People are already accustomed to discussing the color of stool or, say, the nature of pain in their teeth with doctors without undue embarrassment. But sexual health issues still remain taboo for many.
Often women - even those who understand the importance of regular examinations by a gynecologist - are simply embarrassed to ask the doctor about what worries them. However, gynecologists insist 7 Things You Should Always Discuss With Your Gynecologist: they are doctors just like a therapist or a dentist. They will not judge you because of the problem that has arisen (if only because every experienced physician has already seen hundreds of such problems in his practice). Experts will help you solve it. Or they will calm you down, explaining that everything is fine with you.
Therefore, feel free to ask your gynecologist the most embarrassing and stupid (actually not) questions. Well, to reduce the degree of embarrassment, doctors tell 7 Gynecologists on the #1 Question Patients Ask about topics that interest and worry their patients most often.
What kind of pain is normal during menstruation?
Painful sensations during menstruation are quite common. Up to 90% of women experience Primary Dysmenorrhea with cramps in the lower abdomen and chest pain during this period. In most cases, this is unpleasant, but overall it does not cause much discomfort.
However, for some women, menstrual pain goes beyond cramping and becomes a real problem. If the pain is so severe that it significantly reduces your quality of life, and especially if it increases from menstruation to menstruation, be sure to tell your doctor about it. Such symptoms may be a sign of endometriosis, uterine fibroids and other diseases.
And in general, you shouldn’t endure pain in silence. There are many solutions that can improve your well-being. The gynecologist will probably tell you how to eliminate the discomfort in your case.
How is an examination with a gynecologist carried out?
An examination by a female doctor begins with asking the patient:
- complaints are studied (pain when visiting the toilet, during sex, the presence of rashes, the nature of the discharge);
- the doctor asks about the menstrual cycle (at what age did it start, are there any disruptions, how many days, how heavy, the date of the last menstruation);
- data on reproductive function is collected (pregnancies, abortions, miscarriages);
- the sexual aspect is studied (presence of a sexual partner, use of contraception);
- The doctor asks about previous diseases of the genitourinary system.
The next step is an examination in a gynecological chair. It includes 2 stages - using mirrors and bimanual (palpation with both hands). For each category of women (children, pregnant women, virgins, after childbirth), the procedure has its own differences.
During pregnancy
An examination by a doctor begins in the early stages of pregnancy (the first time at 8–12 weeks). At this time, an internal examination of the cervix and perineum is carried out with a mirror. The purpose of the procedure is to determine the general condition of the reproductive organ and exclude ectopic pregnancy. A flora smear (bacteriological culture) and a cytological smear (to detect malignant changes) must be taken. To do this, you need to bring a gynecological kit with you (sold at any pharmacy).
In addition to manipulations on the gynecological chair, the doctor measures the patient’s weight and height, blood pressure, pulse, studies the position of the uterus and the width of the pelvis. The survey will include information about hereditary diseases, chronic pathologies and bad habits.
Starting from week 15, internal examinations on the chair are not carried out. Now, at each visit, the doctor measures the circumference of the patient’s abdomen, the position of the fundus of the uterus, and listens to the child’s heartbeat using a stethoscope. The required parameters are blood pressure, pulse and weight.
Until the 29th week, visits to the gynecologist are limited to once every 3 weeks. Then visits to the doctor become more frequent - 1 visit every 14 days. Starting from 36 weeks – visits every 7 days. 10–15 days before childbirth, the need for a gynecological examination again appears. It is important to check the readiness of the birth canal through which the baby will pass, as well as the condition of the pharynx - the opening of the cervix.
During the entire period of gestation, a woman needs to lie on a gynecological chair at least 5–6 times. It all depends on the course of pregnancy and possible deviations.
After childbirth
Natural childbirth and the normal postpartum period require a visit to the doctor when the discharge takes on a natural character - it will not be abundant and bloody. The purpose of the examination is to check the condition of the birth canal, the formation of the uterus - whether the organ is in place, the degree of its contraction to normal size, to examine the sutures (if any), their healing.
The specialist first examines the woman with a mirror, then takes a smear. Next he performs palpation - he inserts 2 fingers into the vagina, and with the fingers of the second hand he presses on the stomach closer to the groin area. This allows you to determine the density of tissues, check the appendages, find out if there are any foreign seals or scarring on the uterus and its cervix,
Medical examination at school
For the first time, girls’ genitals are examined in the maternity hospital, then at 1 year and before entering kindergarten. At school, visits to the gynecologist begin for the first time at the age of 12–14 years. Girls are examined exclusively by a pediatric gynecologist.
The examination process consists of a survey (complaints, first menstruation) and examination of the genitals. The girls sit on the couch, where the doctor palpates through the rectum. With the second hand, the specialist presses on the peritoneum. In the absence of complaints about the sexual sphere, such manipulation may not occur.
Before the examination, the pediatric gynecologist conducts a survey
Important!
