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VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician
A visit to a gynecologist is associated not only with teenagers with stress and discomfort, but it is the doctor, like everyone else, and regular visits to the gynecological office should come naturally to women. - A visit to the gynecologist is mainly a conversation - explains gynecologist Dr. Tadeusz Oleszczuk, whom we asked about the course and preparation for the visit, as well as about what the specialist may ask.
Patrycja Pupiec: While preparing for the interview, I came across a statement by a doctor who, in his practice, had patients who had to deal with a gynecologist only during their own births. Have you ever had a similar case?
Taduesz Oleszczuk:Yes, it is true. I had such patients. Even 30 years ago, when I started my practice, it was a common phenomenon described in medical publications. Women over 20 gave birth to children, and then there was a certain gap where they did not appear at the gynecologist. They only came when they were having babies, and then only in the menopausal period, when they were around 40-47, when their periods had stopped for fear of being pregnant or having hot flashes and didn't know what was going on.
Unfortunately, this gap is about a 15 to 20-year period when cervical cancer or other cancers can develop. Avoiding preventive examinations is a loss of the chance for early diagnosis and effective treatment.
And now?
Such a phenomenon is now seen much less frequently, because there is a lot of talk about prevention. In fact, it is currently a very small group, somewhere where this knowledge about regular research does not reach yet. Today, every woman who becomes pregnant must be under the care of a specialist and have a pregnancy card.
Are there any other reasons why this is happening?
First, many women are ashamed. Secondly, the woman believes that she is fine, that she is he althy, so why should she go to the gynecologist and visit the office regularly.
I also heard the opinion that if a young patient has not started intercourse, she can wait until she is 25 for the first visit. Right?
No, that's not true. A very important point isthe onset of menstruation up to the age of 16. If, for various reasons, it does not occur, for example as a result of hormonal disorders or weight loss, it is imperative to see a gynecologist, because this is a problem. In the future, this may limit fertility. Young women are afraid of the gynecological examination itself.
Suppose a nineteen-year-old girl has normal menstruation, has not started sexual intercourse, there is no risk of developing cervical cancer and no gynecologist will insist on vaginal examination.
And if she started intercourse?
If she starts intercourse, and most of them start before the age of 25, she should come to the gynecologist so that they can get a pap smear and see what the state of the reproductive organ looks like and, most importantly, talk to a doctor about the regularity of menstrual bleeding cycles, weight painful periods, look for other he alth problems that may arise in a few years, because then it may be too late to fix the shortcomings.
What problems do young patients encounter?
Now we are after the holidays, but young patients come to the gynecologist before the holiday season for contraception - it is very wise. Better to come and think about it than to panic afterwards. Another reason is painful menstruation or intimate infections. Now there are more of them - infections and venereal diseases. They also often consult a specialist because they have cystitis or hormonal disorders, or pain in the breasts or pain in the lower abdomen.
Your period should be monthly, not every six months or every few months. This is a disorder and it is imperative to explain its causes, which may be several. The thyroid gland, pituitary gland, adrenal glands may be responsible for this state of affairs. You must consult a specialist, because if you do not do it, the consequences can be enormous after many years, for example, you may have problems with getting pregnant, but also the quality of life may be reduced. Weight gain, decreased libido, concentration disorders or short-term memory disorders.
Is it possible to prepare for the visit?
This question is very multi-faceted. Sometimes I come across a situation when a mother brings her daughter for an examination because she herself is afraid. No wonder. I would be afraid of visiting a gynecologist myself when I was teenagers (laughs). The young girl reads, listens, and her imagination will tell her. In my practice, I have many "first-time" patients, but they are conscious, determined women who sometimes come for preventive knowledge, because they have already startedintercourse.
It is very important to understand how the body works. By the way, it is possible to obtain reliable answers to the prepared questions. Prepare yourself as you normally would for hygiene. Better to wear a dress or a skirt to make your visit easier. The doctor focuses more on the interview with the patient, on what he hears and asks.
The examination on the chair complements the diagnostics. Although the examination technique may not be a comfortable situation, such a visit may bring a lot of good. The visit itself respects the woman's right to intimacy. The patient can hear that she is all right, that she is he althy and that she is fine. He will be referred for ultrasound of the reproductive organ and breast. She will know that what she is feeling is glandular changes, not cancer.
He will also be sure about his he alth and 90-95 percent. everything will be alright. But you have to come to the gynecologist, not to be in the 5-10% with a tumor, cyst, erosion, high inflammation or an abnormal cytology result, or the risk of cancer
On internet forums, women write about perfuming their intimate areas before visiting a gynecologist …
(Laughter) Nobody demands from the patient that she should perfume the intimate places, but hygiene is absolutely necessary. This first visit is for women of all ages, most often between the ages of 19-25. In my practice, this group is about 80 percent. You don't need to depilate yourself.
