We need an experienced gynecologist. Gynecology. How is an appointment with a gynecologist carried out?

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What happens at an appointment with a gynecologist in the antenatal clinic?

When examining a patient gynecologist collects data on complaints that concern her, and then performs the necessary diagnostic procedures. This allows him to suspect a particular diagnosis, to confirm which he can prescribe additional lab tests or instrumental studies.

Where does the gynecologist see – in a clinic or in a hospital ( maternity hospital)?

You can visit a gynecologist in a clinic or in a special department of a maternity hospital. When planning a visit, first of all, you should make an appointment with a doctor at the clinic. During the examination, the doctor will be able to assess the condition of the woman’s genital organs, collect material to identify infectious or tumor diseases, as well as ( if necessary) order additional tests and studies ( including to detect pregnancy). After assessing all the data obtained, the gynecologist can make a diagnosis and prescribe the appropriate treatment to the patient. At the same time, he must explain in detail and clearly to the woman everything about her pathology, about possible consequences and complications.

If during the examination the doctor doubts the accuracy of the diagnosis or a pathology is identified that requires surgical treatment, long-term observation or the use of special instruments, the patient may be hospitalized in the appropriate department of the hospital. There, under the constant supervision of medical personnel, she will undergo all the necessary diagnostic and treatment procedures, and will also receive assistance in case of any complications.

After discharge from the hospital, the woman will be given recommendations regarding further treatment. She will also need to regularly visit a gynecologist at the clinic to monitor the effectiveness of treatment, make amendments to the treatment regimen, as well as for timely detection and elimination of possible complications or relapses ( cases of recurrence of the disease).

Standard equipment for a gynecologist's office

A modern gynecologist’s office should have all the devices and instruments necessary to examine a woman and perform light diagnostic or therapeutic procedures ( operations).

The minimum equipment for a gynecologist's office includes:

Screen. In the gynecologist's office there should be a special place, enclosed by a screen or curtain, behind which the patient can undress and prepare for the upcoming examination.
Gynecological chair. This chair is equipped with special footrests. During the examination, the woman lies down in a chair on her back and places her feet on supports located on the sides. In this way, optimal ( for the doctor) conditions allowing for examination of the genital organs, as well as diagnostic and therapeutic procedures.
Mobile medical lamp. Allows you to create optimal lighting for the examination.
Gynecological speculum. This is a special device with which the doctor examines the mucous membrane of the vagina and cervix. Today, most gynecological offices use disposable sterile speculums, which are destroyed after use.
Cervical spoon. This is a thin sterile tube with a special thickening at the end. Using this instrument, the doctor collects biological material ( cells) from the surface of the vaginal mucosa, which is necessary to identify infectious agents. It is worth noting that in some medical institutions For this purpose, special sterile cotton swabs are used.
Sterile gloves. The gynecologist should carry out all diagnostic or therapeutic measures only after washing his hands with soap ( or others disinfectant solution ) and wear disposable sterile gloves. Performing any procedures with bare hands is unacceptable.
Colposcope. This complex apparatus, equipped with an optical system and a light source. It is intended for colposcopy - visual examination of the mucous membrane of the vagina and cervix under high magnification. Modern colposcopes are also equipped with special cameras and monitors, which allow you to take photos or videos of the examination and save the data on digital media.
Stethoscope. This is a special device designed to listen to the patient's breathing or heartbeat. The gynecologist should also have a special obstetric stethoscope designed to detect the fetal heartbeat.
Scales. Designed to determine the patient's body weight, which is especially important when assessing the course of pregnancy.
Tape measure. Gynecologists use it to measure the circumference of a woman’s abdomen at different stages of pregnancy, which makes it possible to indirectly judge the development of the fetus.
Tonometer. Designed to measure a woman's blood pressure.
Tazomer. This device looks like a compass equipped with a special centimeter scale. It is used to measure the size of a pregnant woman’s pelvis, as well as the fetal head ( allows you to determine the approximate gestational age). This is necessary in order to determine whether the patient can give birth to a child through natural birth canal. So, for example, when too large fruit And narrow pelvis natural childbirth will be impossible ( the baby's head simply will not pass through the birth canal), in connection with which the gynecologist will prepare the patient for a cesarean section ( surgery during which the fetus is removed from the uterus).
Amniotest. This test can quickly detect a rupture of the amniotic membrane ( surrounding the fetus during its intrauterine development ) and the release of amniotic fluid. The fact is that in some cases this gap can be very insignificant, as a result of which amniotic fluid will flow out unnoticed by the woman. If this situation is not recognized within 24 to 36 hours, the risk of fetal infection increases. The essence of the amniotest is that when examining the cervix, the doctor touches it with special marker paper, which measures the acidity of the tissue ( the acidity of amniotic fluid differs from the acidity of the vagina). If amniotic fluid does leak, the strip will immediately change its color, which will allow the doctor to confirm the diagnosis and promptly take the necessary measures to prevent the development of complications.
Germicidal lamp. Designed to disinfect the office and can only be used when there is no one in the office ( The light emitted by the lamp may harm the eyes and other tissues of patients or medical personnel).

Is it necessary to completely undress at the gynecologist?

During the consultation, the gynecologist may need to examine the woman’s genitals or perform some diagnostic procedures. To do this, the patient will have to undress from the waist down and lie down on a special gynecological chair. That's why before going to the doctor, it is recommended to choose clothes that are easy to take off and put back on.

It is worth noting that in the gynecologist’s office there should be a special place fenced off with a screen or a separate room in which a woman can undress and prepare for the examination. A woman should not undress in the presence of a doctor, nurse, or other healthcare workers.

Will it hurt when examined by a gynecologist?

When examining a patient, a gynecologist can examine her external genitalia, as well as perform some diagnostic manipulations to examine the mucous membrane of the vagina and cervix, take samples to identify infections, tumor diseases, and so on. During these procedures the patient may experience discomfort associated with touching instruments to the genitals. However, it is worth noting that the woman usually does not experience severe pain. If the upcoming procedure may be painful, the doctor informs the patient in advance and, if necessary, performs local anesthesia (the surface of the mucous membrane is treated with special medications, as a result of which it becomes immune to pain for some time).

