Conversation with a gynecologist: how, when and why you need a visit to the doctor. They find the HPV virus in you and say that it needs to be treated urgently because it causes cervical cancer. Lack of interest in sex

OLGA LUTOVINOVA,

obstetrician-gynecologist of the Herpetic Center

What to complain about if you are 100% confident in your only partner, you use a condom, you feel fine, or if you are even a virgin? And complaining is just optional, you, most importantly, come. And the doctor himself knows what to look for. Cervical erosion, ovarian cysts, uterine fibroids, and many sexually transmitted infections begin asymptomatically. Regular examination by a gynecologist allows them to be detected in time, which means avoiding surgery or more serious consequences. The first visit is usually timed to coincide with the 15th birthday or the onset of sexual activity.

WELL PREPARED

Do I need to shave my private hair?
The model of an intimate hairstyle does not affect the quality of diagnosis. But short hair (or even smooth skin) stays fresher for longer throughout the day.

Do I need to douche before a visit to the gynecologist?
Not! Enough to take a shower. Too thorough hygiene procedures will not allow the doctor to get a true picture of the state of your microflora. It is better not to use creams and gels for intimate hygiene: dyes and fragrances can affect the quality of the tests.

What if I go to the doctor in the evening after work?
Use wet wipes. Better for children: special wipes for intimate hygiene may contain antiseptics that affect the vaginal flora and, consequently, the quality of laboratory tests.

Can I have sex the day before the visit?
It is forbidden. It is advisable to refrain from 2-3 days. Test results can be affected not only by seminal fluid that has entered the vagina, but even spermicides or lubricant from a condom.

Should I enter the office with a full bladder or an empty one?
The bladder is located in front of the uterus and in a full state will interfere with palpation, so it is best to empty it. But for some tests, it is recommended not to urinate for 2-3 hours - you will wash off the bacteria. This issue can be discussed already at the reception of the gynecologist.

Most girls don't even know about it.
For a routine examination by a gynecologist, it is better to choose the first days after menstruation. At this time, immunity is slightly reduced, and even latent chronic infections can be detected. In addition, the main studies of the cervix are most reliable in the first phase of the cycle.

2-3 weeks before visiting a doctor, it is better not to take medication.
Even if you are sure that the cause of your worries is just a thrush, you should not immediately run to the pharmacy for a miraculous capsule. You can be wrong, and antifungal drugs, like antibiotics, change the microflora of the vagina, and tests can give a false result. Taking immunomodulators and hormones can also lead to a distortion of the picture - they should also not be drunk for 2-3 weeks before the visit. But if you have chronic diseases and you take pills all the time, then, of course, you should not take a break.

Before visiting the gynecologist, it is advisable to do an enema.
Clogged intestines greatly complicates the study of the uterus and appendages. This is especially important for virgins (they are examined through the rectum).

If you suspect you have a sexual infection, arrange a food provocation.
Dinner with light alcohol, salty and smoked foods will help the latent infection swim out.

Take socks and a diaper with you.
Put a diaper on a chair. Socks must be worn, no matter how luxurious your pedicure may be: these are the rules of etiquette that were established back in the Soviet era. True, now many commercial clinics give out disposable shoe covers and diapers.

WELL SAID

WELL SHOWED

WELL ENDED

If nothing bothers you, then the first visit to the gynecologist can be done at the age of 13 to 15 years.

Why go to the gynecologist if nothing bothers me?

Doctors, including gynecologists, are engaged not only in the treatment of diseases, but also in their prevention. The doctor will make sure that your sexual organs are developing well and correctly and that no disease threatens you. In addition, the doctor may notice early signs of illness that are invisible to you. It is much easier to recover if the doctor notices the symptoms of the disease at an early stage, when nothing bothers you yet.

If you are sexually active, then the doctor can advise you on the best one, as well as tell you how to protect yourself from sexually transmitted diseases.

Do I need to shave before going to the gynecologist?

No, it's not necessary at all. The gynecologist does not pay attention to whether the hair in the intimate area is shaved. It's much more important that you take a shower and put on clean underwear.

