At a reception with a gynecologist. Gynecological examination. Gynecological examination

Each woman should visit the gynecologist at least once a year, even in the absence of complaints.

Preparing for a gynecological examination of

A woman going to see a gynecologist should remember the following:

before a physical examination it is recommended to take a shower or a bath and put on fresh clothes. However, especially carefully wash, and even more so, douche should not be, since the doctor should see the microflora of the vagina in a normal, "everyday" condition;
is not recommended to use special intimate deodorants or perfumes;
a day before the visit to the doctor, exclude sexual contact, since in the vagina there is often a small amount of seminal fluid that prevents reliable analysis;
if a woman had to undergo antibiotic treatment, it is better to go to a gynecologist 1 to 2 weeks after stopping treatment. Antibacterial drugs specifically affect the vaginal flora and complicate the diagnostic process. The same applies to antifungal agents;
is the best time to visit a doctor - the first days after menstruation. During the menstruation to undergo examination and further examination is not necessary, except in case of emergency( for example, severe bleeding, accompanied by sharp pain).
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At home, before visiting a gynecologist, it is necessary to empty the bladder. Intestine, if possible, should also be empty. Otherwise, the gynecological examination, especially palpation( examination of the internal organs through the skin by hands) for the doctor will be difficult. If you sit in the queue for a long time to the gynecologist - do not be lazy to go to the ladies' room when your turn comes to empty the bladder.

In addition, it is important to psychologically prepare yourself for a visit to a gynecologist, especially for young girls. It should be understood that the doctor's questions about the intimate features and specificity of sexual life are necessary for the correct diagnosis. At the same time, in order to successfully diagnose or treat the answers, the answers should be as fair and thorough as possible. A qualified gynecologist will never condemn you for anything, but instead will try to help and explain any difficult moments. All the information entrusted to the doctor will remain in the walls of the office, but it will help the expert to establish the most accurate diagnosis.

What questions does the doctor ask the gynecologist

? To visit a gynecologist you need to know the date of your last menstruation, you must know the nature and duration of your menstrual cycle. The gynecologist will ask questions: when the first menstruation started, regular or irregular, what kind of gynecological and infectious diseases were transferred, whether there are chronic diseases, live or not sex life, whether or not you are protected, what is being protected, whether there were pregnancies( including abortions), childbirththe nature of childbirth, complications, the child is healthy), the composition of the family and the nature of the work.

When diagnosing infertility, a doctor may ask whether there were problems with conception with your close relatives, whether your mother had problems during conception, pregnancy and childbirth, chronic diseases of relatives, shaving your legs( this is very important if you suspect aHyperandrogenism)

Answers to these questions help the doctor in diagnosing - today, very many female diseases are associated with living conditions, work, nutrition and diets, transferred stresses. If you yourself are interested in the reliability of the results and the appointment of the right treatment, answer the questions of the doctor as sincerely as possible. The data, which the gynecologist will receive as a result of the conversation, will help him to choose the further direction of research, methods of examination and diagnostics.

General objective examination at a gynecologist's admission

In general objective examination, first of all, the doctor conducts an assessment of the type of the woman's constitution, skin and hair condition, examines the abdominal cavity organs, characterizes the mammary glands and develops the reproductive system. All these factors are necessary for an accurate diagnosis and the selection of appropriate treatment.

There are the following main types of constitution: a) infantile( hypoplastic);b) hypersthenic( picnic);Intersexual;d) asthenic. The four types of constitution listed are rarely found in a "pure" form. When assessing them, it is necessary to take into account factors such as lifestyle, nutrition, age, which undoubtedly affect the appearance of a woman. It is also necessary to know: the diseases characteristic of this or that type are largely conditional, and in any case, a more thorough individual examination of the patient is needed to establish the diagnosis.

The value of anthropometric indicators for a gynecologist.

Anthropometric indices are extremely important for the diagnosis of a number of endocrine disorders closely related to gynecological diseases. In addition, with a deficiency or excess of body weight, there is a tendency to menstrual irregularities. In this regard, one of the necessary actions for the examination of a woman is the calculation of her body mass index( BMI) equal to the body weight( in kg) and the square of the growth( in m).The BMI of a woman of reproductive age should normally be 20-26. A BMI over 30 means an average risk of developing hormonal and endocrine diseases. BMI over 40 - the degree of development of diseases is high.