Painful sensations during examination by a gynecologist may be due to:

Inflammatory process. During development acute infection in the area of the external genitalia, the affected mucous membranes become inflamed, resulting in increased sensitivity. At the same time, ordinary, even the lightest touches to them can be painful.
Ineffective pain relief. The cause of this phenomenon may be an insufficient dose of local anesthetic drug or too long procedure. Also, painkillers may be ineffective if the patient uses any narcotic drugs. In any case, if a woman feels severe pain during diagnostic procedures, she should immediately inform the doctor.
Careless or rude manipulations of a doctor. This phenomenon is extremely rare and is usually associated with a lack of experience of the doctor.

What questions does the gynecologist ask?

The first thing any woman expects at a consultation with a gynecologist is a detailed survey about her state of health and previous diseases, as well as about the characteristics of sexual life.

During the interview, the gynecologist may ask:

What worries a woman at the moment? When answering this question, you should list all the symptoms and complaints that prompted you to see a doctor ( pain, abnormal vaginal discharge, miscarriages, and so on).
How long ago did these symptoms appear and how did they develop?
Have you met similar symptoms in past? If yes, what doctors did the woman see and what treatment did she take?
At what age did the patient begin menstruation?
How long after the first menstruation did your cycle become regular?
How many days does it last menstrual cycle?
How long does menstrual bleeding usually last?
When was your last menstruation and how did it proceed? Has there been any excessive bleeding, tenderness, or other unusual symptoms?)?
Does the woman have premenstrual syndrome ( a pathological condition characteristic of some women during menstruation, manifested emotional disorders, nausea, vomiting, metabolic disorders and other symptoms that completely disappear after completion menstrual bleeding )?
At what age did a woman become sexually active?
Does the patient experience pain or other discomfort during or immediately after sexual intercourse?
Does the woman have a regular sexual partner or not?
What contraceptives ( ) is used by a woman?
Has the woman been pregnant? If yes, how many, at what age and how did they end ( childbirth, miscarriage, abortion, etc.)?
Does the woman have children? If yes, how many, what age and how did she give birth to them ( through the vaginal birth canal or by caesarean section, were there any complications during childbirth?)?
What gynecological diseases has the woman suffered previously?
Does the patient suffer from any chronic diseases of the cardiovascular, respiratory or other systems?
Does the woman smoke? If yes, how long ago and how many cigarettes per day has he smoked ( approximately)?

This is far from full list questions that a gynecologist may ask during the first conversation with a patient. Based on the answers received, he will make general idea about the woman’s health status, and can also suggest one or another diagnosis.

Examination of the vagina and cervix with a speculum

After the interview, the gynecologist asks the woman to undress from the waist down and lie down in a gynecological chair for a genital examination. First of all, the doctor examines the external genitalia with the naked eye, assessing their anatomical development, the presence or absence of signs of inflammation ( redness and swelling of the mucous membranes), pathological discharge, and so on.

The next stage of the examination is to examine the mucous membranes of the vagina and cervix using special mirrors. Having warned the patient about the upcoming actions and received her consent, the doctor opens a package with disposable sterile speculums, which are a kind of dilator with a handle. Having spread the patient's labia majora and minora with his fingers, the doctor inserts the working part of the speculum into the vagina, and then presses the handle. At the same time, the blades of the mirror expand, pushing apart the walls of the vagina and making them accessible for inspection. At this moment, the patient may experience some discomfort, but pain usually does not occur.

After inserting the speculum, the doctor carefully examines the condition of the mucous membrane of the genital tract, identifying the presence or absence of signs of inflammation, as well as ulcerations, polyps and other pathological conditions. After the procedure is completed, the gynecologist carefully removes the speculum from the patient’s vagina and proceeds to the next stage of the examination.

Examination with mirrors is contraindicated:

Patients who have not yet begun sexual activity. IN in this case the study will be hampered by the hymen, a fold of mucous membrane that blocks the entrance to the vagina.
If there are signs of infection of the external genitalia. In this case, there is a high risk of infection spreading during the insertion of speculum.
If there is severe pain. This can be observed in the presence of infectious inflammatory process or during menstruation.
If a woman refuses. The gynecologist has no right to perform any procedures without obtaining the patient’s consent.

Manual examination by a gynecologist

The study is carried out after removing the speculum from the vagina. Its essence is as follows. The gynecologist places his left hand on the front wall of the patient’s abdomen, and two fingers right hand (index and middle) inserts into the vagina and presses the anterior wall of the vagina to the left hand. This makes it possible to identify various volumetric formations ( tumors) or developmental abnormalities. After this, the doctor moves the fingers of his right hand under the cervix and slightly lifts it, also feeling and identifying changes in the consistency of the organ, the presence of pathological seals or anatomical defects.

Colposcopy

This diagnostic procedure, during which the gynecologist examines the mucous membrane of the vagina and cervix using a colposcope - an optical device that allows you to magnify the image of the surface in question several times. During colposcopy, the doctor identifies pathological changes on the mucous membrane, as well as inflammatory processes and other lesions.

The procedure itself is carried out as follows. The woman lies down in the gynecological chair, and the gynecologist inserts speculum into her vagina, thereby making the mucous membrane accessible for examination. Then he installs the colposcope so that the light from it is directed directly at the cervix, and he examines the surface of the mucous membrane through special eyepieces. No parts of the device touch the patient, and therefore the examination is completely painless.

Hysteroscopy

During hysteroscopy, the doctor examines the inner surface of the uterus and its cervix using special device– a hysteroscope, which is a long tube equipped with an optical system.

Hysteroscopy can be diagnostic ( carried out to clarify the diagnosis) or therapeutic, during which the gynecologist performs various procedures.

Diagnostic hysteroscopy reveals:

polyps;
uterine cancer;
abnormalities of the uterus;
cause of infertility;
remnants of the fertilized egg in the uterus;
foreign bodies in the uterus;
source of bleeding and so on.

Any special training not required before hysteroscopy. The procedure itself is performed under local or general anesthesia. In the first case, the tissues of the vagina and perineum are treated with special drugs that temporarily eliminate pain sensitivity. During general anesthesia, medications are injected into the patient's vein, causing her to fall asleep and also not feel anything during the procedure.