When to shower or wash?

It is better to do this the evening before going to the gynecologist. It is undesirable to wash a few hours before the examination, as you can "wash away the evidence" - discharge that may be a sign of inflammation.

Is it possible to go to the gynecologist during menstruation?

It is possible, but not desirable. During this time, the gynecologist will not be able to perform a normal examination and therefore, most likely, will appoint you a second appointment in a few days. For a preventive examination, it is better not to come to the gynecologist during critical days.

But if during menstruation you have any complaints, then you do not need to wait for the end of menstruation. In this case, you can come to the gynecologist during your period.

What will happen at the appointment with the gynecologist?

In the event that nothing bothers you, during the first visit to the gynecologist, you can just talk. The doctor may ask the following questions:

Have you already started your period? If so, when did you have your first period and how long did it last? Do periods come on the same days every month, or can they be missing for several months in a row? When was the first day of your last period?

Are you sexually active? Have you ever had sexual contact with anyone? If yes, how did you protect yourself (using or )? Did you have any unpleasant symptoms after sexual intercourse (abdominal pain, itching in the genital area)?

Is there anything that worries you and how can a gynecologist help?

Sometimes the gynecologist offers to undergo an examination on the chair during the first visit. Do not worry: this does not mean that something is wrong with you. The doctor wants to make sure that your genitals are developing properly and that there is nothing to worry about. If you are feeling very anxious, you can ask your mother to stand by you during the examination.

What happens in the gynecologist's chair?

"Examination on a chair" is an expression that means a gynecological examination. In the gynecologist's chair, you may not be very comfortable, as you will have to remove your underwear and spread your legs wide apart.

Be sure to make sure that under the ass you put a sterile napkin. In smaller clinics, you may be asked to bring a towel or a disposable gynecological exam kit, which is sold at the pharmacy.

During the examination, the doctor will assess how well your genitals are developed, whether there are any signs of inflammation. If you are a virgin, then the gynecologist will not conduct a deep examination of the vagina, so as not to damage the hymen. The gynecologist may insert a finger into the anus to check the elasticity of the vaginal wall and feel (uterus and ovaries).

If you are a virgin, but you have complaints of vaginal discharge or itching in the genital area, then the gynecologist can examine the vagina and take it. Such an examination is carried out with very thin instruments that cannot damage the hymen. If you are not a virgin, the gynecologist will examine your vagina with a special tool called a speculum.

Before or after a genital exam, the gynecologist will also examine and feel your mammary glands (breasts).

Inspection in a chair - does it hurt?

You can not call a gynecological examination pleasant, but it does not hurt. Some of the doctor's manipulations can be inconvenient and not very pleasant. If during the examination you feel pain, be sure to inform the gynecologist about it.

Can a gynecologist tell if I'm not a virgin?

Yes maybe.

How to deceive a gynecologist if I am no longer a virgin?

Unfortunately, there are no ways to deceive a gynecologist. If you are already sexually active and do not want anyone to know about it, then it is better to tell the doctor about it right away.

If you do not initially deceive the gynecologist, he will trust you and will not take notes about your (or rather, her absence), and also inform your parents about it.

Does the gynecologist have the right to tell my mother that I am no longer a virgin?

The gynecologist has the right to tell your parents that you are no longer a virgin, if you are not yet 15 years old. If you are 15 years old or older, then at your request, the gynecologist is obliged to keep all information confidential. Article 54 of the law says this. "On the fundamentals of protecting the health of citizens in the Russian Federation" dated November 21, 2011.

It is better to immediately establish a trusting relationship with the gynecologist so that he does not have a desire to tell your parents that you are no longer a virgin.

How often should I go to the gynecologist if nothing bothers me?

Once a year, you need to visit a gynecologist for a preventive examination.

Even if the state of health does not raise any questions, this is not a reason to cancel a scheduled appointment with a gynecologist. After all, if there were complaints, then the reception was late! What is worth remembering before going to the gynecologist or how to prepare for the trip?