In adolescents who are not sexually active, a smear is taken with a special thin device, which allows it to avoid damaging the hymen. The examination of minor girls who already have intimate relationships is carried out similarly to a regular preventive visit for adult women.
Virgin at the gynecologist
The examination of a virgin is carried out in the same way as that of a little girl - through the anus. The doctor checks the condition of the external genitalia, palpates the abdomen, and probes the uterus with a finger through the anus. The smear is taken with a thin instrument; inspection with a mirror is not performed.
A virgin is examined through the anus.
Before sexual activity begins and in the absence of complaints from the genital area, it is enough to visit a doctor once every 1–2 years.
A gynecological examination helps to identify pathological changes in the early stages of development, monitor the progress of pregnancy and regularly monitor the condition of the reproductive organs. For preventive purposes, a woman needs to visit a doctor at least once a year. If you have complaints, do not hesitate to visit a specialist - timely examination allows you to prevent dangerous diseases.
Find out more on the topic: Women's health
Do my labia look normal?
This is a common cause of concern: women worry that their vulva is too large, unsymmetrical or too dark in color, for example.
The truth is that there is no such thing as a “normal vulva.” Each woman's labia have an individual structure and vary in shape and size in exactly the same way as men's penises.
But if you are worried that something is wrong with you, talk to your gynecologist. It will help you regain your confidence.
Rights of the child and parents
How do gynecologists check girls? Important features of the procedure can be found in Order of the Ministry of Health No. 1346n (2012) “On the procedure for undergoing medical examinations for minors”:
- The official document says that an appointment with a pediatric gynecologist is recommended at certain periods of life, but the girl’s parents have every right to refuse it.
- Thus, as part of preventive medical examinations, it is recommended to see an obstetrician-gynecologist at 3, 7, 12, 14 years of age and annually thereafter. As for registering a child for a new educational institution, an examination by a gynecologist is always required.
- But parents must remember that examination of their child by a gynecologist is possible only with their consent, confirmed by documentation. It is impossible to refuse medical intervention only when the child suffers from diseases that are dangerous to society, or his life is in danger.
- Parents have the right to prohibit a child from being examined by a gynecologist as part of a preventive medical examination. However, this may be followed by a refusal to visit or enroll in an educational institution within the framework of the Federal Law “On Education”.
- It is important to note that a child under 15 years of age should be examined by a gynecologist only in the presence of parents or guardians.
- The child should only be examined by a pediatric gynecologist. Referring a girl under 16 years of age to an adult antenatal clinic is illegal.
I'm itching there, what is it?
Itching in the genital area can have a dozen reasons, including innocent ones. You may be wearing pants that are too tight. Or spend a lot of time at the gym in wet, tight clothes. Or maybe you've switched to a new detergent and it's not working for you.
But there are more unpleasant options: itching is often the first symptom of sexually transmitted infections (STIs) or fungal diseases.
In general, if it itches for several days, be sure to tell your gynecologist about it.
How to prepare for an examination by a gynecologist?
Before going to the gynecologist, you need to properly prepare.
- Avoid sexual intercourse 3 days before visiting the doctor.
- Do not douche or use deodorizing hygiene products on the day of your visit to the doctor.
- Carry out genital hygiene with plain water without strong pressure on the genitals.
- The bladder and rectum should be empty before examination.
Careful preparation for a gynecological procedure allows the doctor to assess the real state of the genitourinary system and obtain reliable results of a smear on the flora.
Before going to the gynecologist, perform genital hygiene
It hurts during sex, what's wrong with me?
It is important to discuss painful sensations that occur during sexual intercourse with your doctor in the same way as painful periods. The fact is that discomfort always has reasons, and some of them may indicate health problems.
Pain during sex often occurs due to vaginal dryness. Perhaps this is caused by uncomfortable circumstances, for example, too short foreplay, which is why the woman does not have time to get aroused. In this case, the gynecologist will recommend ways for the couple to speed up and enhance arousal.
But sometimes hormonal imbalance leads to dryness - a decrease in estrogen levels. It can be caused by taking inappropriate oral contraceptives, menopause, an unbalanced diet, or excessive exercise. If the gynecologist suspects this is the reason, he may offer you an alternative method of contraception or prescribe drugs that will increase the level of female hormones. And of course, he will discuss with you the necessary changes in your lifestyle.
Another option is that there is no dryness, but sex still hurts. Here we can talk about diseases of the reproductive system - the same endometriosis or uterine fibroids. The gynecologist will make the correct diagnosis and tell you how to cope with the problem.
Why is a gynecological examination necessary?
An important procedure for maintaining women's health is an examination by a gynecologist.
When visiting a doctor, a woman must attend:
- for preventive purposes - at least 1 visit every 6–12 months (even if there are no complaints);
- during pregnancy (visit schedule is individual) - at least once every 3-4 weeks during the first 2 trimesters, and starting from 7-8 months, visits to the doctor are carried out almost weekly;
- after childbirth - be sure to undergo an examination after 2-3 days, then after 1.5-2 months and, if there are no complaints, regularly once every six months or a year.
