As checked in gynecology. Gynecological examination: how is the visit to the gynecologist. Do I need to shave before going to the gynecologist

The initial examination by a gynecologist is carried out after a preliminary consultation and, according to indications, includes various manipulations. The main ones are: visual examination of the external genital organs, instrumental (examination of the walls of the vagina and cervix in the mirrors), manual vaginal and rectal finger examination, examination of the thyroid and mammary glands.

If the doctor suspects a pathology of the cervix or vaginal mucosa, a colposcopy is performed - an examination of the vagina and cervix with special optics - "under a microscope".

An examination by a gynecologist is usually accompanied by taking the necessary tests - these can be smear tests, DNA-PCR for "hidden" infections, crops, etc. At the same time, we use only individual disposable instruments (mirrors, probes) and consumables (test tubes, gloves, etc.).

WHAT CAN BE INCLUDED IN THE INITIAL GYNECOLOGICAL EXAMINATION

Please note that here are the prices for an examination by a gynecologist, without the cost of the doctor's appointment itself. During the initial treatment, the examination is possible only at the appointment with a specialist. Below are base prices for some services.

1. Gynecologist appointment + examination (simple) - 2,500 rubles.
2. Reception at the gynecologist + examination (complex) - 3,200 rubles.
3. Appointment with a pediatric gynecologist (examination included) - 2,500 rubles.

HOW IS THE EXAMINATION AT THE GYNECOLOGIST AT 14 - 15 - 16 - 17 years

What does a gynecologist do when examining adolescent girls at 14, 15, 16 and 17 years old? What to prepare for when you see this specialist? Despite many prejudices, the procedure for such an examination is not terrible. Often it passes even without penetration into the vagina. First of all, an examination by a gynecologist at school is necessary for the timely detection of diseases and hormonal disorders. And certainly not the state of the hymen, as it seems to so many teenage girls who have a visit to the doctor. What are the features of passing an examination by a gynecologist in adolescence? How do virgins and teenage girls who are already sexually active go through a gynecologist?

GYNECOLOGIST AT 12 - 13 YEARS.

At the age of girls under 14 years of age, a standard examination on a gynecological chair is usually not performed. The doctor only checks the growing mammary glands, in which seals (mastopathy) can form, as well as the genitals - they determine the vegetation on the pubis. In girls at 12-13 years old, gynecologists evaluate visible puberty and set the date for the next visit to the doctor. Inspection at school on a chair at an early age is carried out only for girls 12-13 years old who have already experienced menstruation. An examination by a gynecologist at the age of 12-13 involves a visual examination of the external genital organs, the development of the mammary glands, the order of hair growth according to the age norm. If there are complaints, it is possible to check the condition of the internal genital organs through the anus. These manipulations are agreed with the legal representative.

GYNECOLOGIST at 14 - 15 - 16 YEARS.

Until recently, the first examination was held at school by a gynecologist at the age of 14, but today girls get into a chair at the age of 10-12 years. Why? It's all about the early sexual development of children and the natural restructuring of the body. All the changes that occur in the body of a teenager are controlled by the onset of the production of female sex hormones, which leads to an increase in the mammary glands, the beginning of vegetation in the armpit and on the pubis, as well as the onset of menstruation. The lack of a timely gynecological examination at 14, 15 and even 16 years of age leads to the neglect of gynecological diseases. Often, girls with ovarian cysts, acute cystitis, anomalies in the structure of the external genital organs, in particular, with obstruction of the hymen, leading to the impossibility of the release of menstrual blood to the outside, often show up in the departments of pediatric gynecology "by ambulance". Early initiation of intimate relationships is also fraught with both genital injuries and unexpected pregnancy and STDs.

HOW IS THE RECEPTION AND EXAMINATION AT THE GYNECOLOGIST OF TEENAGERS

If you are a virgin and undergo a routine gynecological examination at a school or district clinic, then the matter may be limited to a brief conversation and an external examination of the genitals. If there are complaints or abnormalities identified during a visual examination, it may be necessary to conduct a rectal examination - an examination through the rectum, to understand the state of the internal genital organs. If you are sexually active or have experienced intimate relationships with vaginal penetration, then even at 13, 14, 15 or 16 years old, the gynecologist examines you on the chair in the usual way, like an adult woman. It may be useful to conduct an ultrasound of the small pelvis, passing smears on the flora. But this is already possible only in a clinical setting.