“I can’t do it anymore, I’ll be patient”

“I go to the toilet after taking it” is a very serious misconception and definitely should not be tolerated. On the one hand, a full bladder complicates the process of palpation, so it is better to arrive at the clinic in advance to go to the toilet. But, on the other hand, for some tests it is recommended not to urinate for 2-3 hours, so as not to remove the bacteria. The gynecologist will definitely raise this question himself.

Why stop taking medication

Even if the symptoms indicate that the cause of concern is a common thrush, we advise you to first consult a gynecologist and only then take certain medications. Antifungal drugs and antibiotics greatly affect the microflora of the vagina - the result of a smear may be false.

Also, 2-3 weeks before the visit to the gynecologist, it is better to stop taking drugs to increase immunity and hormonal drugs. You should not take a break in medicines if they are prescribed for continuous use in chronic diseases.

At the first visit to the gynecologist during pregnancy, the doctor starts an individual card of the pregnant woman, in which, throughout the entire period of expectation of the child, data on the health status of the expectant mother and her baby are recorded.

At the beginning of the appointment, the obstetrician-gynecologist asks the patient about past illnesses, operations, injuries, bad habits, working conditions in order to determine their possible impact on the course of pregnancy. If the expectant mother has chronic diseases of the heart, respiratory organs, gastrointestinal tract, kidneys, blood during pregnancy, careful monitoring by a therapist or narrow specialists is required.

Next, the doctor proceeds to collect a gynecological history. Finds out the nature of menstruation (age of the onset of the first menstruation, regularity of the cycle, duration, profusion, painful menstruation). Violation of the cycle may indicate insufficient ovarian function and will require the appointment of special drugs during pregnancy. The doctor always asks the expectant mother about the age of the onset of sexual activity, past gynecological diseases. Then he learns about the course and outcome of previous pregnancies: how they proceeded, whether there were any complications (preeclampsia, chronic placental insufficiency, etc.). If the pregnancy ended in childbirth, then the doctor will need to provide data on the weight of the child born, the method of delivery (birth through the natural birth canal or caesarean section), the presence of complications in the postpartum period (bleeding, divergence of stitches in the perineum, etc.).

At the first appointment with an obstetrician-gynecologist during pregnancy, the doctor also finds out the health status of the future dad: his age, the presence of serious chronic and hereditary diseases, occupational hazards, blood type and Rh factor. In addition, the doctor always asks about the state of health of the next of kin, paying special attention to hereditary and severe chronic diseases. All these data must be taken into account when monitoring pregnancy in order to predict possible complications.

Necessary measurements at the first gynecological appointment during pregnancy

After a conversation at the first appointment during pregnancy, the gynecologist measures the growth and weighs the expectant mother. The ratio of weight and height allows you to determine the body mass index (BMI), on the basis of which the proper weight gain during pregnancy is calculated. The dynamics of this indicator is of great importance, since with some complications (for example, preeclampsia), weight gain exceeds normal values ​​​​(on ​​average, with a normal pregnancy, a woman gains 10–12 kg).

At the first appointment, it is necessary to measure the size of the pelvis of the pregnant woman with a special device - a tazomer. The data obtained make it possible to predict the possibility of childbirth through the natural birth canal. The presence of a narrow pelvis in a future mother, deformations of its bones are a possible indication for a caesarean section.

Using a centimeter tape, an obstetrician-gynecologist measures the circumference of the abdomen. And if the pregnant woman is registered after 12 weeks, the doctor measures the height of the uterine fundus (the distance from the pubic symphysis to the highest point of the uterus). Thanks to these parameters, in dynamics, you can notice a violation of the growth of the fetus, suspect oligohydramnios or polyhydramnios, and immediately before childbirth, calculate the approximate weight of the unborn baby.

At the first visit and then at each appointment, the blood pressure level of the expectant mother is measured. It is important to know exactly the initial pressure figures, since while waiting for the baby, its level may change. A decrease in blood pressure often occurs in the first trimester of pregnancy, and this is due to hormonal changes in the body, and an increase indicates the presence of diseases of the cardiovascular system (hypertension), requires additional examination and, if necessary, treatment. An increase in pressure in the second and third trimesters may be a sign of preeclampsia (a complication of pregnancy characterized by narrowing of all vessels in the body and manifested by edema and the appearance of protein in the urine).