The procedure allows the doctor to evaluate the external and internal condition of the vagina.
During a superficial examination, the specialist pays attention to:
- skin (the degree of dryness or greasyness of the epidermis);
- hair growth (hair growth, presence of hair);
- labia (seals, growths, bulges);
- color of the genital mucosa.
During the examination, the doctor checks in detail the genital structures - the clitoris, labia (internal), urethra, cervix, hymen (if present).
A gynecological examination involves the mandatory submission of biological material - a smear on the flora. This is done both for prevention and to identify the source of negative disorders in the genitourinary system.
Gynecological examination includes a smear on the flora
An experienced doctor, during an external examination, can immediately determine the existing pathological abnormalities:
- inflammation, eczema, ulcerative processes, condylomas, papillomas, warts, tumors;
- hypoestrogenia (labia pale, increased dryness of the uterine and vaginal mucosa);
- high level of estrogen in the body (change in color of the vulva, heavy vaginal discharge);
- pregnancy (bright red genitals, which is associated with increased blood flow to the pelvic organs and hormonal changes in the body);
- hyperandrogenism (the clitoris is enlarged and distant from the urethra, the labia (inner) are poorly developed).
If the doctor notices negative abnormalities, he prescribes a detailed examination - ultrasound, blood tests, urine tests, cytological examination.
Why do you need to know exactly how many men I've had?
Of course, in reality this question does not sound like that. More precisely, it is not even formulated at all. Women, having heard from a gynecologist the standard “How many sexual partners have you had?”, simply name a number out of thin air - often significantly underestimated. The question “How long have you been sexually active?” also causes rejection: they say, why does the doctor need to know this?
Meanwhile, this information is important. For example, those who become sexually active before the age of 18 are more likely to contract the human papillomavirus (HPV), an insidious disease that can lead to cervical cancer. Having a large number of partners also increases risks. Therefore, the gynecologist may prescribe additional examinations for you.
I don't want to have sex, is that normal?
Low libido affects many people. There are many reasons for this: fatigue, stress, lack of sleep, relationship problems, depression... All this can be solved: the gynecologist will advise you on lifestyle changes or, if necessary, send you to a specialized specialist - the same psychotherapist.
But sometimes decreased libido is a purely physiological problem. You may be taking a medicine that has this side effect. Or you develop a thyroid disease that you don't know about yet. Also, decreased libido can be caused by hypertension, high cholesterol, smoking, diabetes and much more. A gynecologist is competent enough to suspect such causes and prescribe the necessary tests and treatment for you.
An important rule: the more often you have sex, the more you want it. This is due to the release of endorphins during sexual intercourse.
Preparation
A girl should not go to a gynecologist during her period, as this will prevent the specialist from obtaining the necessary information. An exception may be the case when menstruation is accompanied by unpleasant symptoms, or they are very heavy or prolonged, if menstruation comes earlier or later than expected. In this case, visiting a doctor should be mandatory. It is better for all other girls to go to the gynecologist 3-5 days after the end of their period.
Before going to a medical facility, you need to shower and put on fresh underwear. At the same time, there is no need to wash yourself too actively, otherwise the doctor will not be able to assess the state of the microflora in a normal, everyday state.
It is strictly forbidden to douche beforehand. In this way, the girl can wash away beneficial and pathogenic bacteria and remove vaginal discharge, which also carries some information for the doctor. There is no need to use special intimate perfume or eau de toilette before going to the doctor.
A day or two before going to the gynecologist, you should stop using medicinal suppositories or sprays. If a girl is undergoing treatment with antibacterial drugs, then she will be able to visit a doctor only 2 weeks after the end of the course of therapy. If necessary, this can be done earlier, but in this case it will not be possible to assess the state of the microflora of the genital organs.
As for shaving hair in the intimate area, this procedure is not mandatory. However, a girl can do this if she personally likes it better. Before the examination, it is very important to empty your bowels and bladder.
Inventory
In most cases, the clinic already has all the materials necessary for the examination. They are issued before virgins are examined by a gynecologist. However, in this case we are talking about good, paid clinics. At the same time, most girls go to regular city clinics. But all this may not be available there, so in this case it is recommended to have with you:
- a diaper (it should be placed under the buttocks);
- clean socks (feet in socks will look more aesthetically pleasing than just bare feet, and it will be more pleasant and safer for a girl to walk from the couch to the chair on the floor, which was previously walked on by no one knows);
- a calendar in which a girl marks the days of her period;
- medical gloves.
I urinate when I sneeze or cough, what should I do?
Urinary or fecal incontinence is a stressful situation that significantly impairs the quality of life. This often happens to girls who have recently given birth, especially if the baby was large or the birth required forceps. Another risk group is women entering menopause.
For some, the incontinence problem goes away on its own. In other cases, medications will help cope with it. Some will need surgery. The gynecologist will determine which option is yours and, if necessary, prescribe treatment.
