Prevention of Women’s Diseases

Screening for Female Reproductive Tract Diseases

Screening for diseases of the uterus, ovaries and fallopian tubes can help detect problems at an earlier stage and guide decisions about follow up or treatment. In many women, these organs can be evaluated during a preventive gynecology visit, even if there are no symptoms.

Most of the time this screening is based on a careful clinical history, a gynecologic examination and a pelvic ultrasound. Together they allow the doctor to look for conditions such as fibroids, adenomyosis, uterine polyps, endometriosis, ovarian cysts and other benign masses.

In Lisbon, Dra. Joana Faria offers prevention focused consultations where these structures are assessed in context, taking into account your age, symptoms, family history and future plans.

What it is

Screening for female reproductive tract diseases is the evaluation of the uterus, ovaries and surrounding structures in women who may feel well or have only mild symptoms. The aim is to identify changes early, understand their significance and decide whether simple observation or treatment is needed.

This screening may include:

  • A detailed conversation about your cycle, pain, bleeding pattern, fertility wishes and family history of gynecologic or ovarian cancer.
  • A gynecologic examination to assess the size and mobility of the uterus, ovaries and pelvic floor.
  • A pelvic ultrasound, most often transvaginal, to visualise the uterus, endometrium, ovaries and adnexal regions.

Depending on the findings, the doctor may suspect or confirm conditions such as fibroids, adenomyosis, uterine polyps, endometriosis, ovarian cysts or other benign lesions. On this website you will find separate pages that explain these diseases and their treatment in more detail.

Main symptoms and when to worry

Screening sometimes takes place in women who have no symptoms and come for a prevention check up. However, certain complaints should always be discussed in consultation and may lead to a more complete evaluation.

You should seek medical advice if you notice:

  • Very heavy periods or bleeding that lasts longer than usual.
  • Bleeding between periods or after sexual intercourse.
  • Pelvic pain, cramping or a feeling of pressure in the lower abdomen.
  • Pain during sexual intercourse.
  • Abdominal swelling, bloating or increase in waist size that does not improve.
  • Difficulty getting pregnant after trying for some time.

These symptoms are common and can have many causes, not all of them serious. They are a reason to be assessed rather than a reason to panic. During the consultation, the doctor will determine whether imaging or other tests are needed.

If you experience sudden intense pain, very heavy bleeding with dizziness or fainting, or acute abdominal symptoms, you should contact emergency services or go directly to the nearest emergency department.

Diagnosis: exams and what to expect

The main tool for screening diseases of the uterus and ovaries is pelvic ultrasound, usually transvaginal. It is a quick exam that uses sound waves, not radiation.

During this assessment you can expect:

  • Clinical interview
    Review of your history, symptoms and any previous imaging or lab results.
  • Gynecologic exam
    Bimanual examination to feel the uterus and adnexal areas, identify tenderness and estimate the size of any masses.
  • Transvaginal ultrasound
    A thin probe covered with a protective sheath is gently introduced into the vagina. This allows detailed images of the uterus, endometrium, ovaries and fallopian tube region. Most women describe the exam as slightly uncomfortable rather than painful.
  • Abdominal ultrasound when needed
    In some cases, especially when the transvaginal approach is not possible or needs to be complemented, the ultrasound is performed through the abdominal wall.

The ultrasound can show the presence, size and appearance of fibroids, polyps, cysts and other masses. It can also provide information about the thickness of the endometrium. Not every ultrasound finding is dangerous. Many changes are benign and only require observation.

Treatment options and follow up

Screening does not always lead to treatment. Often it helps to confirm that everything is normal or that a known condition has not changed. When a new lesion is found, the next steps depend on its type, size, appearance and your symptoms.

Management options may include:

  • Simple observation with repeat ultrasound after a defined interval.
  • Medical treatment for symptoms such as heavy bleeding or pain, when appropriate.
  • Further tests, for example blood work or MRI, in selected situations.
  • Referral for gynecologic surgery when a lesion is large, symptomatic or has suspicious features.

The aim is to avoid unnecessary interventions while not missing problems that need active treatment. All decisions are individualised and take into account your age, desire for future pregnancy, previous surgeries and general health.

How Dra. Joana Faria approaches this screening in practice

Dra. Joana Faria integrates screening for uterine and ovarian diseases into a broader view of your gynecologic health. She does not look only at the ultrasound images, but at how any finding fits with your symptoms and priorities.

In daily practice she:

  • Explains in advance what the ultrasound can and cannot detect.
  • Performs the examination gently, explaining each step and checking on your comfort.
  • Shows and describes the main findings on the screen when this is helpful for your understanding.
  • Clarifies whether a cyst, fibroid or polyp is likely to be benign and what follow up is recommended.
  • Coordinates care with radiologists when more complex lesions are found before proceeding with your surgical treatment.

For many women, knowing that an experienced gynecologist is following their case over time brings clarity and reassurance, even when small lesions are present.

FAQ

Frequently Asked Questions


Why might I need a pelvic ultrasound if I feel well?

In some situations a pelvic ultrasound is recommended even if you do not have symptoms. This can be the case if you have a history of fibroids or ovarian cysts, if you are being followed for a known condition or if you have risk factors such as a strong family history. The aim is to confirm that everything is stable and to detect any changes early, not to look for problems at all costs.

Is transvaginal ultrasound painful or dangerous?

Transvaginal ultrasound is safe and well tolerated. It uses sound waves and does not expose you to radiation. Most women describe a feeling of pressure or mild discomfort rather than pain. The probe is slim and covered with a protective sheath. If you feel pain or intense discomfort at any time, you should let the doctor know so that the exam can be adapted.

Can ultrasound detect ovarian cancer early?

Pelvic ultrasound is a very useful tool to visualise the ovaries and to characterise cysts and masses. However, no test can guarantee the early detection of all cases of ovarian cancer. Ultrasound helps identify lesions that may need closer follow up or further tests. Your overall risk is assessed based on many factors, including family history, age and the ultrasound appearance.

How often should I have a pelvic ultrasound for screening?

There is no single interval that suits all women. Some do not need routine ultrasound at all, while others benefit from regular imaging because of specific conditions or risk factors. The decision about whether and how often to repeat ultrasound should be made with your gynecologist, based on your history, current findings and national recommendations.

Do I need to prepare in a special way for pelvic ultrasound?

Preparation depends on the type of ultrasound. For most transvaginal exams, you do not need to fast and you can empty your bladder before the exam, unless your doctor tells you otherwise. For abdominal ultrasound, you may be asked to arrive with a comfortably full bladder.

If a cyst or fibroid is found, does it always mean surgery?

Not necessarily. Many ovarian cysts, fibroids and polyps are small, benign and cause no symptoms. In these cases, simple observation with periodic ultrasound is often enough. Surgery is considered when a lesion is large, growing, suspicious or responsible for significant symptoms such as pain, pressure or heavy bleeding. The choice is made together with your doctor after a clear discussion of the benefits and risks.

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