After anesthesia, the gynecologist inserts speculum into the vagina and spreads them wide, thereby opening access to the uterus. He then inserts the working part of the hysteroscope, equipped with a video camera and a light source, into the uterus. This allows you to examine the mucous membrane of the organ, identifying pathological changes or removing pathological formations.

After the procedure, the patient should remain in the doctor's office for 30 to 60 minutes until the pain medications wear off, and then she can go home. For 2 to 3 days after the procedure, the woman may feel slight tingling, numbness, or soreness in the genital area. If these phenomena are severe, the patient can contact a gynecologist who will prescribe her painkillers.

Hysteroscopy is contraindicated:

if there is an infection of the external genitalia;
during pregnancy;
in the presence of acute systemic infection ( for example, flu);
with confirmed cervical cancer ( During the procedure, damage to the affected tissues and spread of cancer cells to other organs).

Puncture of the posterior vaginal fornix

Puncture ( puncture) is performed in cases where the doctor suspects that the patient may have pathological fluid in the pelvic cavity ( blood or pus). The presence of such fluid may be a sign of bleeding or infection that poses a risk to the woman's health.

The essence of the procedure is as follows. First, the patient undresses and lies down in the gynecological chair. After local or general anesthesia, the doctor treats the patient’s external genitalia with disinfecting solutions. Then he inserts speculum into the vagina, thereby opening the vaginal part of the cervix for inspection. Having lifted it with special forceps, the gynecologist takes a syringe with a long needle and pierces the posterior vaginal fornix. By introducing the game 2 - 3 centimeters deep ( it then enters the pelvic cavity), the doctor carefully pulls the plunger of the syringe, drawing pathological liquid into it ( if there is one). Then he carefully removes the needle, and the resulting material is sent to the laboratory for research.

After the procedure is completed, the patient should remain in treatment room for 30 - 60 minutes until the effect of painkillers wears off.

Why do brown or bloody discharge appear after a visit to the gynecologist?

Even if the examination by a gynecologist was carried out according to all the rules, upon returning home, the woman may notice that she has minor bloody or brown discharge from the vagina. Sometimes this phenomenon may be a consequence of manipulations performed by a doctor, while in other cases it may indicate the presence of some pathology.

The cause of bleeding after examination by a gynecologist may be:

Injuries to the mucous membrane. Carrying out studies such as speculum examination or hysteroscopy is associated with trauma to the vessels of the mucous membrane of the vagina and cervix with hard instruments. Injury can be caused by rough, careless actions of the doctor or disobedience of the patient ( for example, if she does not lie still and constantly moves during the insertion of speculum or hysteroscope).
Menstrual bleeding. All women are advised to visit a gynecologist a few days before or after menstrual bleeding. If this rule is not followed, it is quite possible that after visiting a doctor, a woman may begin regular menstruation.
Diseases of the genital organs. If a woman has any cervical disease ( for example, erosion) or the uterus itself ( endometritis, endometriosis), hysteroscopy may be accompanied by severe trauma to pathologically changed tissues, as a result of which more profuse bleeding is possible after the examination.

It is important to remember that the release of a small amount of bloody fluid after the procedure gynecological procedures- This is fine. At the same time, it is necessary to distinguish between pathological conditions in which vaginal discharge can pose a danger to a woman’s health in order to promptly seek help from a doctor.

The reasons for re-visiting a gynecologist may be:

Continuing bleeding. If bloody fluid continues to be released from the vagina 2–3 days after visiting the doctor, this may be a sign of the development of an inflammatory process or severe trauma to the vessels of the mucous membrane.
Heavy bleeding. In this case, damage to large blood vessels, which requires urgent medical intervention.
The appearance of pain. If spotting is accompanied by severe pain in the genital area or lower abdomen, you should not immediately take painkillers. First you need to consult a gynecologist who will rule out the presence of any dangerous pathology, after which he himself will prescribe painkillers to the patient.

Why does my stomach hurt after visiting a gynecologist?

Mild painful or unpleasant “pulling” sensations in the genital area and lower abdomen that occur after visiting a gynecologist are completely normal. The fact is that during the examination the doctor palpates ( probes) tissue of the vagina and cervix, as well as the uterus itself. In addition, when performing diagnostic procedures ( examination with mirrors, hysteroscopy) the gynecologist inserts hard instruments into the patient’s vagina, which certainly damage the delicate mucous membrane ( even if the doctor performs the procedure slowly, gently and carefully). All of the above is accompanied by tissue injury, resulting in the development of minor inflammatory reaction. This is the direct cause of pain after examination by a gynecologist.

IN normal conditions a woman may experience painful sensations within 1 – 2 days after visiting the doctor. To reduce their intensity, the gynecologist can prescribe mild painkillers to the patient. At the same time, it is worth noting that in some cases the occurrence of pain may be due to the development of any complications ( for example, damage to the tissue of the uterus or vagina, bleeding, infection, etc.). This is why retention or progression pain syndrome within 3 or more days after visiting a gynecologist is a reason to consult a doctor again. Don't do it yourself ( without appointment of a specialist) “suppress” pain with painkillers for a long time, since the existing pathological process may continue to develop, damaging the uterus, vagina, and other tissues and organs.

Gynecologist services are paid or free ( under compulsory medical insurance policy)?

In public medical institutions ( in hospitals, clinics, maternity hospitals) any woman who has a compulsory health insurance policy can receive free medical consultation a gynecologist, during which the doctor will also conduct a full examination.

The following can count on free help from a gynecologist:

pregnant women;
women in labor;
women with pregnancy pathologies;
women with any gynecological diseases.

At the same time, it is worth noting that some procedures or tests that the gynecologist will prescribe may be paid for ( You should check with your doctor for more detailed information.). There will also be a fee for consultations with gynecologists in private medical institutions ( clinics or hospitals).

Does the gynecologist give sick leave?

A sick leave certificate is a document confirming that for a certain time the patient was unable to go to work due to her illness.

