Gynecology includes a complex of tests and diagnostic methods which every woman will have to go through more than once. An examination by a gynecologist is especially important for that category of women who suspect that they have gynecological disease, planning motherhood or preparing to become a mother. Let's look at exactly what mandatory tests and studies are included in an examination by a gynecologist, how they are carried out and what they can show.
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External gynecological examination
External examination is a simple but very important gynecological examination, which is carried out both as a preventative measure and for direct diagnosis of pathology (in the presence of characteristic complaints or symptoms). During this examination, the doctor draws Special attention on all organs located in the anogenital area - the pubis, external and internal labia, anus. After this it is assessed internal state vagina (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.);
- character hairline(sparse or thick hair, condition of hair roots, 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.
During a more detailed examination, the doctor spreads the outer labia and conducts a visual analysis of the condition of the labia anatomical structures, evaluating:
- clitoris;
- inner 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 is required. bacterial culture or smear microscopy. This will allow you to accurately determine the presence of the disease and find out its causative agent.
Gynecological examinations for women and girls are different!
Gynecological examination with colposcopy
During this procedure, a gynecologist examines internal organs women - the cervix, vagina and vulva. The examination is carried out using a special device - a colposcope. A gynecological examination with a colposcope is an accessible and informative procedure. The process is absolutely painless.
When colposcopy is prescribed, contraindications
As a rule, examination with a colposcope is recommended every six months, but it is not mandatory for healthy women. Colposcopy is required if significant abnormalities are detected as a result of the analysis of the LBC smear or PAP test.
Colposcopy is also prescribed if:
- warts in the genital area;
- cervical erosion;
- inflammation of the cervix at any stage;
- suspicion of presence cancer in the vagina;
- uterine cancer;
- significant changes in the shape and size of the vulva;
- cancerous tumor on the vulva;
- precancer, vaginal cancer.
There are no contraindications for this study, but the doctor will not do the examination in critical days and during pregnancy, unless there are 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 health threat expectant mother. Naturally, the examination by a gynecologist will be carried out with special care so as not to provoke a miscarriage.
Preparation for colposcopic examination
Before performing a colposcopy, the gynecologist will give the following recommendations:
- Abstinence from sexual activity, even with a regular partner, for at least three days before the study;
- If there are any diseases or inflammatory processes, the woman is strictly recommended to refrain from treating them with suppositories and other vaginal means. Treatment can be continued after gynecological examination.
- At hypersensitivity for pain, before the examination you can take painkiller tablet. Your doctor will prescribe pain medication.
As for the date of appointment for colposcopy, it is determined solely by the gynecologist.
How is a gynecologist examined with a colposcope?
Colposcopy is a routine gynecological examination with enhanced imaging. It is carried out in a completely non-contact way, using a modern device with a built-in microscope and static lighting, with lenses. Examination by a gynecologist in modern clinic using a colposcope is the norm in Europe!
The device is installed on a special tripod in front of the woman’s vaginal opening. Next, the gynecologist, using a built-in microscope, examines the vaginal tissues under very high magnification, which makes it possible to note even the smallest changes in them. Lighting also helps the gynecologist. The gynecologist, by changing the angle of the light source, can examine scars or folds on the vaginal lining from all angles.
Typically, colcoscopy is performed with a detailed examination of the cervix and vulva. To better examine the surfaces, the gynecologist first removes the discharge using a tampon. Then, to eliminate subsequent discharge, the surface of the cervix is lubricated with a 3% solution acetic acid. If such preparation is not carried out, then, unfortunately, it will not be possible to obtain accurate results. There is no need to be afraid of this moment - the most a woman feels during a gynecological examination is a slight burning sensation in the vagina.
What will an examination with a gynecologist with a colposcope show?
As mentioned earlier, a colposcope allows the doctor to examine even the smallest changes in structure and color epithelial cells vagina, which means it is able to detect any ailments on early stage development.
- One of the most frequent illnesses, which is revealed by examination by a gynecologist with a colposcope - cervical erosion. Characteristic symptoms erosion - uneven coloring, disruption 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 during examination with a colposcope is polyps. These are outgrowths that have different sizes and shape. Polyps are dangerous and can quickly increase in size, so they are removed.
- No less dangerous are papillomas that populate the walls of the vagina. These formations can develop into cancer. Papillomas easily reveal themselves when a 3% acetic acid solution is applied to them - they turn pale.
- During colposcopy, the doctor may see thickening of the inner lining of the vagina, which indicates the presence of leukoplakia. If treatment for this pathology is not started in time, tumors may form on the cervix.