Examination by a gynecologist during pregnancy

Next, the doctor necessarily examines the patient's mammary glands: evaluates their development, the condition of the nipples, the presence of colostrum (its appearance during pregnancy is a normal phenomenon, indicating the preparation of the breast for the upcoming lactation). Then he feels the glands to exclude pathological formations in them, because the appearance of seals in the chest can signal the presence of a tumor.

The next stage is an examination on a gynecological chair. Many expectant mothers are afraid of this procedure, as they believe that it can lead to termination of pregnancy. However, these fears are unfounded. The doctor always carefully examines the patient and cannot harm the baby. Before visiting the obstetrician-gynecologist, the expectant mother needs to perform hygiene procedures and empty the bladder (a full bladder can interfere with the examination).

First, the doctor examines the external genitalia. The doctor pays attention to the condition of the perineum, the presence of scars after ruptures in previous births, reveals warts (growths of mucous membranes), rashes and other pathological changes. Be sure to examine the anus, the presence of enlarged hemorrhoids. After that, using a gynecological mirror, the walls of the vagina and cervix are examined. Such a study allows you to identify diseases of the cervix (erosion, polyp). During the examination in the mirrors with a special tool, the obstetrician-gynecologist takes smears for the degree of purity of the vagina (to identify the inflammatory process) and oncocytology (to exclude cancer of the cervix).

Next, the expectant mother expects a bimanual (two-handed) vaginal examination. The state of the cervix is ​​necessarily monitored: its density, length, location. With a normal pregnancy, the cervix is ​​tilted backwards, dense, long, the cervical canal is closed. With the threat of interruption, the cervix softens, shortens, the cervical canal opens slightly. In this case, the patient needs to undergo treatment aimed at maintaining pregnancy. Depending on the situation, drugs are prescribed that reduce the tone of the uterus, or hormonal drugs.

Next, the doctor examines the uterus. Starting from the 5th week of pregnancy, the uterus increases in size, changes its shape from pear-shaped to spherical. A characteristic sign of pregnancy is a change in the consistency of the uterus: it becomes denser, which is determined by the doctor during the examination.

After that, the condition of the fallopian tubes and ovaries is assessed. At this stage of the examination, it is possible to identify cysts, formations, adhesions in the appendages. In the early stages, if painful, enlarged appendages are detected, it is important to exclude ectopic pregnancy, and if cysts are detected in the ovaries, dynamic monitoring is required.

Determining the gestational age and DD

At the final stage of the visit, the obstetrician-gynecologist determines the gestational age and the expected date of birth (DDD). The gestational age is determined by the first day of the last menstruation of the expectant mother, as well as on the basis of vaginal examination data. EDD is calculated by the formula: the first day of the last menstruation minus 3 months plus 7 days.

The first tests and examinations during pregnancy

At the first visit, the expectant mother will definitely receive referrals for the following tests, which must be passed:

General blood analysis allows you to determine the content of the level of hemoglobin, erythrocytes (with a decrease in these indicators, anemia develops), leukocytes (an increase in their number indicates inflammatory processes in the body), platelets (with a deviation from the norm, problems with the blood coagulation system are observed).

Blood chemistry includes the determination of the level of glucose, bilirubin, total protein, cholesterol, etc. Knowledge of these indicators allows you to get an idea about the work of all organs of a pregnant woman.

Determination of blood group and Rh factor. During childbirth, a blood transfusion may be required, and these indicators are extremely important. If the expectant mother has a negative Rh factor, then during pregnancy the titer of antibodies is necessarily determined, the appearance of which indicates the presence of a Rh conflict between the mother's body and the fetus and requires certain measures to be taken.

