How can a teenage girl get examined by a gynecologist? What you need to know about a pediatric gynecologist.

Both boys and girls reproductive system closely related to the urinary system, thanks to this appearance external organs is an indicator of whether everything is in order inside. But even the norm can have variations, and small deviations quite acceptable in children.

Even a cursory examination of the baby’s genitals can tell the doctor whether everything is arranged correctly in the “neighbors” - for example, is it displaced? bladder or ureters. And some conditions can be easily noticed by parents. The main thing is to remember that in such a delicate area as the genitals, there are many “variations” and not all of them deserve concern, and many go away on their own.

BOYS...

Violations in the “device” genitourinary system are more common in boys than in girls, but it is also possible for them more options norms. For example, representatives of the stronger sex are usually born with two testicles. But sometimes, by the time of birth, only one testicle has time to descend into the scrotum, and the second testicle reaches its place by one year. This is completely normal, but if the situation does not change by the due time, you need to show the child to a specialist.

Immediately after birth, many babies experience slight deviations in the structure of the penis. For example, in newborns it is impossible to move the skin on the head (foreskin). This is a natural condition and you should only see a doctor if foreskin inflamed. And sometimes it is split: it does not cover the entire head completely, but lies on top, like a hood. This phenomenon can also be a variant of the norm, but it is better to show the boy to a urologist.

But if during the boy’s “small toilet” a stream of urine flows not from the center of the head, but from somewhere on the side, this is a reason to quickly consult a urologist. The baby may have an incorrectly positioned hole. urethra.

IF YOU THINK THAT YOUR BABY HAS A DISTURBANCE IN URINATION OR HIS GENITAL ORGANS LOOK “WRONG,” BE SURE TO CONTACT A SPECIALIST - A PEDIATRIC UROLOGIST OR.

...AND GIRLS

It is not easy to examine the girls’ genitals because they are so tiny. The structure of the labia majora and labia minora will tell the mother if everything is okay with the baby. The labia minora are inside the labia majora and should move apart easily. If this fails, adhesions may be the cause. Sometimes they go away with age, but in any case, the baby should be shown to a pediatric gynecologist.

In newborn girls, as well as in boys, it happens that the opening of the urethra chooses the “wrong” place for itself (for example, it may be in the vagina). In this case, it is again enough for parents to observe the stream of urine during urination. You need to see where it is flowing from, and if everything happens naturally, you don’t have to worry

A visit to a gynecologist causes excitement among girls, especially if they are virgins and are being examined for the first time. If the girl has not had sexual intercourse and the hymen is intact, then the doctor’s examination is somewhat different. To avoid problems, you should prepare for the examination. There are certain rules that should be followed before and during a visit to the doctor.

What to do before the inspection

It is advisable to go to a gynecologist for the first time at the age of 12-15 years. You should not have a negative attitude towards the examination or be afraid. Fear main reason inconvenience during the examination. Before going to the doctor, you should prepare yourself psychologically and physically.

The girl should understand that a gynecologist is a doctor, and his main duty is to provide medical care. He is only interested in the patient's health. A highly qualified gynecologist will provide the girl with information about the state of her body and provide assistance in detecting pathologies.

There is no need to worry and worry once again; an examination by a gynecologist is important for maintaining a healthy reproductive system. During the examination, there is no need to be ashamed or look for excuses.

You don't have to shave your hair before going to the doctor. For a gynecologist, it does not matter whether a girl has shaved intimate place. Before visiting the doctor, you need to wash yourself and put on fresh clothes. underwear. It is advisable to shower the evening before the examination. It is not recommended to wash yourself several hours in advance, since it is important for the doctor to examine the natural microflora of the vagina, and water washes away secretions indicating an inflammatory process.

It is not advisable to visit a gynecologist during menstruation, this will complicate the examination, and the girl will have to come to the doctor again. Optimal time visit - 3-5 days after the end of menstruation. The exception is the situation when complaints arise during menstruation.

If you are taking antibiotics, you should not visit a gynecologist.. It is recommended that the examination be carried out two weeks after the end of treatment, because the drugs affect the test results.

Before going to the hospital, you should purchase a clean sheet or towel to put on your gynecological chair. It is not prohibited to bring your own disposable kit, which is sold at the pharmacy. It is worth ensuring that the doctor uses sterile instruments and opens them during the procedure. If there are suspicions that these rules have been violated, the girl has the right to refuse the examination. It is better to visit another doctor than to allow your body to become infected.

