Gynecologist

A woman is a unique organism with a complex mechanism that is capable of bearing a fetus and giving birth. But there are situations when this mechanism fails or breaks down. What to do in such a situation? You need to urgently run to the gynecologist! Who is this? What does he do? What diseases does a gynecologist treat and when should you contact him? We will try to answer all these questions now.

Who is a gynecologist?

Gynecologist is a fairly broad specialization of a doctor that covers problems of the female reproductive system. It includes narrower areas such as pediatric gynecologist, obstetrician-gynecologist, gynecologist-endocrinologist and gynecological surgeon.

Gynecologists are usually women, but there are also men. There is even a strong opinion that male specialists are more careful and attentive to their patients. But which doctor to choose is your personal decision. Where to seek help? Gynecologists are located in women's consultations of district polyclinics, gynecological departments of hospitals, maternity hospitals, as well as in private clinics.

When should you see a gynecologist?

Often, women go to the gynecologist when things are really "hot". Unfortunately, this doctor still causes embarrassment and discomfort just thinking about him. But you need to take care of your health, so we highly recommend visiting a gynecologist once every six months, even if you feel fine. Also, for preventive purposes, you should contact this specialist in the following situations:

• at the onset of the first full menstruation;
• after the start of active sexual life;
• 3-4 weeks after changing partners (to detect latent infections);
• before marriage (to assess your health);
• when planning pregnancy (to identify hidden infections and treat them in a timely manner);
• in the absence of pregnancy for six months during unprotected sexual intercourse (to determine the cause);
• if menstruation is delayed (at least 7 days);
• at 6-8 weeks of pregnancy and further as prescribed by a doctor (for registration and monitoring of the course of pregnancy);
• one month after childbirth, termination of pregnancy or miscarriage.

You should urgently contact a gynecologist if:

• severe pain during menstruation;
• pain in the lower abdomen or lower back;
• bloody discharge appeared in the middle of the cycle, after sexual intercourse, physical exertion, or during menopause;
• menstrual cycle disorders have occurred;
• there was profuse discharge with an unpleasant odor;
• severe itching, burning, and stinging occurred.

When collecting anamnesis by a gynecologist, do not be embarrassed, since in case of a possible disease, both partners will have to be treated.

What tests should you take when visiting a gynecologist?

When you first visit a gynecologist, the doctor collects an anamnesis, fills out a card, takes smears for vaginal flora and prescribes additional tests. What tests might need to be taken when visiting a gynecologist again?

• general blood test (to detect the inflammatory process);
• PCR blood test (for the presence of antibodies to suspected infections: mycoplasma, ureaplasma, chlamydia, trichomonas, gardnerella, human papillomavirus, genital herpes and others);
• bacteriological culture from the cervical canal, urethra and vagina with an antibiogram (to identify pathogenic flora and its quantity);
• scraping from the cervical canal for cytology (to determine the degree of dysplasia);
• blood test for hormones: follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, progesterone, estrogens, as well as thyroid hormones (thyroid stimulating hormone - TSH) and adrenal glands;
• blood test for hemostasis (to determine the risk of miscarriage);
• karyotyping of spouses (to determine genetic abnormalities of chromosomes);
• partner compatibility analysis (in case of infertility);
• blood test for ovarian tumor markers (to detect malignant tumors);
• tests for syphilis, hepatitis, HIV (when registering for pregnancy).

In case of endocrine dysfunction, the gynecologist will definitely give a referral for consultation with an endocrinologist, and in case of genetic abnormalities, to a reproductive specialist.

What diagnostic methods does a gynecologist use?

The first and most basic diagnostic method is a visual gynecological examination. It is performed on a special chair using so-called gynecological "mirrors". Thanks to this diagnostic method, the gynecologist can examine the vaginal vaults for papillomas, condylomas, evaluate the vaginal mucosa and the cervix. At this stage, smears are taken for flora, cytological scrapings and, if necessary, a biopsy of neoplasms. Next, bimanual diagnostics is performed. It is performed with one hand, while the other hand is on the abdominal cavity. During a bimanual examination, the appendages, the presence of neoplasms, cysts are palpated, the position of the uterus, its size and shape are noted. And the last final stage of the gynecological examination is a rectovaginal examination. It consists of examining the female reproductive organs through the rectum. Such an examination is performed on girls who have not started their sexual life and women over forty years old (to exclude diseases of the rectum).

What other diagnostic methods does a gynecologist use?