In general, the course of a visit to a gynecologist for an examination at the age of 15-16 looks something like this.

A gynecological examination of adolescents, which is first performed at 14 years of age and older, usually begins, like any other visit to the doctor, with a conversation. During her doctor asks questions about the state of health and available complaints from the genitals. The next is a general inspection. It begins with an examination of the skin of the girl, an assessment of their color, the state of hair growth. Then they proceed to examination and palpation of the mammary glands, during which the presence of suspicious formations is excluded. Further examination takes place in the gynecological chair, which girls are most afraid of. Depending on its design, the patient is located lying down, or in a semi-lying position, bending her knees, resting her feet on special supports. In this position, the girl's external genitalia are examined, and a vaginal and / or rectal examination is also performed.

The main stage of the examination of a teenager by a gynecologist, like an ordinary woman, is precisely an intravaginal examination with a mirror and hands. When it is carried out, a special gynecological kit is used, all the instruments of which are sterile or disposable. The latter, for obvious reasons, is more preferable. Vaginal examination is performed with sterile, disposable gloves; while measuring the size of the cervix, the condition of the uterus and appendages, surrounding tissues. This kind of examination is carried out already at an older age, when the girl is sexually active, which often happens after 14-15 years. An examination by a gynecologist of adolescents with an intact hymen is performed through the rectum.

• Do not watch such videos on the Internet and do not study other "manuals" - this only increases the feeling of fear, because everything depicted is far from reality;
• When viewed in a gynecological chair, relax as much as possible - discomfort is caused precisely by tension;
• Trust the doctor, you are not the first to be looked at by a gynecologist at 14-15 and 16 years old on the chair;
• Do not take a shower or wash your genitals at least 3-4 hours before the intended examination;
• Do not shave or epilate yourself - pubic hair indicates the course of her puberty and hormonal status in general.

Further, it all depends on the results of the survey. If everything is in order, then go on your way. If not, the doctor in the examination room or the school gynecologist will write a referral for a consultation with a specialist in pediatric and pediatric gynecology. adolescence.

HELP FROM THE GYNECOLOGIST TO THE SCHOOL

If you want to have a paid examination by a gynecologist in Moscow, we invite you to sign up and visit our center. At the initial consultation, the doctor determines the range of issues that need to be addressed, conducts the necessary studies according to indications and draws up an individual treatment plan. In addition to the generally accepted methods of treating women's diseases (medication, medicinal, etc.), according to indications, additional, time-tested and many years of practice, effective methods are used.

Doctors will be able to see you today:

Every self-respecting woman should periodically be examined by a female doctor.

An examination by a gynecologist is necessary, both for the prevention of diseases of the female organ system, and for the timely diagnosis of possible deviations.

How many times a year you need to be examined by a specialist, and how often you need to do this, depends on the state of health of the woman.

• For the purpose of a preventive examination, you should visit a gynecologist at least once every six months or a year.
• If a woman is pregnant, then you need to come to the doctor at the earliest possible date in order to have time to undergo an examination and be registered in a timely manner. Admission during pregnancy is individual. A visit to the doctor early dates carried out at least once a month, after 7 months - every week.

Many are interested in: “Is it necessary to undergo an examination after childbirth?”. After discharge from the hospital, if the woman has no complaints, a visit to the doctor is not mandatory. But after one and a half to two months, this must be done.

The examination procedure is performed by a doctor on a special gynecological chair. During a visual examination, the condition of the external genital organs is assessed.

The gynecologist evaluates the condition of the skin of the genitals. As well as the mucous membrane of the small and large labia, the hymen, the clitoris, the vestibule of the vagina.

The mucous membrane of the vagina and the vaginal part of the cervix are available for examination with a mirror. During the examination, it is supposed to take biomaterial for examination on the flora and the presence of atypical cells. This is necessary for the timely detection of pathology in women.

Based on the examination data obtained, an experienced specialist is already able to determine by external signs whether there is a pathology.