The most dangerous disease, revealed by colposcopic examination during examination by a gynecologist - cervical cancer. If this disease is detected, a biopsy is performed immediately mandatory.
Complications, consequences after a gynecological examination with colposcopy
Colposcopy usually does not cause any complications. The normal condition of a woman after a colposcopy procedure is lungs bloody issues.
In rare cases, one of the bleeding options may occur. In this case, you need to urgently contact a gynecologist. Another unpleasant symptom of incipient inflammation is severe cutting pain in the lower abdomen.
Examination by a gynecologist with biopsy
The most important test prescribed for girls and women in gynecology is a biopsy. Biopsy does not count mandatory analysis during a gynecological examination, and is carried out according to an individual doctor’s prescription. Its task is to confirm or refute the diagnosis of 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
No diagnostics required additional training and involves taking biomaterials from a woman’s internal genital organs. A gynecological examination with biopsy is painless and lasts no more than 20 minutes. The tissues are examined under a microscope in the laboratory. The gynecologist will be able to announce the results of the study only after 2 weeks.
There are about 13 in total 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:
- Incision type - made by scalpel incision of internal tissues;
- Targeted 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. This analysis is taken from the ovaries.
Before the biopsy, you will need to donate blood and urine to exclude complications after the procedure.
Contraindications and complications after a gynecological examination with biopsy
Biopsy performed good gynecologist in sterile conditions, safe. But it also has contraindications. A biopsy cannot be done if it is diagnosed:
- blood clotting disorder;
- internal bleeding;
- allergies to the drugs used - anesthesia, aseptic treatment, 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. In case of cutting pain, usually accompanied by bleeding, the patient should immediately contact a gynecologist for a re-examination.
You will need to abstain from strong activities for several days. physical activity and intimate contacts. If no abnormalities are observed in a woman’s body after this procedure, this does not mean that you can violate the gynecologist’s instructions and not come for a re-examination by the gynecologist.
As you can see, an examination by a gynecologist, even in its minimal form, provides extensive information about women’s health!
Periodic examination is a necessity, and Koshechka.ru authoritatively states: a gynecologist is the doctor you should visit at least once a year, even if nothing bothers you. When there is unpleasant symptoms or pregnancy has occurred, then the schedule, of course, is assigned individually. And today we’ll talk about discharge after examination by a gynecologist.
It should be said right away that a standard examination is a completely harmless procedure that should not cause concern. But there are also reasons why spotting is possible.
Such discharge can indicate anything: from the onset of a disease to medical negligence.
What's in the article:
Why did you start bleeding after the examination?
The gynecologist performed the examination without due care. When assessing the condition of the cervix, the doctor uses a special gynecological speculum with a hard coating. It can easily damage the vaginal mucosa - delicate and tender. Therefore, after examination there may be discharge, usually brown.
The patient may worry so much that she will not be able to withstand even a simple examination calmly, she will begin to spin in the chair or move involuntarily, which again causes injury to the mucous membrane.
Examination with taking a smear. The gynecologist exfoliates the cells of the vaginal mucosa to analyze it. This manipulation is performed when the shell is partially damaged, hence the discharge.
The patient begins menstruation. And then the inspection is just a coincidence. It seems that because of him, light spotting began. However, the last week before menstruation often manifests itself this way. By the way, this is not always good, because such premenstrual spotting can be a sign of a disease. About it -
Contact discharge: cause – disease
Bloody or brown discharge is not always considered normal or inevitable. So, with any pathology, so-called “contact bleeding” occurs. Usually it indicates some kind of disease.
After examination by a gynecologist, spotting may indicate:
- endometriosis - in addition to this symptom, you will suffer from aching pain, which sometimes intensifies during examination or menstruation;
- polyp - especially in the area cervical canal, since there it is easily injured, especially when the gynecologist conducts an examination with mirrors;
- endometrial hyperplasia - when the mucous membrane thickens, cells are easily excreted, and here even minimal mechanical impact, even careful examination can lead to damage;
- erosion of the cervix - often brown discharge can be seen after an examination by a gynecologist, since the epithelium is inflamed during erosion, it can bleed even without touching, and if a gynecologist conducts an examination, then discharge is almost inevitable;
- venereal disease - many sexually transmitted infections occur hidden, but this does not mean that they do not affect health in any way - on the contrary, they only thin the mucous membrane, which makes it especially fragile
- discharge after an examination by a gynecologist also occurs in those who suffer from fibroids;
- at malignant tumor After the medical examination, a few cells with bloody mucus may come out.
In case of miscarriage
Discharge at the initial stage of pregnancy after examination may indicate a miscarriage. Of course, at the very beginning a woman should learn about her situation, although in practice everything is usually different. It happens that the very first week of pregnancy, when even the doctor is unable to detect the fertilized egg, is interrupted due to overly active actions. As a result, the pregnancy may even stop altogether.
