Gynecologist
A woman is a unique organism with a complex mechanism that is capable of bearing fruit and procreation. But there are situations when there are failures or breakdowns in this mechanism. What to do in this situation? We urgently need to run to the gynecologist! Who is this? What does he do? What diseases are treated by a gynecologist and when should I apply to him? We will try to answer all these questions now.
Who is a gynecologist?
A gynecologist is a sufficiently broad specialization of a doctor that covers the problems of the woman's reproductive system. It includes more narrow areas, such as children's gynecologist, obstetrician-gynecologist, gynecologist-endocrinologist and surgeon for gynecology.
Doctors-gynecologists are usually women, but there are also men. There is even a strong opinion that male experts are more careful and attentive to their patients. But which doctor to choose is your decision personally. Where can I go for help? Doctors and gynecologists are in the women's clinic of district polyclinics, gynecological departments of hospitals, maternity hospitals, as well as in private clinics.
When should I go to a gynecologist?
Often, women go to the gynecologist when they are completely "stuck". Unfortunately, until now this doctor causes constriction and discomfort at the mere thought of him. But you need to take care of your health, so we highly recommend that you consult a gynecologist once every six months, even if you are feeling fine. Also, with a preventive goal, you should refer to this specialist in the following situations:
- at the onset of the first full-fledged menstruation;
- after the onset of an active sexual life;
- 3-4 weeks after the change of partner (to identify hidden infections);
- before marriage (to assess their health);
- when planning pregnancy (to identify hidden infections and timely treatment);
- in the absence of pregnancy for half a year with unprotected sexual acts (to find out the reason);
- with a delay in menstruation (at least 7 days);
- at the gestational age of 6-8 weeks and further on the appointment of a doctor (for registering and monitoring the course of pregnancy);
- a month after childbirth, abortion or miscarriage.
Urgently, you need to contact a gynecologist if:
- there were severe pain during menstruation;
- there were pains in the lower abdomen or lower back;
- there was spotting in the middle of the cycle, after sexual intercourse, physical stress or during the menopause;
- there were violations of the menstrual cycle;
- there were abundant discharge with an unpleasant odor;
- there was a lot of itching, burning, stinging.
When collecting an anamnesis by a gynecologist you should not be shy, because with a possible disease, both partners will have to be treated.
What tests do I need to take when I call a gynecologist?
At the first call to the gynecologist the doctor collects an anamnesis, fills the card, takes swabs on the flora of the vagina and appoints additional studies. What analyzes, probably, it will be necessary to hand over repeatedly at the reference to the gynecologist repeatedly?
- a blood test is common (to identify the inflammatory process);
- PCR blood test (for the presence of antibodies to suspected infections: mycoplasma, ureaplasmas, chlamydia, trichomonads, gardnerella, human papillomavirus, genital herpes and others);
- bacteriological seeding from the cervical canal, urethra and vagina with an antibioticogram (for the detection of pathogenic flora and its number);
- scraping from the cervical canal to cytology (to determine the degree of dysplasia);
- a blood test for hormones: follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, progesterone, estrogens, as well as thyroid hormone (thyrotropic hormone - TSH) and adrenal glands;
- blood test for hemostasis (to determine the factor of miscarriage);
- karyotyping of spouses (for determining genetic anomalies of chromosomes);
- analysis for compatibility of partners (with infertility);
- blood test for ovarian cancer markers (for the definition of malignant tumors);
- tests for syphilis, hepatitis, HIV (when registering for pregnancy).
If there is a violation of the endocrine function, the gynecologist will necessarily give a referral to a consultation with the endocrinologist, and with genetic abnormalities to the reproductive health care provider.
What diagnostic methods does a gynecologist use?
The first and most basic method of diagnosis is visual gynecological examination. It is produced on a special chair with the help of so-called gynecological "mirrors". Thanks to this method of diagnosis, a gynecologist can examine the vaginal vaults for the presence of papillomas, genital warts, assess the vaginal mucosa and cervix. At this stage, swabs are taken for flora, cytological scrapings and if a biopsy of neoplasms is required. Further bimanual diagnostics is carried out. It is performed with one hand, the second hand is located on the abdominal cavity. In bimanual examination, appendages are probed, the presence of neoplasms, cysts, mark the position of the uterus, its size and shape. And the last final stage of gynecological examination is rectovaginal examination. It consists in the study of female reproductive organs through the rectum. Such a study is performed by girls who have not started sex life and women after forty years (to eliminate diseases of the rectum).
What other methods of diagnosis does a gynecologist use?