If the girl has no health complaints and the examination is carried out as a preventive measure, during the first examination the doctor will make do with a conversation. The gynecologist is interested in the following questions:

Has the girl started her period, how long does it last, and have there been long breaks between cycles? Be sure to clarify the regularity of the cycle, sensations during menstruation and between them.
Does the girl have any complaints about discomfort in the reproductive system (pain, itching, burning, problems with urination).

When a virgin is first examined by a gynecologist, it is necessary to clarify that there was no sexual intercourse and that the hymen is intact. You should speak openly and answer questions clearly so that the gynecologist has a correct idea of the functioning of the reproductive system.

The received data is recorded in medical card, no one except the doctor and the patient has access to them.

The doctor may suggest examining the girl in a gynecological chair during the first appointment. The procedure is necessary for virgins, since gynecological diseases occur regardless of whether sexual intercourse has occurred.

The doctor needs to make sure that the patient’s genitals are normal, development is happening correctly, and there is nothing to worry about. If a virgin is very worried at the gynecologist, the mother is not prohibited from being present in the office during the procedure.

Regardless of the structure of the chair, the girl’s position in it is lying down or reclining, her legs are in a half-bent state on special stands. During the examination on the gynecological chair, the girl may experience discomfort, as it is necessary to remove her panties and spread her legs.

The gynecologist examines the labia for inflammation. To avoid damage to the hymen, the doctor does not perform deep research vagina. To collect information about the elasticity of the vaginal walls and the condition of the internal genital organs, the doctor performs an examination following method: he inserts a finger into the rectum through anal hole. The procedure is unpleasant, but does not cause pain to the girl.

If the patient has complaints of discharge, itching, burning in the genital area, the gynecologist will need to take a smear for the flora. During the procedure, the doctor uses fine instruments to keep the hymen intact.

It is also carried out if there is suspicion of oncological diseases, bleeding or presence foreign object, stuck inside.

The doctor will need to examine the patient's condition: blood pressure, height, body weight, skin condition. Palpation is required thyroid gland, since she is responsible for the work female hormones subject to changes throughout life. A girl should also be prepared for the fact that after checking her genitals, the doctor will insist on examining her breasts. It is recommended to wear clothing that can be easily removed in pieces.

It is not true that virgins do not need to be examined by a gynecologist. The girl is recommended to visit a doctor for preventive purposes. Virgins, like women, develop gynecological diseases that develop without obvious symptoms, and the sooner they are identified, the easier the treatment will be.

A gynecological examination of virgins does not cause pain. On the first visit, the procedure is unpleasant, mainly due to the girl’s anxiety. If pain occurs during the doctor's actions, you should immediately inform him about it.

Don’t be embarrassed that someone finds out about your visit to the gynecologist. Qualified doctors store all information about their patients without showing it to strangers. It is recommended to choose the attending physician in advance to be sure that he will not be rude or hurt.

Situations in which a visit to a gynecologist is mandatory:

suspected genital tract infection (pain, itching, burning sensation in the vagina);
genital tract injuries;
spotting not associated with menstruation;
menstrual irregularities;
pain in the lower abdomen or any other discomfort;
delayed sexual development (absence of secondary sexual characteristics after the age of 14 years or menstruation after 17 years);
pregnancy or suspicion of it.

The examination does not take more than fifteen minutes: during this time, the doctor will make sure that the girl’s genitals are normal, or, on the contrary, will give recommendations if she discovers pathologies that the patient did not suspect.

A pediatric gynecologist is a specialist involved in the treatment and prevention of diseases of the reproductive system of girls.

Competence of a pediatric gynecologist

Examines organs such as the uterus, fallopian tubes, vagina, vagina and thyroid gland in girls. The specialist sees patients under the age of 16, and then they are referred to an adult gynecologist.

His responsibilities include:

Conducting a preventive examination of the genital organs.
Treatment and prevention of diseases of the reproductive system.
Identification of congenital and acquired pathologies of organ development (adhesions, absence or fusion of the hymen, urethral tumor).
Detection infectious processes genital tract.
Preparing patients for puberty.