Examination for HIV infection, hepatitis B and C, syphilis. When HIV infection is detected, the expectant mother is prescribed antiviral therapy in order to reduce the risk of passing the infection to her child. If the test results for syphilis are positive, treatment with special drugs may be required. If hepatitis B or C viruses are detected in the blood of a pregnant woman, the degree of progression of the disease must be determined, on which the tactics of managing the patient depend.

General urine analysis allows you to evaluate the work of the kidneys, since during pregnancy the load on them increases.

In addition, the pregnant woman receives referrals to narrow specialists(oculist, otorhinolaryngologist, dentist) and therapist.

At the first appointment, the obstetrician-gynecologist necessarily gives the expectant mother recommendations on lifestyle, nutrition and, if necessary, prescribes medications.

Thanks to the information collected during the first visit, as well as the results of the studies received, the doctor assesses the patient's health and identifies risk factors that can complicate the process of bearing, which is important for maintaining the health of the expectant mother and her baby.

The first visit to the gynecologist: what to foresee

Before visiting an OB/GYN, think carefully about the questions you want to ask the doctor. It is advisable to write them down so as not to forget anything. If you have any health complaints, be sure to tell your doctor about them. Be sure to take your passport, compulsory medical insurance policy, SNILS (insurance certificate of compulsory pension insurance), a diaper or a towel with you. It is advisable to bring a medical card to the appointment. It lists all the diseases that a pregnant woman has had in her life. The expectant mother needs to find out the presence of hereditary diseases from the closest relatives, her own and her husband. Be sure to remember the first day of your last period.

With the development of modern technologies and the Internet, trust in doctors is gradually fading away. Any patient today can independently study the diagnosis and think about the appropriateness of the prescribed treatment. The patient is not always right in such a situation, but there are more cases when diagnoses are made that have nothing to do with the truth. It is especially strange to receive meaningless appointments from a gynecologist. This material contains situations in the gynecologist's office that should alert you. So…

1. You are referred to numerous tests to find contraception

If a woman is generally healthy and she needs to choose a drug for contraception, then only a gynecological examination, ultrasound and the exclusion of contraindications are enough. Hormonal tests in a healthy woman do not indicate which drug to choose. If there are no contraindications, it is specified which type of contraception is preferable: pills, patch, ring or Mirena system. Objectively speaking, you can start with any modern monophasic drug, either a ring or a patch, because you can only evaluate how well the remedy suits you during the first cycles of administration. The normal adaptation period is considered to be two months.

During this period, unpleasant sensations may occur: the chest hurts, spotting spotting appears, weight and mood change, libido decreases. As a rule, if the drug is suitable, the side effects disappear quickly. If they persist, then the drug must be changed. If a woman has concomitant gynecological diseases, then initially you can choose a drug that has a more pronounced therapeutic effect.

In the vast majority of cases, the diagnosis and treatment of ureaplasmas and mycoplasmas is not needed: these microorganisms can normally exist in the genital tracts of men and women without causing any diseases. They can be detected in perfectly healthy people in the absence of disease. At the same time, depending on the state of the protective systems of the vagina, ureaplasmas can disappear, or persist for a long time, or reappear after disappearance - from a sexual partner. It is worth treating ureaplasma only if there are clinical signs of the disease in at least one partner (most often this is frequent painful urination).

Often, patients are advised to treat ureaplasma before a planned pregnancy. In fact, this is not advisable, since the risk of developing complications that is associated with it is extremely low, and the treatment is quite aggressive. During pregnancy, treatment is also very doubtful, since a positive effect has not been proven.

3. They find you have the HPV virus and are told that it needs to be treated urgently because it causes cervical cancer.

It is not necessary to carry out drug treatment of the human papillomavirus - today there is not a single drug that effectively affects this virus. It is impossible to cure him. The immune system can suppress the replication of the virus, but no drugs, no matter what the manufacturers claim, can help the immune system suppress HPV.

Quite aggressive treatment is often prescribed, a biopsy is performed, but the patient is not explained what is really happening and what is the prognosis of the disease. The main thing is that the doctor does not adhere to a clear algorithm that has existed in the world for quite a long time. So, if using the PCR method (polymerase chain reaction) you have a high oncogenic risk HPV, do not panic. There is nothing serious in this find. This is just an excuse to get tested. There is a chance that you will develop cervical cancer, but it is very small. And, if you regularly visit a gynecologist, the disease can be detected at the earliest (precancerous) stages and completely cured.

