Gynecological check-up and cervical screening

When a check is needed

Regular checks help even without complaints. They are needed sooner for bleeding between periods or after sex, pelvic pain, unusual discharge, menstrual disorders (menstrual disorders), signs of menopause and pregnancy planning (family planning). Bleeding after menopause is always assessed, because some causes are mild, such as atrophy, but there may be important causes in the uterus that must be excluded.

HPV, the Pap test and what the result means

Cervical cancer is caused almost always by persistent infection with high-risk types of the HPV virus. Screening looks for high-risk HPV and/or cell changes in material taken from the cervix. Most HPV infections clear by themselves, so a positive HPV test does not mean cancer; it means follow-up is needed, because persistent infection is what brings risk. An abnormal result leads to further investigation with colposcopy and, as appropriate, biopsy.

Sampling for Pap/HPV, colposcopy and biopsy are performed at specialized centers, not at our clinic; we interpret the results and coordinate follow-up. The screening interval depends on age, the test used and earlier results; the HPV vaccine reduces risk but does not replace screening.

How to prepare for the gynecological visit

A good visit starts with an accurate history, so note beforehand the date of your last period, the usual length of the cycle, the amount of bleeding, any bleeding between periods or after intercourse, and any pain or unusual discharge. Bring the list of medicines and your contraceptive method, the history of pregnancies and births, earlier Pap/HPV results and ultrasounds, and family illnesses, especially cancer of the breast, ovary and colon. No special hygienic preparation is needed; vaginal douching is not recommended, because it alters the normal flora and may hide signs.

If the check includes taking material for screening at another center, it is advisable not to have intercourse, not to use vaginal creams or pessaries for 48 hours beforehand and not to be during your period. There is no need to feel embarrassed; you can ask any question. Concerns about pain during intercourse, low desire or difficulty conceiving are common medical problems and are solved best when discussed openly.

HPV vaccination, following up an abnormal result and lifestyle

The HPV vaccine protects against the types that cause most cervical cancers and genital warts; it works best when given before the start of sexual activity, but can also be discussed at older ages with the doctor. It does not replace screening, because it does not cover all types. The condom reduces, but does not completely eliminate, HPV transmission, because the virus can also be found on skin that is not covered.

Smoking is an independent risk factor for cervical cancer, because it weakens the body’s ability to clear the virus; stopping is the most important measure you can take yourself. If a screening result is abnormal, do not take it as a diagnosis of cancer: most mild changes resolve by themselves or are treated easily when found early, but delay in follow-up is the main reason some cases reach more advanced stages. Bring the result to the visit so the next step can be planned (repeat test, colposcopy or treatment). Conditions that lower immunity, such as HIV or immunosuppressive treatment, require more frequent screening.

Breast and other assessments

Any new breast lump, change of the nipple or skin or unusual discharge needs assessment. Breast ultrasound can be done at the clinic; mammography is performed at another center and interpreted by us. Blood and hormone tests are chosen according to symptoms.

Checks continue every 6 months to a year when there is a condition under follow-up, or sooner when the doctor considers it reasonable. Care at Tirana Polyclinic: we offer gynecology consultation, breast ultrasound and interpretation of tests and examinations performed outside the clinic.