The main difference between a pediatric gynecologist and an adult is that the former specialist is familiar with the specifics of working with young patients. Taking into account psychology and pediatrics, he conducts the appointment more delicately.

Diseases diagnosed by a doctor

A pediatric gynecologist treats the following diseases:

Vaginitis or vulvovaginitis, i.e. lack of protection of the genital organs from infections due to thin mucous membranes.
Synechia, i.e. fusion of the labia minora and labia.
Thrush. Most often occurs in children under three years of age. Transmitted from the mother during childbirth.
Urinary incontinence.
Inflammatory processes.
Juvenile bleeding.
Infections. Common cause is the friction of the perineum with dirty hands.
Inflammation of the uterine appendages.
Cystitis. It is a consequence of hypothermia or intestinal dysbiosis.
Hormonal imbalances in newborns and girls during adolescence.
Neoplasm in the genital organs of a malignant and benign nature.

When is it necessary to visit a pediatric gynecologist?

Indications for going to the doctor are the following symptoms:

The appearance of itching and burning of the genitals.
The presence of discharge of various types.
Painful going to the toilet.
Cloudy urine.
Bleeding.
Stains on panties.
Injury to the genital organs.
Increased sweating.
Excessive hair growth.
Unpleasant smell.
Changes in the shape of the mammary glands - their swelling, retracted nipples, redness.
The onset of menstruation before the age of 11.
Early onset of puberty (before 12 years of age).
Frequent pain in the lower abdomen.
Redness and inflammation of the genitals.

Often, childhood diseases do not manifest themselves as clearly as in an adult woman.

An examination by a pediatric gynecologist is necessary to identify pathologies affecting the disorders. reproductive function in the future.

If one of the problems is detected, it is urgently necessary to ! Since this can cause serious harm to the girl’s health.

In this video, the doctor explains why you shouldn’t be afraid of going to the gynecologist, and what the consequences of ignoring the problem may be:

Initial appointment

Examination of girls is carried out routinely at the ages of three, seven, twelve, fourteen and seventeen years.

An extraordinary trip to the doctor is a reason before entering the hospital. kindergarten, in the first grade of school, after graduating from primary school.

The purpose of the intake is prevention, early detection and exclusion of diseases of the genitourinary system.

How is the appointment going?

At three years old the baby is examined as follows:

The specialist visually examines the labia, anus, and clitoris. Gives overall assessment condition of the external genitalia, physique and physical development. Instrumental examination is not carried out.

The gynecologist may inquire about the birth procedure and the child’s complaints.

An examination of a seven-year-old girl by a gynecologist before school is characterized as follows:

IN horizontal position on the couch the doctor looks at the vagina, labia and anus. Also conducts a survey on hygiene.

Examination of a 12-year-old girl involves palpation through the rectum. Within a minute, the doctor determines the condition of the uterus and appendages.

At this age, signs of puberty appear. Some patients begin menstruation and breast growth, so a conversation is held on the topic of changes in the body. The doctor notes pain on palpation and bloating.

If required, a referral for vaccination against human papillomavirus is issued.

At the age of 14, the examination also takes place visually. The doctor conducts a conversation on the topic of preventing the onset of sexual activity. During the survey, answers to questions such as the presence of additional discharge, pain are recorded. lower third belly.

If necessary, an ultrasound of the pelvic organs is prescribed to identify developmental anomalies and disorders. anatomical structure genital organs, as well as discrepancies between the size of organs and age. If you suspect inflammatory process are appointed laboratory tests- analysis of stool, urine, vaginal smear. In order not to damage the hymen, the sampling is carried out using the finest disposable devices.

It is worth noting that all manipulations take place in the presence of a parent if the child is under 15 years of age. After this age, the girl makes her own decision and agrees to undergo a gynecological examination in a chair.

In addition to the examination, an appointment with a pediatric gynecologist involves a preventive conversation. The doctor tells the child the rules of hygiene intimate area, armpits and mammary glands, prepares for the onset of menstruation, gives advice on caring for the intimate area.

Researcher, obstetrician-gynecologist, founder and head of the International Academy Healthy Life(International Academy of Healthy Life), Toronto, Canada.

IN recent years placing a child in kindergarten and school becomes an extremely serious headache due to the need to collect huge amount“papers” about the child’s health status involving large quantity specialists.