So, for example, the doctor may find during the examination:

• inflammation of the genital mucosa;
• the presence of pathological discharge;
• whether there are neoplasms;
• deficiency or excess of estrogen in the body;
• whether the woman is pregnant;
• underdevelopment of the genitals;

If changes are suspected, the doctor will refer you for an additional examination: testing, ultrasound examination of the uterus and appendages.

In order for the doctor to get a real idea of ​​​​the state of a woman’s health, before visiting a doctor, it is necessary to properly prepare for the appointment:

• at least two or three days before coming to the doctor, exclude sexual intercourse;
• on the eve and before the examination, do not douche, do not use intimate hygiene products with fragrances;
• before going to the appointment, it is necessary to toilet the genitals, using baby toilet soap and boiled water, and then put on clean underwear.

Before the doctor proceeds with the examination, it is highly desirable to take care that bladder and intestines were empty. With regard to shaving pubic hair, we can say that this is not a strictly mandatory procedure.

The first thing a visit to the doctor begins with is a survey of a woman.

The doctor focuses on the complaints made by the patient.

• The patient may complain of painful conditions, the presence of pathological discharge accompanied by discomfort, the appearance of neoplasms on the genitals, etc.
• When farrowing a woman, special attention is paid to the nature of the menstrual cycle, the age at which menstruation began, the presence of pain, and duration.
• An obstetric history is being collected: the presence of childbirth, abortion and their consequences.
• The sexual aspect is considered: whether a woman is protected from unwanted pregnancy, if so, in what way.
• The doctor is also interested in past diseases of the genitourinary system.

At the next stage, the woman is examined in the gynecological chair.

The procedure consists of the following steps:

• external examination of the genitals, features of the structure and physiology are revealed;
• examinations in the mirrors, which allows you to assess the condition of the vaginal walls and the cervical part of the uterus;
• bimanual examination, i.e. palpation with both hands. This method allows you to identify changes related to the uterus and appendages.

For each group of women (children, girls, during pregnancy, in the postpartum period), the examination in the gynecological office has its own distinctive features.

Examination of a woman during pregnancy:

• The initial examination is no different from the standard procedure. The main goals are the exclusion of pathological conditions, the determination of the term. When viewed on a chair, smears are taken for cytology and bakposev for flora. The doctor also makes anthropological measurements (height, weight), measures the pulse and blood pressure, determines the size of the pelvis.

• When pregnancy is over 15 weeks, examination on a gynecological chair is not carried out. At this and later dates, the examination is reduced to measuring the circumference of the abdomen and the height of the fundus of the uterus above the pubic part, and the fetal heartbeat is also heard. Be sure to analyze the result of a urine test, handed over by a woman on the eve of a visit to a gynecologist, the pressure and weight of the pregnant woman are measured.
• After 28 weeks, visits to the doctor become more frequent, and the interval between them is already two weeks.
• After the 36th week, the pregnant woman should come to the antenatal clinic every week.
• At about 38 weeks, the doctor re-examines in the gynecological chair for the readiness of the genital tract for childbirth.

After the birth of a child, when the discharge normalizes, a woman needs to visit a doctor. The doctor must make sure that the postpartum period proceeds without pathology.

The uterus should return to its previous state. The condition of the tissues where the sutures were applied (if any) is checked.

Inspection is carried out in stages in a standard way. Many women tend to bypass the gynecologist's office for the simple reason that they are afraid of an examination.

Does it hurt?

It all depends on the psychological mood and condition of the genitals. If pain occurs during examination, then only this comes from the tightness of the woman and the muscle spasm arising from fear. Therefore, during a visit to the doctor, you need to relax as much as possible and completely trust the doctor.

Any manipulations associated with the examination are painless. If you have questions about the sterility of instruments, you can purchase a disposable gynecological kit at the pharmacy. It includes not only a mirror, but also a brush for taking a smear, as well as sterile gloves and a sheet.

How to get a gynecologist if menstruation

According to many women, going to the gynecologist during menstruation is not entirely ethical.