In case of need for further examination of the patient, the gynecologist may prescribe such diagnostic methods as:
- colposcopy - examination of the cervix by a gynecologist with the help of a special optical device with a picture on the screen, for more accurate examination for the presence of dysplasia;
- Ultrasound is an ultrasound examination by a gynecologist of the pelvic organs of a woman for diagnosing the uterine and ectopic pregnancy, determining the exact period of pregnancy, the presence of malformations of the fetus, the size of the ovaries, the presence of cysts and the establishment of their type, and much more;
- folliculometry - examination with the help of ultrasound equipment of the patient's follicles before and after ovulation, to establish the exact date of ovulation (this procedure is usually three times a day);
- hysteroscopy - examination of the inner surface of the patient's uterus using a device with a camera called a hysteroscope. In this procedure, it is possible to take uterine tissues and tumors for biopsy;
- hysterosalpingography (GAS) - diagnosis of the uterus and patency of the fallopian tubes by means of a special fluorescent solution, which is introduced through the cervical canal;
- diagnostic laparoscopy - a cavitary operation that is performed by a surgeon under general anesthesia, using a special device with a camera - a laparoscope. At a laparoscopy examine reproductive organs of the woman, if necessary remove cysts, dissect spikes, restore patency of fallopian tubes and much more. The same method removes ectopic pregnancy.
- biopsy and histological examination can be performed by various methods by a gynecologist. In this procedure, a piece of organ tissue, a neoplasm, a fluid is sampled and examined histologically.
What does a gynecologist do?
Gynecology, as a branch of medicine, existed before our era, but then it was inseparable from obstetrics and surgery. In the Middle Ages, complete stagnation ensued in gynecology, and only in the Renaissance the doctors began to renew knowledge about the structure of the female reproductive system. The real flowering of science occurred in the IX-XX century.
What is a gynecologist doing now? It all depends on a narrow specialization. For example, a children's gynecologist treats genital infections in girls, responds to frequent adolescent issues in puberty, takes preventive talks about contraceptives and sexually transmitted diseases, regulates the menstrual cycle if necessary, and so on. The obstetrician-gynecologist monitors the women during pregnancy, controls and fixes the process of growth and development of the fetus in the exchange card, conducts preventive talks on the topic of childbirth and maternity, consults with the accompanying problems of pregnancy, and also directs, if necessary, the termination of pregnancy or the preservation in hospital, makes abortions and takes delivery. Gynecologist-endocrinologist finds out the problems of hormonal disorders in women, prescribes preparations for their normalization, conducts preventive talks about the hormonal background of the female body and so on. The surgeon on the gynecological profile makes laparoscopic or cavitary operations to remove cysts, tumors, ectopic pregnancies, restore the patency of the fallopian tubes, and also make a cesarean section. Similarly, gynecologists select the optimal method of contraception (oral contraceptives, intrauterine device, cervical cap) and make their appointment and installation.
What diseases does a gynecologist treat?
All the diseases that the doctor treats a gynecologist can be divided into three conditional extensive groups:
- Diseases of female reproductive organs of inflammatory nature;
- Diseases of the female reproductive system associated with problems in the endocrine system;
- Precancerous and cancerous conditions of the organs of the reproductive system.
To inflammatory diseases of the reproductive organs can be attributed:
- purulent-inflammatory processes (endometritis, vaginitis, colpitis, adnexitis, etc.);
- Sexually transmitted diseases (gonorrhea, candidiasis, ureaplasmosis, mycoplasmosis, trichomoniasis, chlamydia, syphilis);
- diseases of a viral origin (human papillomavirus, genital herpes, cytomegalovirus).
Endocrinological disorders of the reproductive system include:
- endometriosis (proliferation of the walls of the endometrium);
- PCOS (Polycystic Ovary Syndrome);
- amenorrhea (absence of menstruation);
- DMK (dysfunctional uterine bleeding);
- SII (ovarian exhaustion syndrome);
- hyperandrogenism (increased content of male sex hormones);
- metabolic syndrome (impaired sensitivity of the body to insulin);
- adrenogenital syndrome (dysfunction of adrenal hormones production);
- hypothyroidism (dysfunction of thyroid hormone production).
Pre-cancerous and cancerous conditions of the female reproductive system include:
- erosion and dysplasia of the cervix;
- benign and malignant neoplasms of the female reproductive organs.
Advices of a gynecologist
To be surveyed at the doctor-gynecologist it is necessary on a regular basis! If nothing hurts and nothing bothers - it does not mean that everything is in order. As they say, "it is better to perebdet than to not have bad taste".
You must always think about your health, so the preferred protected sexual intercourse with barrier contraceptives (condoms, cervical caps).
At the first symptoms of the disease (itching, burning, discharge with an unpleasant odor), you should immediately go to the gynecologist. Very often the acute course of the disease turns into a chronic and practically, and even does not bother, but can cause chronic inflammation, and in the worst case, infertility.
Do not abuse syringing, the use of antibiotics and hormonal drugs. All this disturbs the normal microflora of the vagina and entails an increased likelihood of introducing pathogenic flora.
Watch for the general state of your immunity. This will reduce the likelihood of contracting viral diseases (human papillomavirus, genital herpes and others).
Find yourself a "your" gynecologist. With whom you will be comfortable, and visits to it will not turn into torture. After all, they say that the hairdresser, dentist and gynecologist should be checked!
Observing these simple tips of a gynecologist, you will avoid problems in the reproductive system.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
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