Elena Petrovna Berezovskaya,
obstetrician-gynecologist,
founder and director
International Academy of Healthy Life

What is required of parents in such cases in most countries of the world? Just a certificate from the family doctor or pediatrician stating that the child:

vaccinated according to country/region
the child has no contraindications for attending school or preschool, or does he need specialized assistance ().

And nothing more. It's that simple. This means that the opinion of other specialists is not required. Why? Because there are practically no contraindications for children to attend kindergartens and schools, with the exception of the child having a disease at a stage that threatens his life or the health and lives of other people. For example, at the time of registration of documents for kindergarten, the child has measles or another acute infectious disease. Not necessarily an infection, but in general - the child suffers from a disease that usually requires treatment in a hospital.

They often require special assistance for the care and maintenance of their health, which means that if a kindergarten or school is not equipped to work with such children, then they have the right to refuse to admit the child. Although abroad, very often such children attend ordinary kindergartens and schools, sometimes accompanied by a parent, nurse, or assistant.

When is a specialist examination required?

Only if there are indications that determine family doctor or pediatrician. In other words, the doctor can put the “Healthy” label in the conclusion of the certificate when he sees absolutely no deviations that require the involvement of specialists. And this is where “going to doctors” should stop. That is why he is a family doctor or pediatrician, to make conclusions about the health status of children who come to see him.

It sounds strange when they take you to the pediatrician completely healthy child to obtain a certificate, he sees that the child is indeed “normal” (healthy!), but is afraid to give out his own conclusion - the pediatrician’s conclusion that, from his pediatric point of view, the child is healthy, and he sends the child and mother to specialists, because without them signatures will not sign the certificate either. A rare absurdity that does not exist either in Europe, or in Australia, or in North and South America.

Unfortunately, referral to specialists just for the sake of collecting signatures is a manifestation of “overreaching,” that is, arbitrariness.

Even the orders of the Ministry of Health clearly indicate that examination by specialists is required only when indicated, which includes making a diagnosis in the presence of complaints or signs of disease.

This means that if a girl comes to the pediatrician and she has a strange bulge in the lower abdomen, which, although it does not bother her, is not a sign of normality, then in this case the doctor should recommend an examination by a gynecologist to rule out a tumor of the pelvic organs. Although in general, this condition is not a contraindication for admission to kindergarten or school. Therefore, it doesn’t matter what the gynecologist writes, it should not affect the conclusion: “Healthy for kindergarten/school.” A girl with a tumor can go to kindergarten, because the issue of treatment or observation is the prerogative of the parents.

At what age is a girl examined by a gynecologist?

Now let's talk about gynecological examinations girls, which has become a certain fashionable extortion in clinics and consultations.

The most is carried out by a neonatologist (pediatrician) in the maternity hospital, examining the external genitalia almost immediately after the birth of the child. And this examination is enough to ensure that the healthy girl’s next visit to the gynecologist is not ahead of the attack, that is, in 13-15 years.

In the past, in most countries of the world, examination by a gynecologist was not recommended until sexual activity began or the age of 18 in the absence of complaints. Most doctors still adhere to these recommendations. The American College of Obstetricians and Gynecologists (ACOG), as well as professional societies of obstetricians and gynecologists in other countries, recommends the first visit to a gynecologist at 13-15 years of age. In most cases, such a visit will end with a routine questioning without a gynecological examination.

And who then examines girls up to this age? Most often, there is no need to “get into your pants” and examine the external genitalia of girls without strict testimony No. If complaints appear, if any disease occurs that affects the functioning of the pelvic organs, if there is a suspicion of, then the first examination is carried out by a family doctor or pediatrician. They are obliged (and this is usually what happens in all countries):

Know what changes occur in newborns after childbirth (nipple thickening, vaginal and nipple discharge) and explain this to parents if they are concerned.
Know how to correctly diagnose, how to manage and observe girls with such a diagnosis, explain to parents that in 80-90% of cases no treatment is required, because synechiae will go away on their own, that treatment is very rarely required hormonal ointments that it is enough for parents to maintain girls’ hygiene and monitor their behavior.
Know what nonspecific vulvovaginitis is, explain to parents that it is enough without any treatment, what it is common occurrence after colds, overheating, with helminthic infestations.
Know what the signs are and refer your child for testing if necessary.
Know the signs of sexual violence and take appropriate measures to determine the presence of this type of violence.