A gynecologist can issue a sick leave certificate:

Women who have been diagnosed with a pregnancy pathology requiring hospitalization.
If a disease is detected that requires bed rest.
When performing operations after which the patient must remain in the hospital ( under the supervision of doctors) for a certain time.
In cases where attending work may worsen the patient’s health or cause progression of her existing disease.

The sick leave certificate is drawn up on a special document, which the patient must provide at her place of work. The maximum duration of sick leave can be 15 days, but if necessary, the doctor can extend it.

Is it possible to call a gynecologist at home?

Today, many private medical centers provide such a service as calling a gynecologist at home. It’s worth noting right away that such a consultation will be limited in nature, that is, the maximum that the doctor can do is talk with the patient, collect anamnesis ( ask about her complaints, health problems, past illnesses, etc.) and conduct a superficial examination. Based on the data received, the doctor can suggest one or another diagnosis, and, if necessary, set a date when the patient will have to come to him for an appointment at the hospital, where he can conduct a more thorough examination.

A gynecologist will not be able to perform any diagnostic procedures at home, since he will not have the necessary tools (gynecological chair, hysteroscope) and conditions.

What laboratory tests can a gynecologist prescribe?

After examining a woman, a gynecologist may suspect she has one or another disease. To confirm the diagnosis, the doctor may order certain laboratory tests for the patient.

During the diagnostic process, the gynecologist may prescribe:

general blood analysis ;
general urine analysis ;
analysis for sexually transmitted infections;

hormone tests;
smears on the vaginal flora;
cytology analysis.

General blood analysis

This study allows you to assess the state of the hematopoietic system of the female body, as well as identify signs of certain pathological conditions. Blood for analysis is taken from a vein or finger. No special preparation is required for this.

A general blood test reveals:

Anemia. This is a pathological condition characterized by a decrease in the total number of red blood cells ( red blood cells) and hemoglobin ( substance that transports oxygen throughout the body) in blood. The cause of anemia is most often menstrual bleeding, during each of which a woman loses about 50–100 ml of blood.
Infection. The presence of infection may be indicated by an increase in the number of leukocytes - cells that take part in protecting the body from pathogenic bacteria, viruses and fungi.

Analysis of urine

This study allows you to identify infections genitourinary tract (this may be indicated by the presence of pus or white blood cells in the urine), and also suspect the presence of kidney disease ( this may change the density or chemical composition urine). For analysis, the patient must collect morning urine in a special sterile jar, which will be given to her in advance at the clinic.

How does a gynecologist take a smear for flora?

Purpose this study is to identify pathogenic bacteria in the patient’s vagina. The procedure for taking material is carried out in a gynecological chair. After inserting the speculum, the doctor takes a sterile tampon or a special gynecological spoon and runs it several times along the mucous membrane of the vagina and cervix, trying not to touch the patient’s external genitalia.

Part of the resulting material is transferred to special glasses, stained and examined under a microscope. In some cases, this allows us to identify pathogenic bacteria and suspect some kind of infection. The other part of the material is sent for bacteriological research, during which laboratory conditions colonies of bacteria obtained from the female genital tract are grown. This allows you to determine the exact type of pathogen and select the most effective treatment.

It is important to note that before collecting material for research, it is not recommended to wash the genitals with soap or other disinfectants, as this can destroy the bacteria present there and make the analysis uninformative. The same effect will be observed if a woman takes antibacterial drugs before taking the test.

Cytology analysis

The purpose of this study is to identify abnormal cells that may indicate the presence or high risk of developing cervical cancer. Fulfill cytological examination It is recommended once a year for all women over 30 years old.

exclude sexual intercourse for 2 days;
exclude the presence of an infectious-inflammatory process;
do not use sanitary tampons for at least 2 days;
Do not insert any medications, creams or other products into the vagina for at least 2 to 3 days.

It is also worth noting that the study should be performed at least 2 days before or 2 days after menstrual bleeding, gynecological examination or hysteroscopy ( examination of the uterine mucosa using a special instrument).

The material is collected in a gynecological chair. After inserting gynecological speculum, the doctor visually or under the control of colposcopy assesses the condition of the mucous membrane of the vagina and cervix. If at the same time he reveals pathologically changed areas ( for example, erosion), the material should be taken specifically from the affected tissue. To collect material they are used special brushes, which the gynecologist runs several times over the surface of the mucous membrane. After this, he carefully removes the brush from the patient’s vagina and runs it over a special glass several times. The resulting cells stick to the glass, which makes it possible to examine them under a microscope and identify pathological changes characteristic of the cancer process ( If there are any).

Tests for infections ( HIV, syphilis, gonorrhea)

Identify bacterial infections ( for example, gonorrhea) is possible when examining a smear or during a bacteriological examination. At the same time, identify the pathogen viral infection (for example, HIV – human immunodeficiency virus) is not possible in this way because the viruses are too small ( they are not visible in a microscope) and do not grow on ordinary nutrient media. Difficulties may also arise when diagnosing latent, chronic infections that occur without a clear clinical picture.

To clarify the diagnosis, the gynecologist may examine:

Estrogen levels. Responsible for the development of primary and secondary sexual characteristics ( development of external and internal genital organs, female-type hair growth, etc.). Estrogens also take part in the regulation of the menstrual cycle.
Androgen levels. These are male sex hormones that are produced in female body in small quantities. Increasing their concentration can lead to hair growth by male type, sexual dysfunction and so on.
Progesterone levels. It is produced by the ovaries and prepares the female body for pregnancy, and also ensures its normal course and development.
Prolactin level. This hormone ensures the formation of milk in the mammary glands.

If a deficiency of any hormone is detected, the gynecologist may prescribe the patient replacement treatment with artificial hormonal drugs. It is important to take medications in strict accordance with your doctor's instructions, since the success of hormonal therapy depends on this.

What diagnostic tests can a gynecologist prescribe?

During diagnosis, the doctor may prescribe the patient certain instrumental studies to assess the functions of the patient. internal organs and plan further treatment tactics.

Ultrasound

Ultrasound ( ultrasonography ) is a diagnostic procedure that allows the gynecologist to evaluate the shape, structure, size and consistency of the patient’s internal organs. The principle of the method is as follows. A special device sends ultrasonic waves into the woman’s body, which are reflected from internal organs and tissues. The reflected waves are captured by a special sensor and converted into a visual image of the organs being examined, which is displayed on the monitor.