If further examination of the patient is necessary, the gynecologist may prescribe diagnostic methods such as:

• colposcopy – examination of the cervix by a gynecologist using a special optical device with an image displayed on a screen for a more accurate examination for the presence of dysplasia;
• Ultrasound is an ultrasound examination of a woman’s pelvic organs by a gynecologist to diagnose uterine and ectopic pregnancy, to determine the exact gestational age, the presence of fetal malformations, the size of the ovaries, the presence of cysts on them and to determine their type, and much more;
• folliculometry – examination of the patient’s follicles before and after ovulation using ultrasound equipment to establish the exact date of ovulation (usually this procedure is done three times);
• Hysteroscopy - an examination of the inside of a patient's uterus using a device with a camera called a hysteroscope. This procedure may involve taking uterine tissue and tumors for biopsy;
• hysterosalpingography (HSG) – diagnostics of the condition of the uterus and the patency of the fallopian tubes using a special fluorescent solution, which is introduced through the cervical canal;
• diagnostic laparoscopy is an abdominal operation performed by a surgeon under general anesthesia, using a special device with a camera - a laparoscope. During laparoscopy, a woman's reproductive organs are examined, cysts are removed if necessary, adhesions are dissected, the patency of the fallopian tubes is restored, and much more. An ectopic pregnancy is removed using the same method.
• Biopsy and histological examination can be performed by a gynecologist using various methods. During this procedure, a piece of organ tissue, neoplasm, or fluid is taken and examined histologically.

What does a gynecologist do?

Gynecology as a branch of medicine existed before our era, but at that time it was inseparable from obstetrics and surgery. In the Middle Ages, gynecology experienced complete stagnation and only in the Renaissance did doctors begin to renew their knowledge of the structure of the female reproductive system. The real flowering of science occurred in the 9th-20th centuries.

What does a gynecologist do now? It all depends on the narrow specialization. For example, a pediatric gynecologist treats genital infections in girls, answers frequently asked questions from teenagers during puberty, gives preventive talks about contraception and sexually transmitted diseases, regulates the menstrual cycle if necessary, and so on. An obstetrician-gynecologist monitors women during pregnancy, monitors and records the growth and development of the fetus in the exchange card, gives preventive talks on childbirth and motherhood, consults on concomitant pregnancy problems, and also refers, if necessary, for termination of pregnancy or for hospitalization, performs abortions and delivers babies. A gynecologist-endocrinologist identifies problems of hormonal imbalances in women, prescribes drugs to normalize them, gives preventive talks about the hormonal background of the female body, and so on. A gynecological surgeon performs laparoscopic or abdominal surgeries to remove cysts, tumors, ectopic pregnancies, restore patency of the fallopian tubes, and also performs cesarean sections. Gynecologists also select the optimal method of contraception (oral contraceptives, intrauterine device, cervical cap) and prescribe and install them.

What diseases does a gynecologist treat?

All diseases treated by a gynecologist can be divided into three broad conditional groups:

1. Inflammatory diseases of the female reproductive organs;
2. Diseases of the female reproductive system associated with problems in the endocrine system;
3. Precancerous and cancerous conditions of the reproductive system.

Inflammatory diseases of the reproductive organs include:

• purulent-inflammatory processes (endometritis, vaginitis, colpitis, adnexitis, etc.);
• sexually transmitted diseases (gonorrhea, candidiasis, ureaplasmosis, mycoplasmosis, trichomoniasis, chlamydia, syphilis);
• diseases of viral origin (human papillomavirus, genital herpes, cytomegalovirus).

Endocrinological disorders of the female reproductive system include:

• endometriosis (proliferation of the endometrial walls);
• PCOS (polycystic ovary syndrome);
• amenorrhea (absence of menstruation);
• DUB (dysfunctional uterine bleeding);
• Ovarian failure syndrome (OFS);
• hyperandrogenism (increased levels of male sex hormones);
• metabolic syndrome (impaired sensitivity of the body to insulin);
• adrenogenital syndrome (dysfunction of adrenal hormone production);
• hypothyroidism (dysfunction of thyroid hormone production).

Precancerous and cancerous conditions of the female reproductive system include:

• erosion and dysplasia of the cervix;
• benign and malignant neoplasms of the female reproductive organs.

Advice from a gynecologist

You should be examined by a gynecologist regularly! If nothing hurts and nothing bothers you, it does not mean that everything is in order. As they say, "better safe than sorry."

You should always think about your health, so it is preferable to have 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 becomes chronic and practically, or even does not bother at all, but can cause chronic inflammation, and in the worst case, infertility.

Do not overuse douching, antibiotics, or hormonal medications. All of this disrupts the normal vaginal microflora and increases the likelihood of introducing pathogenic flora.

Monitor your overall immune health. This will reduce the likelihood of contracting viral diseases (human papillomavirus, genital herpes, etc.).

Find yourself "your" gynecologist. With whom you will feel comfortable, and visits to him will not turn into torture. After all, they say that a hairdresser, dentist and gynecologist must be verified!

By following these simple tips from a gynecologist, you will avoid problems in the reproductive system.