A short guide. Situations in which you need to see a gynecologist.
Taking on many family responsibilities and moving up the career ladder, a woman often forgets about herself and her health. Women often do not notice women's health problems that have appeared. In which situations should you see a gynecologist
Reason 1: acute pain
Let's start with emergencies in which you should call an ambulance immediately.
The sudden onset of sharp pain in the lower abdomen, regardless of its nature (pulling, stabbing, cutting), especially together with other complaints (fever, nausea, vomiting, loss of consciousness), may be a symptom of a serious, life-threatening disease requiring urgent treatment, including surgery.
Acute pain in the lower abdomen often radiates to the rectum and may be accompanied by loss of consciousness. Such complaints are possible with bleeding into the abdominal cavity, which develops in the following gynecological conditions:
- ruptured ectopic pregnancy - rupture of the fallopian tube due to the growth of the embryo inside it; emergency surgery is required, since bleeding from a ruptured tube can be significant (up to 1 liter!), and this is a threat to the patient's life;
ovarian apoplexy - a rupture of the ovary or an ovarian cyst that occurs either spontaneously during ovulation, on days 12-15 of the menstrual cycle, or in the second phase of the cycle, on days 16-28, more often after physical exertion, including after sexual intercourse.
Ovarian apoplexy often causes significant blood loss, which is why surgery is performed. In the case of minor damage to the ovary and slight blood loss, conservative therapy is sufficient.
The treatment approach is decided by the doctor. It is important not to lose time and to find out what is going on.
The pain is often accompanied by fever, which may indicate an inflammatory process in the genital organs.
Be sure to call an ambulance if pain and fever appeared:
- after an abortion or another intrauterine procedure (hysteroscopy, hysteroresection, myomectomy), since inflammation of the uterus - endomyometritis - may develop; antibacterial treatment is required and, if remnants of the gestational sac remain after the abortion, their urgent removal;
- after unprotected sexual intercourse, as a result of inflammation of the uterine appendages, often accompanied by pelvioperitonitis - inflammation of the pelvic peritoneum; infusion, antibacterial and anti-inflammatory therapy is needed, which gives a quick effect and helps avoid possible surgery;
while using an intrauterine device (IUD), especially if it was inserted more than 2 years ago, since this is a risk factor for endomyometritis; in this situation the IUD must be removed immediately and anti-inflammatory therapy given; seeking help in time makes it possible to avoid emergency surgery, including removal of the uterus.
Pain in the lower abdomen may be cramping and accompanied by nausea, vomiting and dry mouth.
If such complaints appear in a woman who has not seen a gynecologist for a long time, or in a patient being monitored for an ovarian tumor or uterine fibroids, an ambulance must be called urgently.
Life-threatening conditions are possible:
- torsion of an ovarian tumor;
- impaired blood supply to a fibroid node;
- torsion of the stalk of a subserosal fibroid node.
Reason 2: chronic pain
Very often a woman is bothered by recurring or constant mild to moderate pain in the lower abdomen that does not require urgent medical intervention but nevertheless causes discomfort and interferes with sex life. Chronic pelvic pain is a symptom of the following gynecological conditions:
- endometriosis;
- uterine fibroids;
- chronic inflammation of the uterine appendages;
- pelvic adhesions;
- pelvic varicose veins;
- the painful form of ovarian apoplexy (without intra-abdominal bleeding).
If you have chronic pelvic pain, you do not have to call an ambulance immediately, but you should not postpone a visit to the doctor for long either. It is better to deal with this problem and find out the cause of the pain.
The standard set of examinations for chronic pain syndrome includes the following diagnostic methods:
- pelvic ultrasound;
- smears for vaginal cleanliness grade and flora;
- testing for sexually transmitted infections;
- a blood test for the tumor marker CA-125, which rises in endometriosis.
If gynecological conditions are ruled out, see other specialists, since lower abdominal pain can also be caused by surgical conditions (colitis, appendicitis), urological conditions (kidney stones, pyelonephritis), as well as diseases of the musculoskeletal system (osteochondrosis, herniated intervertebral disc).
Reason 3 : vaginal discharge
It is worth making an unscheduled visit to the doctor if you have discharge and itching caused by vulvovaginitis - inflammation of the vagina and external genitals. This disease is not life-threatening, but it requires thorough examination and treatment, especially if the discharge appeared 1-4 days after unprotected sex.
Even if you think your "chronic thrush" has flared up, you should still see a gynecologist and have smears for flora taken so that appropriate therapy can be chosen.