Using an ultrasound, a gynecologist can detect:

Intrauterine pregnancy– development of the embryo in the uterus.
Ectopic pregnancy- a pathological condition in which the embryo begins to develop not in the uterus, but in other tissues and organs ( in the abdominal cavity, in the fallopian tubes, and so on).
Tumors of the uterus– fibroids, polyps.
Ovarian diseases– for example, cysts ( fluid-filled cavities).
Tubal obstruction– is a common cause of infertility.
Endometriosis– disease of the uterine mucosa.
Remains of the fetus or membranes in the uterus ( after childbirth).
Presence of fluid in the pelvic cavity– may be a sign of an infectious-inflammatory process or bleeding.

The procedure itself is absolutely painless, safe and has virtually no contraindications. Before performing the study, the patient lies down on the couch and exposes the lower abdomen. The doctor applies a thin layer of special gel to the skin ( this is necessary so that ultrasonic waves pass more easily into the body tissues), after which he begins to move the device’s sensor over the surface of the skin, assessing the results on the monitor screen. The procedure itself lasts no more than 10–15 minutes, after which the patient can immediately go home.

It is worth noting that in some cases, the gynecologist may prescribe other types of ultrasound ( transvaginal – when the ultrasound probe is inserted through the patient’s vagina or transrectal – when the probe is inserted through the anus). Such techniques provide more accurate results when examining the ovaries and uterus, however, they require special equipment and the experience of a doctor.

Fluorography

This is an x-ray examination during which the lungs and rib cage patients. The purpose of the study is to detect foci of tuberculosis or tumor diseases of the lungs.

A gynecologist may prescribe a woman a fluorography to exclude pulmonary tuberculosis ( for example, if she has to do something surgery or long-term hospitalization). However, it is worth noting that this study is strictly contraindicated for pregnant women, since X-ray radiation can disrupt the development of fetal organs.

Cervical biopsy

A biopsy is the process of intravital removal of a piece of an organ for the purpose of studying it in a laboratory setting. Such a study allows us to identify tumor diseases genital organs of a woman, as well as determine the nature of the tumor ( that is, whether it is benign or malignant), on which treatment tactics will depend in the future. Most often, the reason for a biopsy can be poor results of a cytological analysis, as well as erosions, polyps or other precancerous processes.

It is recommended to perform a biopsy 2–3 days after the end of menstruation. Preparation for the procedure involves abstaining from sexual intercourse and using tampons for at least 2 days. Also, do not insert any medications or other products into the vagina. The day before the test, you should take a shower without using soap or other hygiene products.

The procedure itself is carried out under general anesthesia, that is, the patient sleeps and does not remember anything. First, the gynecologist inserts speculum into the vagina, after which, under the control of a colposcope ( an optical device that allows you to obtain an enlarged image of the mucous membrane) finds pathologically altered areas. After this, the doctor takes a syringe with a special ( thick and sharp) with a needle and pierces the “suspicious” area several millimeters deep. The cells of the mucous membrane enter the needle cavity. After this, the doctor removes the needle, and the resulting material is sent to the laboratory for further research.

After the procedure, a woman may experience slight bleeding from the vagina for 1 to 2 days. During this time, she is advised to use sanitary pads ( not tampons), and also abstain from sexual intercourse.

When can a gynecologist refer you for consultation to another specialist ( urologist, oncologist, surgeon, therapist)?

If, during an examination of a woman, a gynecologist reveals any diseases in other organs and systems, he can refer her for examination to an appropriate specialist.

A gynecologist can schedule a consultation:

Urologist– a doctor who diagnoses and treats diseases of the urinary system.
Oncologist– a doctor involved in diagnosis and treatment ( including surgical) benign and malignant tumors.
Surgeon– upon detection acute illness abdominal organs ( for example, with appendicitis - inflammation of the appendix of the intestine).
Therapist– when identifying diseases of the cardiovascular, respiratory, digestive or other body systems.

Treatment by a gynecologist

After examining the woman and making a diagnosis, the doctor can prescribe treatment, which can be conservative or surgical. During the treatment process, a woman should periodically visit a gynecologist, who will monitor the effectiveness of the therapy and, if necessary, make certain changes to the treatment regimen.

What pills can a gynecologist prescribe?

Drug therapy is the first and main therapeutic measure, which the doctor prescribes to patients when various diseases. When using prescribed medications, you should strictly adhere to the dosage prescribed by your doctor, as exceeding it can lead to the development of undesirable side effects.

The gynecologist may prescribe:

Antibiotics– for treatment bacterial infections genital tract.
Antiviral agents– for the treatment of viral infections.
Antifungal drugs– for the treatment of fungal infections of the genital organs.
Hormonal drugs- as replacement therapy with a lack of sex hormones, and also as a means of contraception ( preventing pregnancy).
Painkillers– prescribed for pain relief, including after some painful gynecological procedures ( hysteroscopy, biopsy and others).
Iron supplements- prescribed upon detection iron deficiency anemia (a decrease in the concentration of red blood cells against the background of regular bleeding).

What operations can a gynecologist perform?

If conservative means It is impossible to eliminate the patient’s problem; the doctor may prescribe surgical treatment. The operation may be urgent ( prescribed for diseases life-threatening woman or fetus) or planned, in which there is no immediate danger to the patient’s life. Before planned operation the patient undergoes a series of tests and undergoes additional examinations to clarify the diagnosis and plan the scope of surgical intervention.

If necessary, the gynecologist can perform:

Fallopian tube removal– in case of their obstruction due to the formation of adhesions or other pathological process.
Oophorectomy- when a cyst forms in it ( cavity filled with liquid) or cancerous tumor (in this case, a preliminary consultation with an oncologist is required).
Operations on the uterus– deletion benign tumors (polyps, fibroids).
Removal of the cervix– in the presence of precancerous diseases or cervical cancer.
Uterus removal– may be required for multiple fibroids, as well as for malignant tumors, when the uterus ruptures during childbirth, and so on.