A woman has the right to whatever suits her. There is one issue with each visit that is very important, but often doctors forget about it when they are in the heat of work. It is important to properly sit on the chair. If you sit down like you would in a movie theater, the examination may be unpleasant and painful. I have to admit that this position is not comfortable for a woman, but at the dentist's office a man also sits with his mouth open and it is also not comfortable.
How should I arrange myself?
You have to slide down low, so that the buttocks almost hang in the air, because then the tension of the pelvic muscles is reduced and it is easier to carry out the examination, which is then painless for the patient. If the gynecologist does not say this, the woman tightens her muscles and stomach and it can be unpleasant. I always remind you about it, because the right position is important. It's such a small remark, and it can significantly increase the comfort of the visit.
Patients are surprised more than once and I often hear that you were supposed to get a Pap smear, and I say that I already did (laughs).
You mention visits of patients before the age of 18. If the girl is underage, thenhas to come with a legal guardian, right?
Yes, necessarily with an adult.
What information does the parent have access to?
It happens in two ways. Mom is bringing her daughter who was afraid of the visit and is overweight or with menstrual disorders. Then the daughter feels safe in the company of her mother and I, as a doctor, respect it very much. At some point, when I ask about everything and examine it, you can ask my mother for intimacy and the parent will wait in the corridor. I know that this young person would like to ask embarrassing questions from time to time and it would be better for her to hear an answer from a specialist than to look for it on the internet.
What can the gynecologist ask about during the appointment?
It depends a bit on the direction of the medical interview with regard to the state of he alth. First of all, the doctor will ask about the fluctuations in body weight, what is the regularity of the cycles, how long the bleeding lasts, if it is painful. If there are any thyroid diseases in the family, has she checked the thyroid gland when she performed breast ultrasound and cytology, or if there are any intimate ailments, vaginal discharge and pain. And this is the key question - when was the last period. So let's prepare your answer in the waiting room.
Why is it crown?
This is what the doctor always asks. Often, women sit in front of the office, waiting, sometimes it happens that the visit is prolonged, they get nervous. Then it's her turn, I ask when was the last period and she doesn't know. The next few minutes pass as it searches, checks the calendar, finds the application to check the date of the last period.
I see it and it irritates me personally that more patients are waiting now. So it's worth remembering or checking exactly the first day of the last menstruation, because it's 90 percent. the doctor will ask about it. Especially when he has to fill in the details in the referral for a Pap smear.
Can the gynecologist ask about anything else?
I am also asking about bowel movements, because they indicate gastrointestinal disorders. For example, if you experience constipation every few days, then in pregnancy it may be a threat of premature birth. A lot of things come from the way the digestive tract works.
If everything is fine and the woman is not taking any medications, she has no disorders, it is important that she comes to the gynecologist to talk about her he alth. She does not have to sit down in the armchair right away. Not every visit ends with an examination. She should come, find out, see what such a visit looks like. He may be referred for blood tests, hormone levels, ultrasound or other tests based on he alth assessment.
Or even come andto say that everything is fine, but she would like to make sure of one thing, so she asks the doctor to check it out. Such a visit is an interview, usually an examination, cytology collection, possible further referral. And that's it.
(Laughter) So there is nothing to be afraid of?
Of course. A visit to the gynecologist is mainly a conversation. The examination takes a while, taking the cytology takes several seconds. Whenever a patient who came to the gynecologist for the first time leaves the office and I see that the stress has passed, I ask how it was.
What is the most common answer?
Usually he laughs and says it was okay, there was nothing to be afraid of. A gynecologist is not a man who only watches he althy women themselves. My colleagues say that they envy me because I have such a profession, but a gynecologist is first and foremost a doctor who focuses on the symptoms, on finding the cause of problems, because then he is effective in treatment. The specificity of the specialization is truly unique and it requires exceptional delicacy and respect for the intimacy of a woman.
gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones".
www.tadeuszoleszczuk.pl
fb.com / drtadeusz
Read other articles from the StrefaKobiety series:
- Ignorance or maybe ignorance? Why do women die of cancer?
- 20 percent couples deal with infertility. Mostly not the fault of women
- Last menstruation and menopause. How to prepare for it?
- A woman must be he althy before starting contraception
- How to take care of intimate hygiene to avoid infections?
- Allergies - where do they come from? Allergy to semen and condoms
- A couple in the gynecologist's office? Situations in which it is worth coming with a partner
- Gynecologist banning abortion: Let's not condemn women to suffering at risk of losing he alth and life
- Pain in the intimate areas. Is it normal to feel pain?
- Sexually transmitted diseases. How to take care of your safety?
- Polycystic Ovary Syndrome (PCOS), or when the body and mind suffer
- Gynecological visit during a pandemic. What has changed?
- Breasts. What about their appearance should worry us?
- Are you pregnant and afraid to vaccinate against COVID-19? Expert explains why it is worth doing this
- Why is it so long to be diagnosed with endometriosis?
- Endometrial cancer, i.e. a cancer in which lifestyle is important
- Why are uterine fibroids the most commononly observations?
- Gynecologist: People are afraid to name the basic elements of the reproductive system, let alone know what the physiology of the cycle looks like