Depending on the question, there are a number of other investigations. Their application depends on the various complications or concerns of the patient.
- Sonography: Ultrasound plays an important role in gynecological practice - especially in pregnancy, but also in the case of the desire to have children or suspected a tumor. It can be inserted through the vagina (vaginal ultrasonography) or over the abdomen (abdominal ultrasonography) or chest (mamma sonography).
- Smears and biopsies: In speculum examinations, cells from the cervix and duct for cancer screening ("PAP examination") or small tissue specimens from suspicious areas can be obtained and examined under the microscope. Usually, these samples are sent to the laboratory and evaluated there. From vaginal secretions, the pH can be determined - it is less acidic than normal, this is a first indication of colonization with pathogens. If the vaginal secretion then develops a fish-like odor, when it is spread on a microscope slide with potassium hydroxide solution (amine test), this suspicion condenses. Under the microscope, then possibly the bacteria or fungi can be recognized. In this case, the vaginal secretions are sent to the laboratory where they are examined more precisely by microbiology (eg germination of germs and test, which antibiotics act against).
- Urinalysis: This is a routine check-up during pregnancy; otherwise it is carried out, for example, in suspected cystitis.
- Cycle and hormonal diagnostics: If there is a suspicion of hormonal imbalances, or if irregularities in the cycle or an unfulfilled wish to have children are clarified, other methods are used in addition to the methods mentioned above. For example, different hormone concentrations can be measured in the blood or the so-called cervical factor in the secretion of the cervix can be determined. This means that various factors, such as appearance and consistency, are used to test how the secretion reacts to the different hormones during the menstrual cycle.
- Endoscopy: In children and virgins, a narrow endoscope can be inserted over the vagina instead of the speculum examination (vaginoscopy). In certain situations (eg sterility, bleeding from the uterus) - under local anesthesia - the uterine cavity can also be examined with an endoscope (hysteroscopy). For diagnostic and often also directly therapeutic purposes, an endoscope can also be inserted through small incisions in the abdominal wall (laparoscopy).