One of the best gynecologists in Moscow for everyone who wants to undergo examination and treatment is located in the city center, at Kutuzov Avenue, building 33. We work daily from 10-00, including on weekends (Sunday and Saturday). Reception of patients in the capital region and other regions of Russia and abroad. Experienced gynecologists, good, balanced prices, excellent results treatment! For your convenience, it is recommended to pre-register by calling the center's contact number or online on the website.

THE BEST GYNECOLOGY IS TIME TESTED

For almost 20 years, perhaps the best gynecologists in Moscow have been working in our women's medical center near the metro station and the Kutuzovskaya MCC. It is equipped with the most modern diagnostic and treatment equipment and offers full examination, get tested, and, if necessary, receive treatment. You are assigned a doctor who will monitor all stages of diagnosis and the results of therapy.

If you ask our patients, “Recommend a good gynecologist who to go to,” we are sure that the vast majority of women will recommend our clinic and its specialists.


INSPECTION	COLPOSCOPY	ANALYSIS	Ultrasound DIAGNOSTICS	TREATMENT

Do you need the best gynecology clinic? Tired of going to different doctors, antenatal clinics and clinics?
We invite you to sign up and visit our women's medical center on Kutuzovsky, in the very center of Moscow. On initial consultation a gynecologist, a good professional and a sensitive interlocutor, determines the range of issues that need to be resolved, according to indications, conducts the necessary studies (tests, examination, ultrasound) and draws up individual plan. In addition to the generally accepted methods of treating diseases (medication, drugs, etc.), according to indications, additional methods that have been tested by time and many years of practice are used, effective methods. Remember, timely contact with a competent specialist is the key to positive results and the success of treatment in general! At the following link you can find out which gynecologist you should go to with a particular problem.

REVIEWS ABOUT THE GYNECOLOGY CENTER

REVIEW #1
"I would like to express my gratitude to the staff of the gynecology center for their professionalism. I couldn’t get pregnant for a long time, and although in the previous 2 private clinics they only offered me surgeries or IVF. I came here on the recommendation of my work colleague. I have chronic inflammation appendages and commissures. I have not been able to get pregnant for 3 years, despite the medications I took. She underwent treatment (medicines, physical therapy, gynecological massage, mud) and after 4.5 months she became pregnant herself. and now I am the mother of a wonderful 5-month-old girl! Many thanks to everyone - the doctor (Vakhrusheva Diana Andreevna) and other employees of the gynecology department - the best in their profession, excellent specialists and pleasant people!)..." - Karina, Moscow.

REVIEW No. 2.
“For a long time I was looking for a clinic in Moscow with good gynecology - the reviews that I came across on the Internet were very different. I turned to my friends for advice, they advised me to come here. Now I am being seen at the Center women's health on Kutuzovskaya for almost 5 years, she was undergoing treatment, gave birth to her second child together with her doctor Bezyuk Laura Valentinovna. I have never met a better doctor, since there is nothing to compare with. Attentive, very knowledgeable doctor. Now my eldest daughter is seeing her and she is also very happy..." - Anna, Moscow region.

REVIEW No. 3.
“We needed a gynecologist, a good ultrasound doctor and tests, and quickly, since we were passing through Moscow. Gynecology at Kutuzovsky, 33, according to reviews on the Internet, seemed the most attractive to me. I’m glad that my expectations were met. A wonderful center, although small. I went to the doctor, did an ultrasound and took tests. Everything was simple and fast, without these crazy queues since the appointment is by appointment. And the prices are not so high. I received answers to all my questions. Thank you and especially the uzist and Dr. Vakhrusheva Diana Andreevna!..." - Irina, St. Petersburg.

REVIEW No. 4.
"Thanks to completing a course of procedures for the treatment of chronic adnexitis and adhesions on the uterus in the spring with Dr. Bezyuk L.V. (some folk remedies and treatment methods, as well as physiotherapy, gynecological massage, mud) is now already in the fifth month!! We are expecting a girl, they said at the ultrasound at the clinic, by the way, I made a 4D recording on a disc for the future album, I was very pleased. Girls, don’t let your appendages go, then you’ll have to undergo treatment for a long time, God forbid, if they treat you correctly!... Therefore, if you want to find out where is a good gynecologist, an uzologist and best treatment like a woman, take a closer look at this center!" - Natalya, Moscow.

REVIEW No. 5.
My review is not about gynecology, but about intimate contour plastic surgery, which I did in this center. I would like to sincerely thank the doctor Vakhrusheva Diana Andreevna, she gave me freedom in intimate relationships. I came with the problem of underdeveloped labia majora and rare and weak sensations of orgasm during sex. Diana Andreevna suggested correcting the problems with this procedure. Reviews about injections hyaluronic acid I knew before and so I decided to try it. The labia majora and G-spot were tidied up with injections in one session. A week later - narrowing of the vaginal opening, also with injections. The recovery period was short, a week, and it was possible to try everything in action. The feeling during an intimate relationship with my husband became much brighter, and he also noted the difference in his feelings. I am very grateful - a good clinic, excellent gynecology, excellent work by the doctor!..." - Snezhana, Moscow.

If you urgently need a gynecologist, the doctors at our medical centers will be happy to help you.

Situations when a gynecologist is needed are very delicate, so often girls delay visiting a doctor until the last minute, although the symptoms of pathologies can be very obvious. You should never delay visiting a gynecologist if you notice any deviations from the norm. After all, the health of the intimate area depends normal operation the entire female body. Moreover, every woman should undergo preventive examination see a gynecologist at least once a year. This must be done in order to detect and prevent diseases that occur with subtle and absent symptoms. It is also recommended to undergo an examination by a gynecologist before starting sexual activity. Treat your health with care and it will more than repay you for it!