Reason 4: contact bleeding
Spotting from the vagina after sexual intercourse is a well-founded reason to see a doctor. It very likely indicates a condition of the cervix.
If such complaints appear, the following examinations should be performed:
- colposcopy;
- cytological examination of a scraping of the cervical epithelium and the lining of the cervical canal;
- cervical biopsy with diagnostic curettage of the lining of the cervical canal - if necessary.
There is a mistaken belief that women who have not given birth should not have their cervix treated, since this will cause rough scars. Today there is a wide range of highly effective, completely safe treatment methods that are gentle on the cervix:
- cryodestruction;
- laser treatment;
- radiowave surgery.
Folk remedies (honey, urine therapy, tampons with sea buckthorn oil, etc.) are powerless against cervical conditions! Do not waste time!
Timely detection and proper treatment of cervical diseases prevent precancer and cancer of the cervix, which now affect increasingly younger women. Cervical cancer can be operated on only in the early stages.
Reason 5: problems in menopause
A serious reason for an urgent visit to the doctor is bloody discharge after menopause, except in cases when the woman is using hormone replacement therapy (HRT).
After menopause there should be "not a drop of blood". Bloody discharge during this period indicates a condition of the endometrium: hyperplasia, a polyp, precancer or cancer of the endometrium.
In this situation you need to see a doctor and have a full examination:
- pelvic ultrasound;
- aspiration biopsy of the endometrium;
- hysteroscopy and separate diagnostic curettage of the uterine lining and the cervical canal.
Hysteroscopy is a modern, informative diagnostic method that makes it possible to detect all intrauterine conditions and, if necessary, remove the altered endometrium.
I do not recommend diagnostic curettage without hysteroscopy because of its low informativeness.
After receiving the results of hysteroscopy and histological examination of the scrapings, the doctor decides on the management plan and chooses one of the treatment methods for the endometrial condition:
- hormone therapy;
- endometrial ablation (thermal, electrical or laser);
- surgical treatment - removal of the uterus.
Reason 6: bleeding during pregnancy
If you are 5 to 12 weeks pregnant and spotting from the vagina appears, you must see a gynecologist urgently, since this indicates a threatened miscarriage.
With timely and properly conducted therapy, the pregnancy can be preserved.
Moderate or heavy bloody discharge is a symptom of a miscarriage in progress. In this case, urgent intervention is needed to remove the remnants of the gestational sac.
Reason 7 : heavy periods
If you have heavy periods with clots lasting more than 7-8 days, as well as spotting before or after menstruation, or bloody discharge between periods, this may indicate the following gynecological conditions:
- a submucosal fibroid node;
- adenomyosis;
- an endometrial polyp;
- endometrial hyperplasia.
Most often, heavy periods or bleeding are accompanied by anemia of varying severity, with weakness, hair loss, brittle nails, tachycardia, pain in the heart area, and heart rhythm disturbances.
If you have heavy periods or bleeding, to clarify the diagnosis you need to have an examination that includes a pelvic ultrasound and hysteroscopy.
Today all intrauterine conditions are treatable! Organ-preserving treatment methods, in which the uterus is not removed, are widely used.
A woman with heavy periods also needs to monitor her hemoglobin level.
If it drops significantly (below 100 g/L), she should undergo anti-anemia drug treatment. A diet with increased intake of iron-rich foods (liver, pomegranates, etc.) alone is ineffective in such situations!
Reason 8: a painful lump.
A woman often feels a lump in the perineum near the entrance to the vagina, which may be painful. This is a Bartholin's gland cyst, which forms when its duct becomes blocked.
When injured, the cyst becomes infected and bartholinitis or a Bartholin's gland abscess develops, accompanied by sharp pain in the perineum and fever.
In this situation, emergency intervention (marsupialization surgery) is needed - opening the cyst, draining the pus, washing out the cyst cavity and restoring the gland's duct.
If you have found a Bartholin's gland cyst yourself, do not wait until it becomes infected! See a gynecologist in time!
A planned opening of the cyst in the "cold" period will be safer for you.
Reason 9: abdominal enlargement
A rare symptom that may make a woman see a gynecologist is a sudden enlargement and hardening of the abdomen. Apart from pregnancy, the cause of this complaint may be:
- giant uterine fibroids (can reach the size of a 30-week pregnancy!);
- a large ovarian tumor;
- a malignant tumor of the uterus (sarcoma);
- ascites due to ovarian cancer.
See your doctor regularly, at least once a year. Love yourself! Value your health!
www.passion.ru Olga Pankova.
