What tests are needed to check if the uterus is healthy

To check the health of the uterus, gynecological ultrasound, cervical TCT and HPV testing, hysteroscopy, diagnostic curettage, and tumor marker testing are usually required. These examinations can evaluate the structure, endometrium, cervix, and the presence of space occupying lesions of the uterus from different dimensions.

1. Gynecological ultrasound:

Gynecological ultrasound is a fundamental examination for evaluating the morphology, size, myometrial echogenicity, and endometrial condition of the uterus. It is mainly divided into two types: transabdominal ultrasound and transvaginal ultrasound, the latter of which can more clearly display the endometrium, small lesions in the muscle layer, and the situation inside the uterine cavity. Through ultrasound, it is possible to determine the presence of structural abnormalities such as uterine fibroids, adenomyosis, endometrial polyps, intrauterine adhesions, and uterine malformations. For patients with abnormal vaginal bleeding or menstrual changes, ultrasound can preliminarily evaluate the thickness of the endometrium and whether the echo is uniform, providing direction for subsequent examinations.

2. Cervical TCT and HPV testing:

These two tests are the core means of screening for cervical lesions and cervical cancer. TCT stands for liquid based thin-layer cytology examination, which collects cervical exfoliated cells and observes whether the cell morphology is abnormal, in order to detect cervical intraepithelial neoplasia or precancerous lesions. HPV testing is to check for infection with high-risk human papillomavirus, which is the main cause of cervical cancer. The combined screening of the two can significantly improve the detection rate of cervical lesions, and it is recommended that women with a history of sexual activity undergo regular screening.

3. Hysteroscopy:

Hysteroscopy is a minimally invasive endoscopic technique that allows for direct observation of the interior of the uterine cavity. It is suitable for ultrasound detection of abnormal echoes in the uterine cavity, suspected endometrial lesions, recurrent miscarriage, or abnormal uterine bleeding. Through hysteroscopy, doctors can directly observe the color, thickness, presence of polyps, adhesions, submucosal fibroids, endometrial cancer, and other lesions of the endometrium. Biopsy can be taken under the microscope for pathological diagnosis, which is the gold standard for diagnosing intrauterine lesions.

4. Diagnostic curettage:

Diagnostic curettage is a method of pathological examination by scraping endometrial tissue. It is mainly used to evaluate the periodic changes of the endometrium, diagnose endometrial hyperplasia, endometrial polyps, endometrial cancer, and exclude intrauterine residues. For patients with ultrasound indications of endometrial thickening, uneven echo, or irregular vaginal bleeding, especially in perimenopausal or postmenopausal women, diagnostic curettage can obtain tissue samples to determine whether there is atypical hyperplasia or malignant lesions in the endometrium.

5. Tumor marker examination:

Tumor markers such as CA125, HE4 and other serological indicators can be used as auxiliary screening methods for uterine related tumors. CA125 may be elevated in endometrial cancer, uterine sarcoma, and partial uterine fibroid degeneration, but its specificity is low, and it needs to be comprehensively judged in combination with imaging examinations. HE4 has high diagnostic specificity for endometrial cancer, and combined with CA125 testing can help improve diagnostic accuracy. This type of examination cannot be used as a standalone diagnostic basis, but it can provide important reference information for clinical doctors, especially for women with a family history or high-risk factors. To comprehensively evaluate uterine health, it is recommended that women choose an appropriate combination of examinations based on age, symptoms, and risk factors. Maintaining a regular daily routine, balanced diet, moderate exercise, and avoiding long-term use of estrogen containing health products or medications can help maintain uterine health. If there is abnormal vaginal bleeding, significant changes in menstrual flow, lower abdominal pain, or palpable lumps, medical attention should be sought promptly, and a personalized examination plan should be developed by a doctor.