What symptoms require consultation with a gynecologist:

Frequent, persistent pain in the lower abdomen
Problems conceiving a child lasting longer than one year
Menstruation has become longer and more painful - discharge during menstruation has become more abundant
The menstrual cycle is disrupted - periods do not come on time
Are you or your partner experiencing discomfort in sexual activity?
Abundant ones appear
The appearance of redness and swelling in the vaginal area
Pain during intercourse

If the listed symptoms appear, do not hesitate - you really need a gynecologist. Each of them talks about pathologies, many of which can be very dangerous for women's health. Check out the gynecologist's list of the main gynecological diseases:

Vaginitis
Polycystic ovary syndrome
Thrush
Climax
Endocervicitis of the cervix
Ectopic cervix
Cervical ectropion
Cervical cancer
Ovarian cancer
Papillomas
Various STDs (chlamydia, gonorrhea)
Colpitis

The list can be continued, but one thing is clear - there are thousands of options for gynecological diseases and only a qualified gynecologist can understand the final cause of concern based on the results of the examination.

How is an appointment with a gynecologist carried out?

After an oral dialogue in which the patient talks about his complaints, the doctor examines intimate area using a gynecological speculum. Based on the results of the examination, the doctor will decide whether further tests are needed.

Gynecological examinations

Colposcopy - using a special colposcope device, the doctor conducts a deep examination of the external and inside vagina. During colposcopy, the cervix is also examined. This is done with help. video colposcope.
Ultrasound of the cervix - ultrasound examination of the cervix will help identify diseases such as cervical erosion
Ultrasound of the pelvic organs - used to determine the condition of the ovaries and uterine canals. It is also the most common ultrasound scan during pregnancy.
Cervical biopsy - a test that determines the presence or absence of cervical cancer

Treatment of gynecological diseases at Doktorru

Our centers provide treatment for various gynecological diseases. You can undergo a full diagnostic cycle at any of our five medical centers. Among classical techniques treatment of sexually transmitted diseases, infectious and inflammatory pathologies, our clinics have several high-quality innovations.

Treatment of gynecological diseases with plasma lifting

Plasmolifting is a popular rejuvenating procedure in cosmetology, during which the patient is injected with his own plasma, which stimulates regenerative processes at the injection site and improves the quality of facial skin, has found a new application in gynecology. Today

A female doctor, according to tradition, is most often referred to by women simply as a gynecologist. Although this is not entirely true, because there are several rather narrow specializations for such a noble profession. And sometimes it is very difficult to find a specialist. Very often, a doctor such as a gynecologist-endocrinologist is in demand in Moscow. Reviews from patients help you choose not just a specialist, but an attentive, competent and truly good professional.

What kind of doctor?

If many girls know about what a gynecologist does, then some have to seriously think about the activities of a gynecologist-endocrinologist. And it's worth knowing. The study of hormonal levels and hormones in the female body is what a gynecologist-endocrinologist does. It is not difficult to find a good specialist; it is more difficult to decide on the choice of a specific doctor. Moreover, unstable hormonal levels are the scourge of modern women. As a result of an excess or deficiency of one or another hormone, changes occur throughout the body, which often leads to overweight or underweight for no apparent reason, mood swings, depression, and unstable metabolism. In addition, violations in endocrine system in the female part most often end in infertility. Many women have to undergo treatment before becoming pregnant. And some people also need this in order to bear and give birth to a healthy and strong baby.

Choosing a specialist

Naturally, everyone wants to be treated by the best. According to reviews, gynecologists and endocrinologists in the capital are very bad, very good, and completely ordinary. It is worth remembering that people's opinions may not coincide with yours. However, we must not forget that a large number of laudatory reviews from patients indicates that the specialist really knows his job and has proven himself well. A good endocrinologist and gynecologist-endocrinologist most often do not work in an ordinary run-of-the-mill clinic, and getting an appointment with them is very problematic. Therefore, you must make an appointment in advance, placing your bet not on one, but on several doctors at once. In Moscow, fortunately, there are no difficulties with this. There are many really good specialists who are ready to see the patient at a time convenient for her.

Shaharatova I.A.

Irina Aleksandrovna is a specialist with 23 years of experience. Many women pass on her name and contacts as a “relay baton.” And there are reasons for this. Having graduated with honors in 1992, Irina Aleksandrovna actively moved from theory to practice, constantly improving her qualifications and expanding her knowledge base. Most often, when treating, she adheres not to traditional medicine, but to homeopathic alternative options. And this also bears fruit. In addition, the doctor seeks an individual approach to each specific patient, relying not only on general data and statistics, but also on the women’s comfort. It’s really quite good that Irina Aleksandrovna Shaharatova’s work is very different.

What many patients don’t like

Most often, girls and women who, for one reason or another, did not like treatment from a specialist, say that they prescribe the same medications for everyone. More precisely, biologically active additives and herbs. It is worth noting that many non-serious deviations in hormonal background it's really better to treat homeopathic remedies, without the use of drugs, which usually have a lot of side effects. However, if you have serious, advanced or chronic diseases, you should turn to traditional medicine. For those who are trying to get pregnant, natural preparations and infusions help strengthen the immune system and prepare the body for the long-awaited event. In advanced cases, Irina Aleksandrovna turns to traditional medicine, prescribes the most gentle but effective drugs, and performs operations herself.

What do patients like?

Irina Aleksandrovna Shakharatova currently conducts receptions in a private medical organization“Health Clinic”, located in Klimentovsky Lane, or, as the institution was popularly called, in the “clinic on the Mile”. Many patients appreciate the attentive and sensitive approach, the opportunity to learn in detail about the exact treatment plan prescribed, possible problems during its implementation. In addition, the majority note the benefits of gynecological massage, which is not included in traditional medicine, but brings real benefits to the body. That is why many women and girls sincerely believe that Irina Aleksandrovna Shaharatova is a worthy gynecologist-endocrinologist and they also willingly leave the work of a specialist both in the clinic itself and outside its walls. In addition, many patients note the high qualifications of the ultrasound doctor, who works in tandem with Irina Alexandrovna Shakharatova.

Gevorkyan M.A.

Marianna Aramovna is considered one of the most the best specialists in the field of infertility treatment in the capital. Many girls and women turn to her based on recommendations, waiting in line for quite a long time. A doctor with more than twenty years of experience, who is attentive to the problems and experiences of patients, a candidate of science, an expert in her field. Many even note that she is the best gynecologist-endocrinologist in Moscow. Feedback about this can be heard not only from patients, but also from other specialists who redirect women for consultation with Marianna Aramovna Gevorkyan. The doctor sees you at hospital No. 68 on Shkuleva Street, building 4. Getting to a specialist, although difficult, is quite possible.