It is often advised to remove genital warts or cervical mucosa - their appearance is caused by the same HPV (condylomas and papillomas are two names for the same formation, just in different languages: warts - Greek; papillomas - Latin). Small condylomas of the vulva and vagina should not be removed if they do not create aesthetic or physical discomfort for you, and only a doctor indicates their presence - they are safe and usually go away on their own within 1.5–3 years from the moment they appear.

4. You are diagnosed with cervical erosion and are told that it needs to be cauterized

Let's start with the fact that the term "cervical erosion" is outdated, and now it can be considered colloquial. The correct name is cervical ectopia. This is a fairly common condition and generally completely safe, it should be treated only in two cases: if there is spotting after intercourse; if a woman has an excessive amount of normal odorless discharge.
In the vast majority of cases, erosion will "heal" on its own.

However, we must remember that its presence is a reason for regular examination by a gynecologist, colposcopy and cytological examination. You should not agree to the proposal at all costs to “burn” it just because the doctor says: “This must be done without fail.” If the tests show that this is a simple ectopia and there are no 5 questions of atypical cells, just come back for a second examination in a year (of course, if there is no reason to show up earlier).

5. You are diagnosed with Gardnerellosis

There is no such diagnosis. There is a disease called "bacterial vaginosis", which increases the number of several types of opportunistic microorganisms, including gardnerella. Isolated detection of gardnerella by PCR does not indicate the presence of the disease. The most common misconception: if gardnerella is detected by PCR, then this means that there is a disease “bacterial vaginosis”, or they often say “gardnerellosis”. This is wrong: gardnerella can normally be present in the vagina without causing any disease.

In addition, gardnerella is far from the only microorganism, the amount of which is increased in this disease. For the diagnosis of "bacterial vaginosis" there are special criteria - Amsel criteria and Nugent scores.

6. They find Candida on you and say it's thrush.

Mushrooms normally live in the vagina, so their detection in the absence of clinical manifestations of the disease is not an indication for treatment. The main symptoms of thrush are abundant or moderate curdled discharge, redness, swelling, rashes on the skin and mucous membranes of the vulva and vagina, itching, burning, which intensifies during sleep, after showering and sexual intercourse. If you have frequent recurrences of thrush, you should do additional examinations and exclude endocrine and other diseases that can contribute to frequent exacerbations.

7. The doctor insists that small endometririd ovarian cysts need to be removed.

Not all endometrioid ovarian cysts require mandatory surgical treatment: for small cysts (up to 2 cm), dynamic observation is acceptable. Pregnancy against their background is also acceptable and safe.

8. You are prescribed about 10-15 drugs at the same time

Remember: for the successful treatment of gynecological diseases, immunomodulators, interferons, vitamins, dietary supplements, hepatoprotectors, as well as agents for restoring the intestinal and vaginal flora are not needed. In medicine, there is the concept of "polypharmacy" - the simultaneous unjustified prescription of multiple drugs and medical procedures to the patient.

It is known that in the human body there is an interaction of various drugs. At the moment, it is possible to predict the interaction of two, maximum three agents simultaneously present in the body. If there are more, the effect is unpredictable. Any doctor knows this, but quite often you can find treatment regimens that use 15-20, or even 30 drugs. This approach is completely wrong and not justified. Most often, such treatment regimens are prescribed for infections and inflammations.

The list of recommendations may include antibiotics, local antibacterial drugs, immunomodulators, enzymes, vitamins, hepatoprotectors, bio-additives... There is no reason to prescribe most of these drugs. For example, the basis for the treatment of infection and inflammation of the genital organs is antibiotics. In modern medicine, broad-spectrum antibiotics are mainly used; they act on a very large number of various microorganisms. For most infections and inflammations, it is enough to prescribe only one antibiotic, a maximum of two. You should not save on yourself, so my personal opinion is that it is better to use the highest quality antibiotic, since a cheaper option may not completely destroy pathogenic microorganisms, and because of this, the process will become chronic.

