Explanation of a well-woman check up

In the following article, we explain to you, what a typical check up includes and what each test is for.

In today’s world, a woman not only plays many roles, but she also makes the process seem effortless! However, amidst trying to achieve a 100 things at the same time, it’s important to pause now and then to focus on your health and wellbeing. Starting from age 40, an annual woman’s health check up is a must. If a woman has serious medical illnesses or a family history of conditions like breast cancer and diabetes, check ups should begin even earlier.

What does a well-woman check up include?

By and large a complete woman’s check up includes:

1. Complete hemogram (also called CBC or complete blood count)
2. Blood group and Rh factor
3. Blood sugar – Fasting and Post prandial (2 hours after food)
4. Routine urine and stool examination
5. Urea and creatinine – to judge kidney status
6. Liver function tests (LFT) – to judge condition of liver
7. Lipid profile – to check good and bad cholesterol levels
8. Thyroid profile – to detect thyroid disorders
9. HIV test – this is routinely done to detect HIV status
10. X-ray chest – to check heart and lung problems
11. ECG or electrocardiogram
12. USG abdomen and pelvis – to detect ovarian tumours, etc.
13. Mammogram – to detect breast cancer
14. Pap smear – to detect cervical cancer
15. Bone density check – to detect osteoporosis
16. Physician consultation
17. Gynaecologist consultation with family planning advice.

So what does each test entail, exactly?

1. CBC consists of Hb, PCV, RBC, TC, DC, MCV, MCH, MCHC, ESR.

Hb is the haemoglobin present in the blood and along with PCV, MCV, MCH, MCHC, this test gives an idea of the type of anaemia. RBCs or red blood cells, when viewed under the microscope, may reveal malarial parasites and help identify the type of malaria.

Total count and differential count (TC, DC) tell us how many white blood cells are present in the blood and how many of the different types are present. For instance, an increase in neutrophils suggests a recent infection while an increase in lymphocytes suggests a chronic one.

ESR is raised in chronic infections like tuberculosis.

2. Blood group and Rh factor: It is very important to know your Blood group if you want to donate or receive blood or in case of an accident when you have lost a lot of blood to enable blood transfusions. The different blood groups are A, B, AB and O. Rhesus factor or Rh factor is of two types, positive and negative. So totally 8 groups are present when we ascribe a positive (+) or negative (-) to each of the four group types.

3. Blood sugar: To detect diabetes mellitus which has emerged as a major lifestyle illness that Indians are particularly prone to, we need to document the fasting and postprandial (after a meal) sugar levels. Fasting levels should be between 80-120 mg/dl while postprandial should not be above 160 in a normal person or in a person whose diabetes is under control.

4. Routine urine and stool examination: These essential tests reveal sugar in the urine in case of diabetes and eggs of worms in stool in case of a worm infection among other things.

5. Urea and creatinine: Broadly, the functioning of the kidney can be assessed by urea and creatinine levels in the blood.

6. Liver function tests comprising of AST, ALT, alkaline phosphatase, albumin, globulin, A/G ratio are enzymes some of which will be raised in jaundice and hepatitis.

7. Lipid profile measures HDL, LDL, VLDL, triglycerides and total cholesterol. Cause for alarm is when LDL or bad cholesterol levels are raised. Ideally, HDL (good cholesterol) should be higher and LDL should be low.

8. Thyroid profile: Women are prone to hypothyroidism and thyroiditis. Hence it is important to do a thyroid profile regularly as excess or lack of thyroid hormones prove detrimental to health and wellbeing.

Read more about hyper- and hypo-thyroidism. 

9. HIV screening: A simple blood test is enough to detect HIV status. Women with multiple sex partners or those having unprotected sex should get themselves checked for HIV. In case of a positive result, counsellors are available to guide and advise on further course of treatment.

All the info you need on HIV/AIDS

10. X-ray chest: This is useful to detect heart and lung problems. Pneumonia, enlargement of the heart and rib and collarbone fractures, among other conditions, can be detected.

11. ECG detects abnormalities in the electrical activity of the heart. In case of chest pain or symptoms related to the heart, an ECG is the first test to be ordered by the physician.

12. USG abdomen and pelvis: Solid structures like the liver, spleen, kidneys, pelvic masses and cysts can be easily picked up on a routine USG. Since it is safe and non-invasive, it is a very popular test.

13. Mammogram: After the age of 40, a woman must have a mammogram done every 2 years and after age 50, it is recommended she do it every year. This is because mammogram is the most reliable test to detect breast cancer.

Read a detailed description of the mammogram here.

14. Pap smear: A sharp increase in the number of cases of cervical cancer has been seen in recent years. Pap smear is a quick and easy-to-do test used for screening and detecting cervical cancer. If caught at an early stage, this cancer can be easily treated if caught.

15. Bone density test: This test helps detect osteoporosis and becomes especially important after 50, as a woman is prone to osteoporosis around menopause.

Dr Mythri Shankar busts open some myths on osteoporosis

16. Consultation with physician: After all tests are completed, the woman can consult the physician to discuss the results, allay any fears or doubts and ask for advice.

17. A gynaecological check up includes a pelvic examination. The doctor will insert two fingers into the vagina (per vaginum examination) to check pelvic organs. In case of positive findings, further investigations or procedures may be advised.

Written by Dr Nisreen Nakhoda, General Physician