But there are times when it is necessary to do so. Even in some cases, gynecologists recommend coming for an examination or undergoing an ultrasound scan on critical days. Therefore, the question of whether it is possible to undergo a gynecological examination during menstruation can be answered positively. Yes, this is quite appropriate if further health depends on it.

Circumstances requiring a mandatory visit to the doctor during menstruation:

• in the presence of severe pain in the genital area;
• if the body temperature has risen;
• if during the critical days there was a general weakness;
• with abundant or, conversely, meager spotting;
• when bleeding lasts more than seven days;
• if there is a specific smell and the color of menstrual blood is changed;
• if menstruation is accompanied by engorgement and severe soreness of the mammary glands;
• if there is discomfort in the vagina.

If symptoms of this nature appear, then a trip to the doctor should be immediate. In some cases, the doctor may schedule a visit during your period. So, for example, to install or remove the intrauterine device.

On such days, the neck is slightly open, which makes it easier to insert or remove the IUD. In other cases, it is better to postpone the examination until the complete cessation of menstruation.

This needs to be done for a number of reasons:

• Blood is a nutrient medium for microorganisms, including pathogenic flora. On examination, it is easy to introduce an infection, which can lead to an inflammatory process.
• The cervix is ​​ajar during menstruation, which can also provoke inflammation of the uterine cavity.
• During this period, the mucosa is easily vulnerable and, upon examination, can be easily injured.
• With painful periods, the introduction of a mirror or palpation may increase discomfort.
• Leaking blood can interfere with a detailed examination of the genitals.
• Blood masks the color and consistency of the secretions, and it is also impossible to determine their smell.
• It is difficult to take smears for research.
• If an additional urine test was prescribed, then the result of the study may not be reliable.
• It is impossible to determine the size and position of the uterus in the pelvic cavity.

For the above reasons, it is better to postpone a visit to the doctor until the end of the critical days.

How is the examination of a gynecologist in virgins

Often mothers of virgins do not understand why a girl should go to a gynecologist.

The problem is that not always pathologies of the genitals at the initial stages of development are manifested by any symptoms. In many cases, the disease makes itself felt in the later stages of development.

It is no secret that the treatment of any pathology is always more effective at the very beginning of changes.

• The very first examination of the girl's genitals is carried out in the maternity hospital immediately after the birth of the child.
• Then, when the child reaches 1 year old, the girl is examined in the clinic by a pediatric gynecologist.
• The next visit to the doctor is planned before the baby goes to kindergarten, after which at the age of 12-14 due to the onset of menstruation.

Further visits to a pediatric specialist are carried out with a frequency of once every 1 or 2 years. If there are signs of pathology of the genitourinary system, the girl needs to consult a pediatrician.

During the examination, the doctor assesses the degree of development of the genitals and, if necessary, prescribes the necessary treatment. In this way, serious problems can be prevented. At the beginning of the appointment, the gynecologist collects an anamnesis. During the examination, the girl is located on the couch.

The doctor examines the external genitalia and conducts a bimanual examination not through the vagina, but through the rectum. Examining girls with a mirror does not apply. In virgins, in the absence of complaints about the genital area, such manipulation is not carried out.

To take smears, a special tool is used to prevent injury to the hymen. It will not be difficult for a specialist to determine whether a girl is a virgin, so it is impossible to deceive a specialist. But, if the patient is already 15 years old, the gynecologist has no right to tell parents that virginity has been violated.

The doctor can tell about this if the girl is not yet 15 years old. Most often, the first visit to the doctor occurs at the age of 16-17 years. Those. at the time when the girl finishes her studies at school and goes through specialists for admission to an educational institution.

A visit to the gynecologist will also be justified after the first sexual contact. If a minor girl has entered into an intimate relationship, then the examination is carried out in the same way as for an adult woman.

Most often, clinics, especially paid ones, have everything that is necessary to receive a patient. But in ordinary clinics, there may often not be any accessories.

• a disposable diaper that a girl will need so that she can spread it under the buttocks area;
• sterile medical gloves. They will be needed for a bimanual examination of the patient;
• clean socks so that the girl can safely walk across the floor from her things to the chair, and her legs look more aesthetically pleasing in them;
• a calendar in which every self-respecting girl makes notes on the days when menstruation came for the last time.

