers comprise around 40 % of all cancers. Around 1.3 million people worldwide lose their lives annually because of these.

The causative factors for gynecological factors include genetic mutation, viral infections, and hormonal imbalances. The screening methods for gynecological cancer include:

Self-Screening Methods -

These are symptoms that are closely related to gynecological cancers.

1. Abnormal vaginal bleeding and discharge (not seen in vulvar cancer).

2. Itching and burning sensation around the vulva.

3. Change in the color of skin, presence of rash, and warts, particularly in vulvar cancer.

4. The frequent urge to urinate.

5. Blotting in the belly after eating or drinking water.

6. Pain in the lower abdomen and pelvic region.

7. Constant fatigue and swelling in the legs.

Diagnostic Tests For Screening -

1. Visual Examination by Colposcopy: In this technique, direct visualization of the female genital tract is done under magnification.

2. Ultrasound: High-frequency ultrasound is used for the detailed study of pelvic structures and organs. Trans-abdominal and trans-vaginal are two types of ultrasound methods used for this purpose.

3. Positron Emission Tomography (PET-CT): In this technique, special injections of radioactive substances are injected into the body to track the cancerous cells.

4. Magnetic Resonance Imaging (MRI): This radio wave-based diagnostic procedure is ideal for diagnosing endometrial and cervical cancers.

5. Biochemical Markers Screening: Different biochemical markers like CA 125 and urinary gonadotropin peptides are accessed to identify the presence of gynecological cancers.

What Is the Screening of Infections?

Viral or bacterial infections are a very common threat to gynecological health. These infections may cause a common gynecological problem or may lead to a life-threatening condition. The cause of such infections are various; these include:

1. Infection transmission during sex or use of contaminated substances like sex toys.

2. Improper vaginal hygiene.

3. Hospital-acquired infections or infections after surgeries or delivery.

Self-Screening Methods:

The self-screening methods of such infection include assessment of symptoms. These are:

1. Thin, grey, or white vaginal discharge.

2. Vaginal bleeding.

3. Pain during urination, abdominal pain.

4. Pain during sexual intercourse.

5. Redness and swelling of the skin around the vagina and uvula.

6. Itching and burning sensation around the vagina.

Diagnostic Screening Tests:

Various tests can be performed to detect the presence of the infection.

1. Swab Culture: Collection of the vaginal swab and its culture and examination is the most common procedure for vaginal infection diagnosis.

2. PAP Test: This is a common test for detecting the presence of HPV ( human papillomavirus). In this process, exfoliative cells are taken, and cellular analyses are done.

3. Vaginal pH: Alteration in the vaginal pH is indicative of the presence of the infection. The bacterial infections pH is high.

4. Whiff Test: After taking a vaginal sample, a special solution is added, and the smell is checked. A fishy smell indicates the presence of vaginal infection.

What Are the Screening of Hormonal Disorders?

Hormonal disorders are a very common cause of gynecological problems. These conditions lead to problems related to pregnancy and cyst formation or may even cause infertility.

Self-Screening Methods -

Patients can observe various symptoms indicative of hormonal disorders.

1. Irregular menstrual cycle.

2. Abnormal bleeding during the menstrual cycle.

3. Bleeding after menopause.

4. Fullness and pressure in the belly.

5. Dull pain in the lower back and the pelvic region.

6. Abnormal weight gain or loss.

7. Unwanted growth of hair or excessive hair fall.

Diagnostic Screening Test -

Diagnostic screening tests assess hormonal levels in the blood. Apart from this, ultrasonography can be done to detect the presence of cysts and changes in the genital tract.

Conclusion

Gynecological health issues are serious problems for women. In developing countries, such problems are severe. Proper screening and awareness in such cases can reduce mortality and infertility. Self-screening methods should be taught to people with poor economic backgrounds to increase awareness. Also, economic diagnostic screening tests should be available for mass people.