Some physicians already collect treatment regimens brought to them by patients (often from paid clinics). Studying these schemes, one involuntarily asks the question: what was the goal of the doctor, prescribing, say, 16 drugs for the treatment of bacterial vaginosis or trichomoniasis, which in 90% of women are treated with just one drug?

If you are experiencing a similar pattern, you can ask your doctor the following questions:

• Why did the doctor decide that you have reduced immunity and a lack of vitamins (after all, you eat normally)?
• Why, without enzymes (enzymes), drugs will treat infections poorly or not reach the focus of inflammation (after all, all drugs were tested for effectiveness without the use of enzymes and they were effective)?
• Why do you need to take several identical antibiotics if you have not yet taken one (after all, it should be effective)?
• You never complained about the liver, and when you used to take drugs, everything was fine. Why are you prescribed drugs that protect the liver, if the need to take them is not mentioned in the annotation to the antibiotic?

9. You are urged to remove uterine fibroids

Uterine fibroids - for many women, this diagnosis sounds like a bolt from the blue, and it often happens that a misconception about the disease dooms the patient to difficult experiences and unjustified surgical interventions.

Some statistics:

• About 80% of all operations in gynecology are performed for uterine fibroids, 90% of them are removal of the uterus.
• Every third woman over the age of 55 has had her uterus removed due to a diagnosis of uterine fibroids.
• The average age at which the uterus is removed due to fibroids is 42 years.

There are several reasons: conservatism of doctors, lack of knowledge about new methods of treating uterine fibroids and technical capabilities for conducting modern therapy, subjective distrust of all new methods of treatment, etc. If all operations for uterine fibroids are removed from the work of the gynecological department, then in fact doctors will sit out of employment.

Quite often, fibroids can be treated without removing the uterus itself: there is an effective non-surgical method - embolization of the uterine arteries. In menopause, uterine fibroids are not treated. This does not apply to those cases when it suddenly begins to grow.

When should the uterus be removed for fibroids? Only in very advanced cases, when the size of the uterus is very large and it is so "stuffed" with knots that it is impossible to find healthy tissue.

It's a shame that many women themselves start the disease. They see that their belly is growing, but they do not visit a gynecologist for 10 years (and some even more) and come when their disease reaches a stage at which organ-preserving treatment is impossible. Some women avoid going to the doctor because they are offered to remove the uterus from the very beginning without being told about the available alternatives.

10. You have no complaints but are told to treat adenomyosis

You come for a routine examination, you are given an ultrasound scan and are diagnosed with adenomyosis, despite the fact that you do not have characteristic symptoms (abundant, painful and prolonged menstruation with clots and pain during intercourse). In such a situation, the doctor is obliged to describe the changes that he saw, but this does not mean at all that you need to be treated urgently. Adenomyosis is a very common condition in which the endometrium is embedded in the muscular wall of the uterus, leading to thickening of the muscle fibers. Adenomyosis may not manifest itself in any way for a lifetime and regress on its own after menopause. In most women, it does not require treatment - only preventive measures.

5 questions to the gynecologist

Patients often ask questions about the treatment of ureaplasma and mycoplasma at the appointment, but not every doctor answers them impartially.

Why are ureaplasmas.mycoplasmas sometimes determined, sometimes not?

This is a transient flora, and it can itself disappear and reappear, coming from a sexual partner.

Why do I have these bacteria and my partner doesn't?

Because in men, ureaplasmas in most cases do not last long.

They found ureaplasma / mycoplasma in me, but why then does nothing bother me?

This microorganism causes disease only under certain conditions, and until then it is safe.

Do I need to treat these infections?

It is necessary if there are clinical manifestations of the disease in at least one of the partners.

Do I need to be treated during pregnancy?

There is no proven improvement in prognosis. In the vast majority of cases, the presence of ureaplasma in pregnant women does not lead to a violation of pregnancy and diseases in the fetus.