It is better to come to the appointment in comfortable clothes (for example, in a dress or skirt). So that you can easily undress, and the process does not take much time, which you can’t do if you put on trousers or shorts. Not only girls, but also women are embarrassed to go to the doctor if he is a man.

You shouldn't worry too much about this. It must be understood that the male gynecologist and the woman who came to see him are a qualified specialist and a patient. There is also an opinion that male gynecologists are more careful and attentive than their female counterparts.

In the event that, nevertheless, the girl is against being examined by a male doctor, then she has the right to turn to another female specialist.

Gynecology includes a set of tests and diagnostic methods that every woman will have to go through more than once. An examination by a gynecologist is especially important for the category of women who suspect a gynecological disease, plan motherhood or are preparing to become a mother. Let's look at what kind of mandatory tests and studies are included in the examination by a gynecologist, how they are carried out and what they can show.

THE COST OF A GYNECOLOGIST'S RECEPTION IN OUR CLINIC - 1000 rubles.

External gynecological examination

External inspection - simple, but very important gynecological examination, which is carried out both as a preventive measure and for the direct diagnosis of pathology (in the presence of characteristic complaints or symptoms). During this examination, the doctor pays special attention to all organs located in the anogenital region - the pubis, external and internal labia, anus. After that, the internal condition of the vagina is assessed (examination of the cervix).

During a superficial examination of the genital organs, the doctor, first of all, focuses on such points as:

• skin condition (dry, oily, greasy, etc.);
• the nature of the hairline (sparse or thick hair, the condition of the hair roots, the presence of power lines, etc.);
• the presence of bulges or any tumors on the surface of the genital organs;
• redness, swelling of areas of the skin or the entire organ.

With a more detailed examination, the doctor pushes the outer labia apart and conducts a visual analysis of the state of the genital anatomical structures, evaluating:

• clitoris;
• internal labia;
• opening of the urinary canal;
• vagina (outside);
• hymen (in teenagers).

During such an examination, the doctor may notice pathological discharge, which will already indicate any violations in the woman's body. In such a situation, an additional analysis of bacterial culture or smear microscopy is mandatory. This will accurately determine the presence of the disease, and find out its causative agent.

Gynecological examination of women and girls is different!

Gynecological examination with colposcopy

During this procedure, a gynecologist examines the internal organs of a woman - the cervix, vagina and vulva. Inspection is carried out using a special device - a colposcope. Gynecological examination with a colposcope is an affordable and informative procedure. The process is absolutely painless.

When a colposcopy is prescribed, contraindications

As a rule, a colposcope examination is recommended every six months, but it is not mandatory for healthy women. A colposcopy is mandatory if significant deviations are found as a result of the analysis of the BAK-smear or Pap test.

Colposcopy is also prescribed if there are:

• warts in the genital area;
• cervical erosion;
• cervical inflammation at any stage;
• suspicion of having cancer in the vagina;
• uterine cancer;
• significant changes in the shape and size of the vulva;
• a cancerous tumor on the vulva;
• precancer, vaginal cancer.

There are no contraindications for this study, but the doctor will not do an examination on critical days and during pregnancy, if there are no serious indications for this.

The gynecologist will prescribe an examination with a colposcope during pregnancy if the procedure cannot be postponed until the baby is born, due to a serious threat to the health of the expectant mother. Naturally, the examination by a gynecologist will be carried out with special care so as not to provoke a miscarriage.

Preparing for a colposcopic examination

Before performing a colposcopy, the gynecologist will give the following recommendations:

• abstaining from sexual life, even with a regular partner, for at least three days before the study;
• If there are any diseases or inflammatory processes on the genitals, a woman is strictly recommended to refrain from treating them with suppositories and other vaginal remedies. Treatment can be continued after a gynecological examination.
• With increased sensitivity to pain, before the examination, you can take painkiller pill. Pain medication will be prescribed by a doctor.

As for the date of the appointment of colposcopy, it is determined solely by the gynecologist.

How is a gynecological examination with a colposcope performed?

