The annual gynecological check-up
"Get checked once a year" is the right instinct, but the list is usually assembled from memory or a friend’s advice. It almost always contains something unnecessary that you pay for, and almost always misses the one or two items the whole exercise was for. Here is what is needed at what age, what is needed less often than yearly, and what is not needed at all.
The short answer
If there is no time for the rest, the yearly minimum for a woman with no symptoms looks like this:
- a gynecological examination — once a year;
- a pelvic ultrasound — not required by any guideline, but reasonable to add to the yearly examination;
- cervical screening — an HPV test every five years or cytology every three, not annually;
- breast ultrasound — every one to two years from roughly 25 as a precaution; screening mammography from 45;
- everything else on indication, not by the calendar.
Below: why that is so, and what to do when age, history or plans differ from "a woman with no symptoms".
What the examination and the scan give you
The examination takes a few minutes and answers questions no laboratory result closes: how the cervix looks, whether there are changes on the vaginal walls, whether anything is tender. It is also the one moment for asking calmly about whatever has been put off all year.
The pelvic ultrasound looks at the uterus, endometrium and ovaries. It is what finds the things that give no symptoms for years: fibroids, cysts, endometrial polyps. The best window is days 5 to 10 of the cycle, counted from the first day of your period; the details are in the article on preparing for a pelvic scan.
Combining them is both easier and cheaper: a consultation with a scan is 460 zł against 540 booked separately.
Cervical screening: every three or five years, not every year
Annual cytology is the most common unnecessary item on self-made lists. Current recommendations (WHO 2021, European guidelines, PTGiP) for women aged 25–64: a high-risk HPV test every five years as the primary screen, or cytology every three years where HPV testing is not used. No referral is needed.
Three years is not a saving, it is medicine: cervical changes develop over 10–15 years, so a three-year interval catches them with an enormous margin. Annual cytology does not find more — it finds more equivocal results, which cost the patient six months of worry and some unnecessary procedures.
More often than every three years applies with reduced immunity, after treatment of cervical changes, and when the last result was abnormal. What the letters on the report mean is set out in reading a cytology result.
The HPV test is the more sensitive of the two; in Poland's screening program it is offered every five years from age 25, while WHO recommends starting at 30. Detail — here.
Breasts
Here everything depends on age, because the tissue itself changes:
| Age | What is done | How often |
|---|---|---|
| roughly 25 to 40 | breast ultrasound | every one to two years. The tissue is dense and nearly opaque on mammography, while ultrasound sees it well |
| over 40 | ultrasound; mammography from 45 | ultrasound every one to two years; screening mammography every two years from 45 to 74 (European guidelines) |
| at any age | examination and self-examination | with any finding, do not wait for the scheduled date |
Book for days 5 to 12 of the cycle: before a period the breasts are swollen and the picture is poorer. What BI-RADS means on a report is covered separately.
If you are 45 or older and not sure when your last mammogram was, ask at the visit — I tell you whether it is due.
What should not be on the yearly list
This half matters as much as the other. The following are ordered often and, without an indication, do no good:
- A vaginal swab "just in case". It is needed when there are symptoms: discharge, itching, odour. Without them it finds things that need no treatment and leads to treating healthy people. Telling normal from a problem is covered in the article on discharge;
- Cultures for ureaplasma and mycoplasma. These are part of the normal flora in a large share of healthy women. They are not looked for routinely and a positive finding alone is not treated;
- An annual HPV test. Five years after a negative result is not a saving; it is a period in which nothing has time to happen;
- "Preventive" suppositories and douching. Douching washes out the lactobacilli and leads directly to bacterial vaginosis;
- Hormones "just in case". A hormone panel without a question to answer is a set of numbers with nothing to compare them against. They are measured for cycle disturbance, for pregnancy planning, or when a specific condition is suspected.
By age
| When | What is added to the examination and scan |
|---|---|
| under 25 | cytology usually not yet needed; HPV vaccination is worth having if it did not happen earlier |
| 25–30 | cytology every three years |
| 30–40 | cytology every three years or an HPV test every five; breast ultrasound every one to two years |
| 40–50 | the same plus screening mammography from 45; with cycle disturbance, hormones — but on indication |
| over 50 | screening continues to 64; a conversation about menopause is added — which tests are needed and which are not |
| planning a pregnancy | a separate list — tests before pregnancy |
How to make the visit count
- Pick the cycle day: days 5–10 for a pelvic scan, 5–12 for breasts, 10–20 for cytology. One visit rarely covers everything at once, and that is normal.
- Bring your previous results. One scan is a point, two are a trend. A comparison often removes the need to do anything at all.
- Write your questions down beforehand. Half of them vanish in the room and then wait another year.
- Do not order tests before the visit. The set is chosen after the conversation; anything ordered blind usually turns out to be beside the point.
The yearly minimum — a gynecological exam and an ultrasound — I do in one visit, and I take the HPV test or cytology at the same visit if it is due. Appointments are in Warsaw at ul. Głębocka 9/U1. No referral or insurance is needed — a PESEL number or an identity document is enough. Prices are on the prices page.
Short answers
What tests should a woman have every year?
For a woman with no symptoms, a gynecological examination and a pelvic ultrasound once a year are enough, plus breast ultrasound from about 25. Cervical screening is an HPV test every five years or cytology every three, not annually. Everything else is ordered on indication rather than by the calendar.
Does cytology need to be done every year?
No. Cervical screening is an HPV test every five years or cytology every three, between the ages of 25–30 and 64. Cervical changes develop over 10–15 years, so these intervals catch them with room to spare. It is done more often with reduced immunity and after an abnormal result.
From what age should breast ultrasound be done?
Many women choose a precautionary scan every one to two years from roughly 25; it is not a formal screening programme. Before 40 the breast tissue is dense and ultrasound sees it better than mammography does. From 45, screening mammography is added (European guidelines: 45–74). Book for days 5 to 12 of the cycle.
Which tests are not necessary?
Without symptoms there is no need for a vaginal swab "just in case", cultures for ureaplasma and mycoplasma, an annual HPV test, or hormones "just in case". The rule is simple: a test is worth doing only if you know in advance what you would do with each result.
Which day of the cycle should I book a check-up for?
Pelvic ultrasound on days 5–10, breast ultrasound on days 5–12, cytology on days 10–20. Examinations are not done during a period. After menopause the day does not matter.
Sources
The primary sources this text rests on. Links open in a new tab.
- WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, 2nd editionWorld Health Organization, 2021 — HPV testing as the primary screening test, intervals and what follows a positive result
- Standardy opieki okołoporodowejPolish Ministry of Health — the mandatory schedule of tests in pregnancy
This text describes the general picture and does not replace a consultation. Timings and indications differ from woman to woman and are decided at the appointment, from your history and test results.