Should you be afraid of erosion? Should endometriosis be treated? Is IVF safe? These and other questions were answered by the chief freelance specialist in obstetrics and gynecology of the Moscow Department of Health, Doctor of Medical Sciences, Professor Alexander Konoplyannikov.
July 5 2018
– The main thing that you have to remember: you need to sunbathe in the sun or in a solarium in moderation, not for long and in no case burning out. When the outside temperature is high on the beach, in a solarium, sauna, bath in the body, blood circulation is accelerated, and the blood rushes to the pelvic organs. This can lead to profuse discharge, increase pain and increase the number of critical days.
Alexander Konoplyannikov
– Nowadays there are many products for intimate hygiene with a slightly acidic pH, which does not disturb the natural environment of the internal genital organs and helps to make hygiene procedures comfortable. Pay attention to the composition, the pH should be 3,5-4,5. The much-touted “gold standard” pH 5,5 is only suitable for the skin of the body, but not for sensitive intimate areas. Ideally, there should be no fragrances and natural fragrances, they can cause allergies. Modern panty liners are not a threat, but their use does not eliminate the need to change linen every day. And, of course, you should take a shower, paying special attention to intimate areas, at least once a day.
– No, it’s not dangerous. But before undergoing a course of laser hair removal to exclude diseases of this area, be sure to visit your attending gynecologist. There are general contraindications to laser hair removal, which apply not only to the bikini area: birthmarks and moles in the area of laser exposure, varicose veins, acute and chronic skin diseases, acute infectious diseases, for example, colds, pregnancy, lactation, precancerous conditions and many others. For a complete list of contraindications, it is more correct to check with a dermatologist.
– The timing of the onset of puberty is blurred, and, as a rule, it is from 12 to 14 years. A young woman develops in two stages. First, the breast enlarges, hair appears on the body, and only then menarche comes – the first menstruation. The period of its occurrence can be influenced by heredity in the female line, lack of sex hormones, hypothyroidism and other hormonal disorders, diabetes mellitus, bronchial asthma, chronic infectious disease, psychological stress, physical exhaustion. The girl should visit a pediatric gynecologist to schedule an examination.
– Indeed, several decades ago it was customary to cauterize erosion, but medical science, including obstetrics, is constantly being improved. Now it is enough to do a cytological screening of the cervix and an analysis for HPV, the human papillomavirus, is mandatory. Some types of HPV provoke the appearance of genital warts and papillomas, while others can cause cancer of the cervix. If necessary, a colposcopy is performed for further examination (examination of the cervix using a colposcope – a special magnifying optical device) with a biopsy of suspicious areas. An HPV test should be taken regularly for all women after 30 years of age every 3 years.
– This is a complex and serious disease in which the cells of the endometrium (the inner layer of the wall of the uterus) grow outside of it. Due to regular blood loss, anemia (lack of hemoglobin in the blood), peritonitis (inflammation of the peritoneum) and damage to nerve fibers in the foci of the endometrium, leading to neurological disorders, can develop. Also, endometriosis is often the cause of infertility. Moreover, without treatment, the disease can progress. It is necessary for the gynecologist to determine the location and size of the lesion or foci of the endometrium and, depending on this, prescribe treatment for you. It can consist of hormone therapy, in some cases surgery is required, which is now done in a gentle way using laparoscopy.
– As in the case of endometriosis, it is first necessary to be examined to determine the location, size and number of myomatous nodes. The doctor will then select a treatment plan that is right for you. Now there are modern methods to preserve the reproductive organs, the most common of which is UAE (uterine artery embolization). With the help of UAE, not only uterine fibroids are treated, but also other benign neoplasms of the uterine body. Through a puncture in the right thigh, a catheter is introduced to the patient, and through it a substrate, which, after a few hours, causes a blockage of the vessels in the myomatous nodes and reduces the nutrition in them. The effectiveness of this procedure is very high. After it, in most cases, pregnancy occurs, which ends with the birth of an absolutely healthy child. In Moscow, EMA is performed free of charge in almost all city hospitals where there is a gynecological department.
– Feelings of hot flashes can be not only during menopause, but also with other diseases. You need to go to an appointment not only to the gynecologist, but also to the endocrinologist.