Also an important anthropometric characteristic is the degree of development of fatty tissue in a woman. Therefore, a qualified doctor can judge the function of the endocrine glands. In the presence of any disorders, fat deposits on the face, trunk, back and abdomen are observed. For example, a sharp decrease in the functional activity of the ovaries( which often occurs in the climacteric period) can be characterized by the deposition of fat on the shoulders, chest, abdomen, thighs. Therefore, if you notice that you have recovered, and it is due to fat deposits, and not muscle tissue, do not rush to diet. It is better to see a doctor, as this may be a symptom of serious diseases requiring prompt treatment.

Together with the clarification of anthropometric characteristics at the first reception, an evaluation is made of the woman's hairiness. The peculiarities of the distribution of the hair cover and its density give information about the hormonal activity of the ovaries, and also allow one to judge the action of hormones such as androgens, which are used to treat certain gynecological diseases. On the phenotypic manifestations of hormonal characteristics, thus, it is possible to predict in advance whether any medicine will be effective, or it is better to replace it with another.

Assessment of sexual development and mammary glands

The evaluation of sexual development is carried out on the sum of three indicators - the degree of development of the mammary glands, the degree of pubic furrowing in the pubic region and in the armpits and the characterization of menstrual function.

Menstrual function is defined as follows: menstruation has never been;primary menstruation( menarche) at the time of examination or shortly before it;

irregular menstruation;regular menstruation.

Based on the information obtained during the conversation with the patient, the specialist draws a conclusion about the nature of the menstrual function, which allows us to diagnose as soon as possible the presence of any disturbances.

The study of mammary glands in gynecology is caused by the fact that many specific diseases are accompanied by mammary pathology. First of all, pay attention to the degree of their development, the shape of the nipple. In addition, it is important to determine whether there are seals, pain when pressed, discharge.

Methods of examination of the abdominal cavity

When examining the anterior abdominal wall, maximum attention is paid to its size, shape, participation in the respiratory process. All this is determined by the method of palpation( probing), which, in addition, allows you to find out the presence of tumors and their nature.

The next method of examining the abdomen is percussion. This method consists in the fact that the doctor tapes the surface of the abdomen with the help of fingers or a special instrument and analyzes the resulting oscillations. When using it, you can determine the boundaries of the existing tumors, as well as the presence of free fluid in the abdominal cavity. Percussion is completely painless and is often performed during a primary examination, if there is a suspicion of a number of diseases.

The method of auscultation of the abdomen is the listening of the movement of gases or fluids inside the body and is usually carried out using a special stethoscope. This method is well suited for the study of the intestines, the condition of which often indicates the presence of a number of gynecological diseases and disorders. Auscultation also allows for differentiation between large tumors of internal genital organs and pregnancy without special analyzes.

Gynecological examination

All gynecological examinations are carried out mainly in a horizontal position on a special gynecological chair that meets all modern requirements. Inspection is carried out using disposable and sterile instruments( mirrors, tweezers, instruments for taking swipes, etc.).Before the examination, the doctor puts on sterile rubber gloves, which are destroyed after preliminary treatment in a special disinfectant solution.

The gynecological chair consists of the armchair and leg supports( slingshots).Settling on a gynecological chair, in fact, is not difficult. You lay on the surface on which you will "sit" a napkin, climb up the steps to the armchair and lie on it so that the buttocks are at the very edge of the gynecological chair. Then raise your legs and place them on the supports so that the slingshots are in the popliteal fossa. Do not be shy and do not hesitate to ask the gynecologist how to properly arrange in the gynecological chair, if this design is unfamiliar to you.

The examination in the gynecological chair begins with the examination of the external genitalia. The next most common method is examination in mirrors - there are special gynecological instruments called mirrors that allow you to examine the cervix and vagina. The next in priority after examination in the mirrors is the study of internal genitalia. In this study, the doctor determines the position, size, condition of the uterus itself, the fallopian tubes and ovaries. Using vaginal examination, it is possible to suspect endometriosis. Such diseases as uterine fibroids, inflammation of the appendages, ovarian cysts, ectopic pregnancy, uterine pregnancy, etc. are diagnosed. At the examination, doctors take a smear for infection, for cytology, if necessary, conduct colposcopy, prescribe ultrasound and other additional methods of investigation. For example, if there are suspicions of infectious diseases, gynecologists will recommend giving blood and scraping from the vagina.