A colposcopy is a routine gynecological examination with enhanced visualization. It is carried out in a completely non-contact way, using a modern apparatus with a built-in microscope and static lighting, with lenses. Examination by a gynecologist in a modern clinic using a colposcope is the norm in Europe!

The device is installed on a special tripod, before entering the woman's vagina. Further, the gynecologist, using a built-in microscope, examines the tissues of the vagina, under a very large magnification, which allows you to note even the smallest changes in them. Helps the gynecologist and lighting. The gynecologist, by changing the angle of the light source, can examine the scars or folds on the vaginal membrane from all angles.

Colposcopy is usually performed with a detailed examination of the cervix and vulva. To better examine the surface, the gynecologist first removes the discharge with a swab. Then, to exclude subsequent secretions, the surface of the cervix is ​​​​lubricated with a 3% solution of acetic acid. If such preparation is not carried out, then, alas, it will not be possible to obtain accurate results. There is no need to be afraid of this moment - the maximum that a woman feels during a gynecological examination is a slight burning sensation in the vagina.

What will the examination by a gynecologist with a colposcope show

As mentioned earlier, the colposcope allows the doctor to examine even the smallest changes in the structure and color of the epithelial cells of the vagina, which means that it is able to detect any ailments at an early stage of development.

• One of the most common diseases that a gynecologist's examination with a colposcope detects is cervical erosion. The characteristic symptoms of erosion are uneven coloration, violation of the epithelial layer, bleeding, etc.
• Another disease that can be detected with a colposcope is ectopia. With ectopia, the doctor observes significant changes in the shape and color of the epithelium. This is a precancerous condition.
• A pathology that is easily detected on examination with a colposcope is polyps. These are outgrowths of different sizes and shapes. Polyps are dangerous and can quickly grow in size, so they are removed.
• No less dangerous are papillomas that inhabit the walls of the vagina. These formations can degenerate into cancer. Papillomas easily give themselves away when a 3% solution of acetic acid is applied to them - they turn pale.
• During colposcopy, the doctor may see a thickening of the inner lining of the vagina, which indicates the presence of leukoplakia. If the treatment of this pathology is not started in time, then tumors can form on the cervix.

The most dangerous disease detected by a colposcopic examination during a gynecological examination is cervical cancer. If this disease is detected, a biopsy is performed immediately without fail.

Complications, consequences after a gynecological examination with colposcopy

Usually colposcopy does not give any complications. The normal condition of a woman after a colposcopy procedure is light spotting.

In rare cases, one of the bleeding options may be observed. In this case, you need to urgently contact a gynecologist. Another unpleasant symptom of incipient inflammation is severe cutting pains in the lower abdomen.

Examination by a gynecologist with a biopsy

The most important analysis that is assigned to girls and women in gynecology is a biopsy. A biopsy is not considered a mandatory analysis during a gynecological examination, and is carried out according to the individual doctor's prescription. His task is to confirm or refute the diagnosis - cancer. If the gynecologist recommends a biopsy, there is no need to panic - often the examination shows that the tumor is associated with inflammation or other processes.

Preparing and performing a biopsy

Diagnosis does not require additional preparation and involves the taking of biomaterials from the internal genital organs of a woman. Gynecological examination with biopsy is painless and lasts no more than 20 minutes. Tissues are examined under a microscope in a laboratory. The gynecologist will be able to announce the results of the study only after 2 weeks.

In total there are about 13 different types biopsies, only 4 of them are used in gynecology. These techniques are the most effective and informative when examining the female reproductive system:

• Incisive type - made by scalpel incision of internal tissues;
• Sighting type - carried out by colposcopy or hysteroscopy;
• Aspiration type - extraction of the material necessary for research by aspiration - vacuum suction;
• Laparoscopic type - taking material for research using special equipment. Such an analysis is taken from the ovaries.

Before the biopsy, you will need to donate blood and urine to rule out complications after the procedure.

Contraindications and complications after gynecological examination with biopsy

A biopsy performed by a good gynecologist under sterile conditions is safe. But it also has contraindications. A biopsy should not be done if diagnosed:

• blood clotting disorder;
• internal bleeding;
• allergy to the drugs used - anesthesia, aseptic processing, etc.