What women like

Many people note that the endocrinologist does not just conduct a routine examination, but listens carefully to the complaints and concerns of women. In addition, if necessary, Marianna Aramovna answers all questions that arise in detail, in an accessible and detailed manner, describes the problem and ways to solve it. Naturally, many girls and women who, after a long period of infertility, get the desired pregnancy, remain grateful to such attentive and professional person. And the reviews are left accordingly. Marianna Aramovna is a friendly and professional doctor who prefers to be attentive to the problems of her patients and adjust the treatment plan if necessary.

What's not to like about treatment?

Some are absolutely sure that paid medicine (taken by Marianna Aramovna for a fee) is a “pulling” Money without a positive result in the end. That is why the specialist himself even recommends a consultation not only with her, but also with another doctor. However, she does not say that the patient needs this or that gynecologist-endocrinologist in Moscow. Reviews in this regard are not the most positive. Some people feel that this is disrespectful and unreasonable - after paid reception contact someone else to confirm or refute the diagnosis and treatment method. But in some cases it still makes sense, although consultations cost a lot of money in the end.

Kaplina Lyubov Ivanovna

A doctor of the first category with more than 35 years of experience, who specializes in gynecology and endocrinology. Visited by a specialist at the clinic on Zoologicheskaya Street, building 22. The appointment is paid, average cost visits are 2500 rubles. At the same time, it is quite difficult to make an appointment with Lyubov Ivanovna, since her work schedule is scheduled months in advance. That doesn’t stop her from seeing as many patients as possible per day. The approach to each of them remains purely individual, attentive and professional. Perhaps, Lyubov Ivanovna Kaplina is the best endocrinologist-gynecologist (Moscow). Moscow medical centers, which employ many doctors of various specialties, have repeatedly invited her for cooperation, but the specialist remained faithful to her clinic in Beauty Park, as the patients used to call this place.

What clients like

The first thing people pay attention to is a friendly and attentive approach to sensitive issues. Patients note that the doctor not only looks at test results, but also listens to complaints on this or that issue. And even quite high price the reception does not bother any of those who apply. Many girls and women note that the treatment plans prescribed by Lyubov Ivanovna Kaplina always bring the desired results. positive result. And that she is a really good gynecologist-endocrinologist in Moscow. Reviews about Kaplina L.I. passed on by word of mouth, from one girl to another. And not only in the capital, but also beyond its borders. At the same time, no one said bad words about the doctor or reported negative opinions. It seems that the specialist is really worthwhile, a true professional in his field.

How to choose a good doctor

Gynecologists-endocrinologists in Moscow, making an appointment with whom can sometimes be very problematic, most often are all professionals. But in order to choose a really good doctor, you need to listen not only to the reviews of the patients who visited them, but also to the opinions of other specialists. Thus, if a particular problem is identified, the staff gynecologist at a district clinic or hospital, as a rule, recommends consulting a doctor of a more narrow specialization. In addition, it would be useful to visit not one, but several gynecologist-endocrinologists. And only then choose the most appropriate treatment option.

For any woman, a gynecologist is one of the main doctors, because diseases of a reproductive nature can appear at any age, regardless of lifestyle and health status. In the first stages, it’s easy to get rid of them, but to do this you need to see a doctor in a timely manner, without postponing the visit.

The appearance of unpleasant symptoms

Most often, women come to the doctor already with complaints about a change in condition. At the same time, the first symptoms are often quite mild and do not cause concern, but they should make you put everything aside and make an appointment with a gynecologist:

. They appear in a woman during puberty and disappear only during menopause, but any change in their character should be alarming. Unpleasant smell, skin irritation, unexpected color, increase in quantity, change in structure - all this may be evidence of illness.
Unpleasant sensations. Itching, pain, burning in the vagina, irritation of the genital mucosa, pulling or sharp pains in the pelvic area - any unpleasant or unusual sensations in the genital area is already an alarming sign.
Urinary dysfunction. If going to the toilet has become unpleasant, accompanied by burning, stinging or itching, you should also consult a gynecologist.
Delayed menstruation. Regardless of whether you are sexually active or not, a delay that lasts more than 5-7 days is a reason for examination, since in addition to pregnancy, it can be a sign of various diseases.

The listed symptoms, individually or together, should become warning sign, indicating that a consultation with a gynecologist is needed immediately. Immediately as soon as they appear, or the next day, you need to see a doctor. However, there are many other reasons to visit a gynecologist.

Other reasons to consult a gynecologist

Many people mistakenly believe that only adult women need to consult a gynecologist and only if any problems arise. But you should start getting to know him much earlier and there may be much more reasons for meeting:

Puberty period. After the start of menstruation, a girl should undergo an examination and meet with a doctor. After this, he must be visited every year for preventive maintenance.
Beginning of sexual activity. This stage also requires consultation with a gynecologist, in particular the first vaginal examination, because it is not performed on virgins.
Selection of contraception. If pregnancy is undesirable, then you should worry about suitable method contraception. will help you choose the best option.
Painful menstruation. Many women and girls suffer from them, not knowing that a gynecologist will help relieve severe course PMS.
Prevention after unprotected sexual intercourse. To protect yourself from being attacked unwanted pregnancy or infection infectious diseases, the next day after accidental unprotected sexual intercourse, you should contact a gynecologist to select post-coital contraception and emergency preventive medications.
Pregnancy planning. If you want a child, you should undergo an examination in advance and consult with a gynecologist.
Management of pregnancy. Throughout the entire period of pregnancy, a woman visits a doctor who monitors its progress.
Severe menopause. If menopause causes discomfort, then you should consult a doctor and choose the appropriate treatment.

In addition to all of the above, consultation and examination with a gynecologist is necessary at least twice a year, even if there are no unpleasant symptoms and there are no warning factors.

And whatever the reason for consulting a gynecologist, you can get it for a fee in the Health Protection network of clinics in Moscow, where sensitive and attentive doctors will be happy to answer any of your questions and help you sort out any problems.