Healthcare

Did not give birth until 30 – listen to the ticking of the clock. How to recognize a non-professional gynecologist and find a caregiver

In today’s world of “punitive gynecology” women should not face, but, unfortunately, such doctors still meet. There are signs that you can tell that the doctor sitting in front of you is unprofessional. If one or more items describe your usual visit to the gynecologist – change your doctor as soon as possible.

What a gynecologist’s reception should really be

The reception of any doctor, and especially a gynecologist, should be respectful and neutral. Yes, the doctor has to ask a lot of questions, often quite intimate, but he does it to make a diagnosis, not to comment on your personal life. You should not be hurt during the examination, although a slight discomfort is possible.

The professional doctor explains his actions, warns of any uncomfortable manipulations, tells you about your condition, answers all your questions.

If your gynecologist recommends an examination, he should always explain how it will affect the outcome of treatment or diagnosis. Also, the doctor should not insist on one method of treatment – he always talks about the pros and cons of several options and does not resist your desire to hear a second opinion from another doctor.

In order to make the reception time as useful as possible, you should follow simple rules:

  • Think in advance what problems or issues you want to discuss with your doctor, which ones are the most important. Feel free to talk to your gynecologist about all the things that worry you, even if they seem intimate or embarrassing – such as urinary incontinence or pain during sex. These are the same medical issues as any other.
  • Look at the average duration of the cycle, remember when the last menstruation began.
  • If you have had gynecological surgery, find a hospital discharge. If you have already passed many examinations and passed the tests, collect all the documents and arrange them in chronological order. This will make it easier for the doctor to understand your situation, and you will not waste time trying to find the right test.
  • At the reception, ask everything that remains unclear. It depends on how well you understand and remember what the doctor said. Feel free to ask why you have been prescribed tests and medications and what the diagnosis means.

What is important to discuss at the reception

Often women come to the reception with one of the most pressing issues, while others seem less important to them and therefore remain outside the scope of the consultation. However, there are situations that must be discussed with your doctor:

  • You started thinking about pregnancy. In this case, your doctor will advise you on how to properly begin the planning process, and if necessary, appoint an additional examination.
  • You need contraception or you are unhappy with the method you are already using. The doctor will tell you what other types of contraception there are and which ones are right for you.

How often you need to see a doctor

It is enough for healthy women to go to the doctor once a year for a preventive examination: it includes a chair examination and palpation of the mammary glands. Every 3-5 years at a regular examination it is necessary to do an additional Pap test (this is when the doctor takes a smear from the cervix for precancerous cells).

If you have any gynecological diseases, your doctor may recommend more frequent monitoring and additional tests.

How to understand whether to change the method of contraception

If one of the topics you want to raise at a gynecologist’s appointment is contraception, you should also prepare a little for the conversation. For example, find out in advance what the methods are and how effective they are. This way you will be able to discuss the topic more objectively with your doctor, who, based on your preferences, will choose the method that is right for you.

There are no 100% contraceptive methods of contraception. However, some of them are more effective than others, and their use can significantly reduce the risk of unplanned pregnancy.

You can understand how effective a method of contraception is by the Pearl Index (PI): it shows how many women out of 100 will become pregnant on average during a year using this method.

For example, the SP of condoms in ideal use is 2: this means that two women out of a hundred will get pregnant within a year of their use. However, the application of the method in ideal conditions differs from the so-called typical application: in real life, a couple can not use condoms during every sexual intercourse or a man can wear it only at the end of intercourse.

All this reduces the effectiveness of the method – with the typical use of condoms is 13.

What methods of contraception exist

Interrupted intercourse. Yes, it can be considered a method of contraception, although not the most effective – with the typical use of the method during the year unplanned pregnancy will occur in one in five women (IP is 20).

Condoms. This is one of the simplest methods. It has virtually no contraindications, does not require medical advice, and as a bonus protects against sexually transmitted infections. If you use condoms correctly, according to the instructions and during each sexual intercourse, this method effectively protects against pregnancy.

Calendar method. Calculating “dangerous” and “safe” days is suitable mainly for women with a regular cycle. However, the effectiveness of this method is about the same as that of interrupted intercourse – SP is 15-24.

Spermicides. These are substances that destroy sperm before they enter the uterus. The inconvenience is that they need to be inserted into the vagina before sexual intercourse. The efficiency of this method is also small – with the typical use of SP is 28.

Vaginal diaphragm. It is a membrane that is inserted into the vagina, closes the cervix and prevents sperm from entering the uterine cavity. SP in typical use is 12.

Contraceptives, cervical ring, contraceptive patch. These products contain analogues of female sex hormones that prevent ovulation. Their SP with typical use is 7. However, with the ideal use of SP of such methods 0.3: less than one woman in a hundred gets pregnant. That is, if, for example, take pills according to the instructions without passes, their effectiveness will be very high.

IUD. This is a special device that is inserted into the uterine cavity. Spirals are metal-containing (with copper, silver, gold) and hormonal. Metal-containing spirals make the mucus in the cervix more acidic, which reduces the motility of sperm and destroys them. Hormonal substances thicken mucus, thereby slowing down sperm, and also do not allow the inner layer of the uterus to prepare for pregnancy. The spiral is installed and removed by a doctor. Its IP is equal to 0.7–0.8.

Contraceptive implant. It is a small rod that is inserted under the skin of the shoulder and contains a hormone that blocks ovulation. IP equal to 0.1.

Tubal ligation. This is the most radical method, analogous to male vasectomy. Its main disadvantage is that the effect is irreversible: it is impossible to “untie” the pipes if a woman still wants a child. SP is equal to 0.5 (sometimes the tied pipes can fail).

If the couple did not use contraception during sex or the method of contraception failed, you can use the pill emergency contraception – they block ovulation and do not allow the egg to meet the sperm, that is, make conception impossible. Their effectiveness is maximum in the first 72 hours after sex.

Many methods have contraindications, and not every woman can use them without health risks. Therefore, it is always best to consult a doctor to decide on contraception.

“The clock is ticking”

Unfortunately, the ticking clock is not a myth. With age, the likelihood of conceiving and giving birth to a child really decreases – this is due to the fact that a woman is born with a limited supply of eggs, which is spent at each menstruation. Also, with age, the quality of eggs deteriorates – they accumulate “errors” of DNA. In addition, the risk of chromosomal abnormalities of the fetus, ectopic pregnancy, miscarriage and other problems increases.

According to statistics, the age after which the ovarian reserve is significantly reduced – 35 years. But this is an average figure: for some the process happens earlier, for others – later. However, a decrease in ovarian reserve does not mean that pregnancy is impossible.

Despite the fact that the process of “wasting” eggs can not be stopped, they can be preserved: in most major cities in Russia there are clinics that conduct cryopreservation of eggs. This is a good option for women who want to postpone pregnancy to a later date – whether for medical reasons (such as cancer treatment) or social (such as work or study).

However, it is important to remember that with increasing age, the likelihood of miscarriage, premature birth, pregnancy complications, such as gestational diabetes. If you want to postpone your pregnancy, your doctor should warn you about the medical risks. However, at what age to give birth and whether to give birth at all is your business, and if instead of dry fixation of facts the doctor gives inappropriate advice in the style of “it’s time to give birth” and “the clock is ticking” – this is a signal to look for another specialist.

An appointment with a gynecologist can be comfortable if you immediately go to a proven doctor. For example, DocMed specialists diagnose and prescribe treatment based on international standards and proven methods.

Special project DocMed Evidence Clinic and KNIFE Magazine

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