After a biopsy, a woman may feel tolerable pain in the vaginal area or lower abdomen. However, the nature of the pain should be strictly pulling. With cutting pain, usually accompanied by bleeding, the patient should immediately contact a gynecologist for a re-examination.

For several days, you will need to refrain from strong physical exertion and intimate contact. If no abnormalities are observed in the woman's body after this procedure, this does not mean that it is possible to violate the instructions of the gynecologist and not come for a second examination by the gynecologist.

As you can see, an examination by a gynecologist, even in the minimum version, provides extensive information about women's health!

Gynecological examination is a preventive procedure that allows you to determine the degree of women's health and identify diseases of the genital area, even if there are no manifestations of them. It is mandatory both for the treatment of any gynecological diseases, and for their prevention.

Inspection principles

A standard scheduled inspection consists of several stages:

1. The collection of anamnesis involves the study of the patient's medical history, clarification of complaints. The doctor asks questions about the date of the last menstruation, the nature of menstruation, previous diseases, the number of pregnancies and abortions, lifestyle and heredity.
2. General examination - study of the height and weight of the patient, the nature of hair growth, skin condition, measurement of blood pressure, palpation of the abdomen.
3. Gynecological examination (using mirrors and bimanual).
4. Palpation of the mammary glands. The doctor pays attention to the size and structure of the glands, the condition and color of the nipples, the presence of seals.

The examination is carried out using a disposable gynecological kit. The minimum set is a Cuzco mirror, gloves and a diaper. In addition, in different variations, it may include other tools:

• Eyre spatula for taking ectocervical samples;
• Volkmann's spoon (curette) for taking material from the cervical mucosa;
• cytobrush, which is used, as a rule, to take material from nulliparous.

Training

In order for the information that the doctor will receive to be as accurate as possible, it is necessary to prepare for the examination. Preparation includes the following measures:

• hygiene (shower, clean linen);
• emptying the rectum and bladder;
• douching is prohibited, especially with aseptic solutions;
• it is worth giving up sexual intercourse for a day;
• if the case is not an emergency, but a preventive examination, it is better to go through it in the first phase of the cycle;
• for a day you can not use tampons and suppositories;
• from the course of antibacterial and antifungal therapy to the examination should take at least two weeks;
• Please bring socks and diapers for inspection.

How is a gynecological examination performed?

The main stage of the examination is the examination on the armchair, which is carried out by the following methods.

External examination

The appearance of the genitals is one of the criteria for gynecological health. The doctor, having examined the condition of the vulva, assessing the presence of discharge and rashes, can fix the following deviations:

1. Manifestations of hypoestogenia - hypoplasia of the lips (both large and small), dryness of the mucosa.
2. An increased level of estrogen, which is characterized, on the contrary, by the richness of the color of the mucosa, an abundant secret.
3. Hyperandrogenism, indicated by an increase in the clitoris and the distance between it and the opening of the urethra.
4. Changes in the integrity of the muscles after childbirth, manifested in the prolapse of the walls of the vagina and the opening of the genital slit.
5. Detection of pathological formations on the mucous membranes and skin - for example, genital warts or eczema.
6. Prolapse of the vagina, in which its walls are visible at the entrance.

Inspection of the neck with mirrors

One of the main tools of a gynecologist is a speculum that is inserted into the vagina and helps to keep it open, thereby allowing you to assess its condition, as well as the condition of the vaginal part of the cervix. Gynecological speculums come in different diameters and shapes; the doctor selects the required depending on the anatomical features of the patient. The gynecologist evaluates the following parameters:

• the condition of the walls - color, the presence of growths and ulcers, tumors;
• cervix - shape and size, erosion, ruptures, tumors;
• the presence of secretions and their nature.

As a rule, examination with mirrors is supplemented by taking a urogenital smear to determine the composition of the microflora and the presence of inflammatory processes.

Bimanual study

This term is called an internal examination, which involves palpation of the internal organs of the reproductive system. In this case, two fingers of one hand are inserted into the vagina, while the other hand is placed on the stomach. Bimanual examination determines the following parameters:

1. Size, mobility and shape of the uterus. It decreases with infantilism, with menopause, and increases during pregnancy and with tumors.
2. The presence of myomatous nodes and other formations.
3. The presence of adhesions and salpinx.
4. Soreness of appendages and uterus.
5. Depth of the vaginal vaults. If there is an inflammatory process, they are smoothed out.