– If you have anemia, then you should understand what it is: non-ferrous or iron deficient. If not iron deficiency, then, most likely, its cause is in the blood coagulation system. But iron deficiency anemia often happens due to heavy menstrual and intermenstrual bleeding, which can be 200-300 ml per day. Of course, this worsens the state of health, and then tough measures are required. Endometrial hyperplasia – overgrowth of the lining of the uterus – is a serious disease that can provoke the appearance of oncology. With myomatous nodes, leading to bleeding and anemia, and when the patient is in premenopause or menopause, the question is raised whether the uterus can be removed. During the operation, a colposcopy and a biopsy of the ovaries are done, and if there is no erosive change in the cervix and suspicions of a malignant formation, then the uterus and tubes are removed, and the cervix and ovaries are left. In this case, you will not need to drink hormonal drugs. In Moscow, such operations are performed laparoscopically.
– There are such cases, and there are many of them. We are examining the wife and husband, both have normal indicators, and pregnancy does not occur. Then we do IVF, the woman gives birth, does not protect herself, because she has infertility, and suddenly, after a few months, she becomes pregnant. Why is this happening? A woman decides that she needs a child, two months pass, she does not become pregnant and begins to think that something is abnormal in her, goes to be examined, closely monitors the cycle, tries to conceive at certain hours. Children show up for love, not on schedule! But it’s very important to know that if the couple actually has a problem, they don’t have to wait long. Sometimes women are treated for ten years and during this time they reach an age when IVF may not help. If you cannot get pregnant during treatment for a year or two, you need to go to a fertility specialist. My teachers instructed me: don’t knock on closed doors, you need to make them open.
– IVF is done all over the world. And in no country is there any evidence of a link between an increase in cancer and IVF. Another question is that this is a huge blow to the body. For example, when a woman forms 1-2 follicles, and IVF requires 20 follicles. This requires serious hormonal support. But when they say that “test-tube babies” are obtained and that they are somehow not like that, this is not so! Children conceived with IVF do not differ from their peers either physically or intellectually. And many of them have already become parents themselves.
– Yes, sure. In Moscow, we do 3600 free IVFs per year. You need to contact the antenatal clinic at your place of residence, pass all the tests according to the list. After the examination, confirmation of the diagnosis of infertility and the elimination of contraindications, you will be given a referral to the clinic. You choose it yourself. For residents of Moscow, a list of clinics can be found on the website of the City Health Department.
– In the last century, many ladies believed that they should look at the gynecologist only after the woman became pregnant. This is the wrong approach. Now for the first time a newborn girl is examined by a neonatologist while still in the hospital. The next visit to the pediatric gynecologist should take place when the baby is one year old, then at 7, 10, 12 years old. But this is a schedule of preventive examinations, when there are no complaints and deviations. Under the supervision of a gynecologist, girls with urinary tract and kidney infections, allergies, diseases of the thyroid gland and adrenal glands, diabetes mellitus, neuroses, obesity, after operations in the abdominal cavity, especially due to complicated appendicitis, must be kept. From the age of 14, a girl, if there are no complaints, should visit a gynecologist 1-2 times a year, do an ultrasound examination of the pelvic organs to diagnose ovarian neoplasms, take smears for oncocytology, this makes it possible to detect serious diseases of the cervix in the early stages. Competent prevention is the key to women’s health!
What day of the cycle what food should you eat
In each phase of the female cycle, different hormones are produced that are responsible for the psychological state, well-being and appetite, so adjust your diet in accordance with the cycle. The first day is considered the beginning of critical days.
1. Cycle phase: 1st-6th day
What is happening: a decrease in the level of “female” hormones estrogen and progesterone and iron in the blood, the appearance of drowsiness and some weakness.
Required diet: lean, red meat, eggs, fish, pumpkin seeds, sunflower seeds, sesame seeds, flaxseed, pistachios, almonds, figs, parsley, seaweed, nettle tea, pomegranate juice.
2. Cycle phase: 7st-12th day
What is happening: an increase in the level of estrogen and testosterone, an acceleration of metabolism, a surge of strength, a positive mood. A convenient time to reduce your diet, if you need to lose weight, and increase physical activity.
Required diet: peas, all types of cabbage: collard, broccoli, Brussels sprouts and other fresh green vegetables, especially if pregnancy is planned.
3. Phase of the cycle: 13-15th day
What is happening: the maximum amount of estrogen accumulates. The best period for conception, for which you need to keep a stable level of insulin in the blood.
Required diet: raw vegetables, fish, eggs, whole milk, olive or sunflower oil, nuts, seeds.
4. Phase of the cycle: 16-28th day
What is happening: Progesterone lowers estrogen levels and, as a result, serotonin (the hormone of happiness), mood swings and fatigue, the so-called premenstrual syndrome. A woman consumes 200 kcal more per day, sometimes due to water retention, the weight increases by 2-4 kg.
Required diet: about 2 liters of pure water (6-8 glasses between meals), fresh or dried fruits, meat, fish, grain bread, beans, beans, nuts, sunflower seeds, cocoa.