Women's Health Screening

Women's health screening is a tailored package of examinations and tests focused on the organs and conditions that matter most for women. A gynaecologist takes a history of periods, pregnancies, contraception, symptoms and family history, then performs an examination. Cervical screening takes a small sample from the cervix that is tested for high-risk human papillomavirus, HPV, the cause of almost all cervical cancers, and for abnormal cells. Breast screening includes a clinical examination and imaging: mammography, often as 3D tomosynthesis, from the age set by guidelines, and ultrasound for younger women or dense breasts. A pelvic ultrasound may be added when symptoms or findings call for it. Blood tests often include a full blood count, iron stores, thyroid function, blood sugar and cholesterol, and specific hormones when there is a question to answer. A bone density scan, called DXA, measures bone strength around and after menopause.

Most women benefit from regular screening, with content that follows age and risk. Cervical screening usually starts in the mid-twenties and continues to about 65, every 3 years with cytology or every 5 years with HPV testing, depending on the programme. Breast screening with mammography generally starts between about 40 and 50 and is repeated every 1 to 2 years, while women with a strong family history, a known gene change such as BRCA or previous chest radiotherapy start earlier, often with MRI. A bone density scan is recommended from about 65, or earlier after menopause for women with risk factors such as early menopause, low body weight, smoking, long-term steroid use or a previous fracture. Hormone tests are useful for irregular or absent periods, suspected polycystic ovary syndrome, fertility planning and unclear menopause symptoms. Abnormal bleeding, pelvic pain or a breast lump need a diagnostic visit rather than screening.

The visit usually starts with blood samples, taken after a fast if blood sugar and cholesterol are included, followed by the gynaecology consultation. The examination is done lying on a couch: the gynaecologist inspects the vulva, places a speculum gently to see the cervix, takes the cervical sample with a small brush and, if needed, feels the womb and ovaries. A transvaginal or abdominal ultrasound may follow. The breast examination is followed by imaging: for mammography each breast is compressed briefly between two plates while images are taken, which can feel uncomfortable for a few seconds, and an ultrasound may be added. The bone density scan takes about 10 minutes lying still on a table, with a very low radiation dose. A coordinator usually guides you between departments, and at the end the doctor reviews the available results, discusses contraception, HPV vaccination or menopause care if relevant, and explains what happens next.

Any woman can have a tailored women's health screening, and the programme is adjusted for age, pregnancy, previous surgery and family history. Book it about a week after your period ends if possible, because menstrual blood can make a cervical sample less reliable, and avoid intercourse, vaginal creams, lubricants and douches for about 2 days beforehand. Hormone tests may need a specific day of the cycle, which the team will advise. On the day of mammography, do not use deodorant, powder or lotion under the arms or on the breasts, as these can show on the images. Tell the team if you could be pregnant, have breast implants, are breastfeeding or have had previous breast or gynaecological surgery. Bring earlier cervical results, mammograms and reports for comparison, plus details of any relatives with breast, ovarian, womb or bowel cancer and their ages at diagnosis.

There is no recovery after women's health screening. Some women have light spotting for a day after the cervical sample, and the breasts may feel tender for a few hours after mammography; both settle on their own. You can return to normal activities immediately and usually fly the same or the next day. A practical plan is to arrive the day before, complete the programme in the morning and keep a short margin in case an extra view or ultrasound is needed. Mammography and ultrasound findings are often discussed the same day, while HPV, cervical cytology and some hormone results usually take about 1 to 2 weeks and are sent electronically with a remote review. If a finding needs follow-up, such as a colposcopy for an abnormal cervical result or a biopsy for a breast change, the team explains whether to arrange it during the trip or at home.

The tests in women's health screening are safe, and discomfort is brief. Mammography and bone density scans use low doses of radiation, and mammography is offered at set intervals for that reason. The main limits are false alarms and missed findings. An HPV-positive result or mild cell changes are common, often clear on their own and usually lead to monitoring or colposcopy rather than treatment. Mammograms can call women back for extra images that turn out to be normal, and dense breast tissue can hide small cancers, which is why ultrasound or MRI is sometimes added. Some breast changes found through screening grow so slowly that they might never have caused harm. Routine pelvic ultrasound and the CA-125 blood test are not reliable screening tests for ovarian cancer in women at average risk. Repeated at the right intervals, screening lowers deaths from cervical and breast cancer and detects bone loss early.