Pediatric gynecologist - who is he?

Foreign pediatric gynecologists are a rare specialization, and the number of specialists is determined by the needs of the population, as well as the level of prevalence gynecological diseases in girls. The most common category of patients of such doctors are teenage girls. Therefore, the majority of pediatric gynecologists around the world, both in the most developed countries and in the most backward ones, deal with issues of adolescent gynecology.

Younger patients are referred to such specialists if they have tumors in the pelvis, discovered by chance or during examination, the appearance of pronounced signs early puberty, the presence of malformations of the urogenital organs, when there are problems with urination, after trauma to the perineal area and less often for other indications.

Why did so many pediatric gynecologists “divorce” in post-Soviet countries, like in no other country in the world? This is due to the distortion of policies for improving the health care system. The state allocated money for the development of those branches of medicine that were in an extremely neglected state. Among them are genetics, hematology and pediatric gynecology. This made it possible to create many positions for these specialists, where the overwhelming majority of doctors got jobs through connections, through acquaintances and bribes.

Since these subjects were practically not touched upon in medical institutes, with the exception of several hours of lectures, then, accordingly, there are practically no progressive specialists.

But there are positions filled with doctors, and in order to receive a larger budget from the state, it is necessary to create the appearance of doctors being busy (they won’t sit all day without patients). Therefore, as a directive, patients are now referred to hematologists, geneticists, and pediatric gynecologists without any indication.

Hematologists prescribe an expensive examination for all pregnant women and those who have lost their pregnancy. thick blood"and such dangerous drugs, like heparin and aspirin. Geneticists are searching in collaboration with hematologists and obstetricians, so that later this trinity can “treat genes” for a long, long time.

And pediatric gynecologists require visits from frightened and intimidated mothers to examine girls almost every month. And, of course, they intimidate and provoke unnecessary bacterial cultures vaginal discharge, they take a long time to treat the discharge that they “don’t like” and the redness of the perineum, they try to separate the labia minora with their fingers (and most importantly, not even in the place where their fusion carries a certain risk).

Thus, in the reports of clinics to the state in order to receive a new portion of the budget, there is a bold tick indicating the full employment of all specialists. Although a lot of money is siphoned out of the pockets of the patients themselves. And what mother would spare money, even her last, to “save” her child?

What parents should know about a girl's gynecological examination

Examinations of the child(ren) cannot take place without the presence of one of the parents, up to 14-15 years of age, when a teenager has the right to confidentiality of examination in most cases.
None of the examinations, including those by specialists in kindergarten or school, are mandatory. If a child feels unwell, they must inform the parents about this, and then decide what to do next. If in children's institution source detected dangerous infection, it is also necessary to inform parents about this and obtain their permission to conduct an examination if necessary.
Refusal to be examined cannot be a reason for expulsion from kindergarten or school. There must be serious justification for such an action.
The examination of the child should not be carried out in the presence of other children and people. In reality, educators and teachers do not have the right to know what a child is suffering from if it does not concern the safety of other children and adults. Any findings during the examination should be discussed by doctors only with parents (guardians), and no one else.

How is a gynecological examination of a girl performed?

How is a gynecological examination carried out if you still had to forcibly visit a pediatric gynecologist (although nothing can be forced)? The doctor should first ask one of the parents (usually the mother) a few questions. If there are no complaints, then the trip to the doctor may end. Undressing the child and examining his genitals in such cases is completely unnecessary. If the doctor finds signs of possible sexual abuse (bruises, scratches on the skin, withdrawal and fear in the child, etc.), he may suggest examining the external genitalia.

Since it is impossible to carry out a manual (digital) examination through the vagina in girls, it is carried out through the anus. However, such an examination can be very uncomfortable and even painful. IN in rare cases anesthesia is required.

Thus, a healthy girl does not need gynecological examinations until the onset of menstruation and even later in the absence of complaints.

For women who grew up in endless conditions preventive examinations(which turned out to be completely irrational) and the eternal search for diseases, in constant fear“to miss something, such recommendations may seem strange, unacceptable, harmful. But since Ukrainian society is aligned with the West, accepting the progress of Western technologies and electronics, fashion, and new household items into its life, then it’s time to accept progress western medicine Same. Health to you and your girls!