Rectovaginal examination

This technique is not used for every examination. Indications for its use are postmenopause and cases when it is required to more accurately determine the condition of the appendages. The technique involves inserting the index finger into the vagina, and the middle one into the rectum.

Additional Methods

If necessary, if pathological changes are detected, the examination may include additional methods. A complete gynecological examination includes the following studies:

1. - a study using a colposcope with a camera, which allows you to examine and evaluate the condition of the cervix in detail using special tests.
2. to detect precancerous changes.
3. Ultrasound examinations - transabdominal and transvaginal.
4. Biopsy - taking a piece of tissue for analysis for the presence of atypical cells.

procedure during pregnancy

A slightly different technique is used to examine a pregnant woman. In addition to the standard criteria, the doctor pays attention to the following parameters:

1. The presence of varicose veins, cracks, hemorrhoids.
2. The nature of the discharge: bloody may indicate an existing threat of miscarriage, and cloudy, with a smell - an infection.
3. On palpation, special attention is paid to the tone of the uterus.
4. At each examination, a smear is taken for the flora, and at the beginning of pregnancy, a smear for cytology is also taken.

The frequency of examinations depends on the course of pregnancy. If no complications are observed, examinations are mandatory upon registration, before the decree and on the eve of childbirth.

How to prepare for an examination

Gynecological examination of virgins

1. Most often, the doctor is limited only to external examination and palpation of the abdomen.
2. Vaginal examination may be required only if abnormalities are suspected.
3. As a rule, vaginal examination is carried out with the help of fingers; special tools are rarely used.
4. The study of the elasticity of the vagina can be carried out through the anus.
5. If instrumental research is required, special children's mirrors are used that do not violate the hymen.

After the examination, there should be no discomfort. They can appear only if a cytology smear was taken during the examination - a slight soreness, meager short discharges are not excluded.

Hello, Galina Leonidovna! I'm not quite sure if this is a question or a statement.

If there is a question, I dare to answer. In virgins, the so-called rectal (or rectovaginal) examination is really carried out. It is carried out instead of vaginal, or in cases where vaginal examination alone is not enough. But first, the doctor must examine the girl's external genitalia.

Inspection of a virgin is carried out without a mirror. The doctor actually inserts a finger into the anus of the patient, which allows him to determine the state of the muscular septum that separates the vagina and anus. The specialist also checks whether or not there are any neoplasms on the back wall of the vagina and in the anus. Through such an examination, you can also determine the condition of the uterus and appendages. Feel the retrouterine space - when the second hand of a specialist is located on top of the patient's abdomen and moves towards the one in her anus. This procedure may seem unpleasant, but not too painful. Therefore, you just need to be patient for a while. Also, the doctor can take a swab from the outer labia of a virgin with a special wand. The results of this smear will be available in two to three days.

In addition to the examination described, a specialist gynecologist can perform an ultrasound examination of the genitals of a virgin if the specialist has any questions.

All virgins who are afraid to visit a gynecologist should understand that this is the same doctor as any other and you should not be ashamed of him. It is also not necessary to avoid visits to him, because your reproductive health is very often in the hands of this specialist. He can notice any pathologies or diseases in time, and, accordingly, prescribe timely and effective treatment.

At what age it is necessary to visit a gynecologist for the first time - it is impossible to say unequivocally. If you follow the standard rule, then a girl from eighteen years old needs to visit this doctor twice a year. Often, the first examination of girls is carried out at school during medical examinations. But they examine only the external genitalia. If the doctor wants to examine the girl differently, he should get permission from the girl's mother or her guardian. However, neither the mother nor the guardian has the right to force the girl to undergo an examination by a gynecologist if the girl herself does not want it! Also, the doctor can examine the girl in the presence of her mother, or ask (at the request of the girl) her mother to wait outside the door.

If a girl is not yet 18 years old, but is already sexually active, then an examination by a gynecologist can and should be done earlier.