Dangers of Gynecological Examination
I don’t want to talk about the fact that a gynecologist can neglect the rules of hygiene and other professional duties. You just have to believe that everything is sterile and clean..
So, discharge, and necessarily bloody, may indicate that the girl has candidiasis, bacterial vaginosis, uterine inflammation.
Sometimes pregnancy, especially with a complication, also causes concern, because after consulting a doctor, spotting begins. But the reasons are not at all harmless. This could be placental abruption, cervical damage, or early birth.
The cause of bleeding can be any factor, not the examination itself. And if discharge appears, then these may be signs of placenta previa.
What to do?
So, the gynecologist has been through, everything seems to be fine, but you have brown discharge, which is why you may be worried.
It happens that those who have not yet become pregnant experience slight pain and slight discomfort due to the fact that the vaginal muscles are still poorly stretchable.
You should definitely go to the doctor again if appeared in the lower abdomen severe pain, the feeling of discomfort only intensifies, a burning sensation is felt in the genitals, the heart beats faster and shortness of breath increases, the temperature rises, there are other impurities in the discharge, which is not just brown, but also with pus.
If it’s not just discharge, but full-blown bleeding that lasts an hour or longer, you definitely need to go to the doctor.
Women who are planning a pregnancy simply need to do this.
But still, don’t worry ahead of time. The doctor will tell you exactly what to do next.
The article was checked by a practicing family doctor, Elizaveta Anatolyevna Krizhanovskaya, 5 years of experience.
It is recommended that girls and women undergo gynecological examinations every year, and if possible, once every six months. But, unfortunately, it is not always possible to do just that. Therefore, sometimes coming to the gynecologist so rarely, some problems begin. One of these problems is spotting or pain in the lower abdomen. This can happen by various reasons and most often this is preceded by certain diseases or careless treatment by the gynecologist.
It is better to worry if blood appears during pregnancy. Because this may be a sign of serious violations.
Why is there spotting after a gynecological examination?
If there are no serious violations, and blood still starts to flow after the examination, this can only happen because the doctor used a speculum. Everyone knows that a gynecological speculum is intended for examining the vagina and cervix. If it is not used carefully, it can damage the vaginal mucosa and, accordingly, provoke light bleeding.
When taking a smear, mucosal cells are scraped off and injury can occur. If after examination the bleeding does not stop as soon as possible, you should consult a doctor again. Perhaps some kind of violation has occurred, and the injury is making itself felt. Or it could be that this is a manifestation of some disease.
In any case, it is necessary to re-examine and make sure that everything is in order or undergo treatment. There are cases when, after visiting a gynecologist, there is a feeling of itching, burning in the vagina and other unpleasant sensations. This also does not need to be tolerated, but it is advisable to immediately go to the hospital.
It is possible that an infection was introduced during the examination. Don't be shy and ask for help.
After the examination, blood began to flow - this is normal.
Quite often there are situations when, after an examination, a woman develops spotting. This may also be within the normal range, because the cervix is supplied with blood, especially during pregnancy. If light spotting appears after the gynecologist, then do not immediately despair.
Perhaps this happened due to slight mechanical damage to the gynecological speculum. Weakening of the walls of blood vessels is not a pathology, it is rather purely individual characteristics. Therefore, there is no reason to worry. Perhaps it is enough to simply change the doctor to a more careful one. Also, normally, pregnant women after examination may experience weak painful sensations during urination. This is also due to the fact that a slight violation could occur during the analysis.
We can say that all bloody discharge or light spotting after an examination by a gynecologist that appears as a result of mechanical damage to the gynecological speculum is normal. There is no reason to worry. Also, do not forget about time, that all allocations must end as soon as possible.
Dangers of Gynecological Exams
As stated above, all gynecological examinations are necessary, and in some cases especially useful. Firstly, all such examinations are designed to take a smear from the walls of the vagina and cervix. Mucosal cells are precisely the substance for laboratory research.
There are cases when, after extremely careless examinations, women experience serious problems accompanied by bleeding and pain in the lower abdomen. In such cases it is necessary urgent help And further treatment. Everything is different for all women, so normally, after examination, symptoms may be observed. discomfort or light ointments. If within a few hours or even days there's blood coming out– scarlet or dark, you should consult a doctor.
Concerning various diseases, then in this case everything is much more complicated. As a rule, the doctor himself must determine the presence of the disease or know about it in advance - from the woman’s medical history. There is also a so-called two-handed examination, during which the doctor examines the position of the organs, their sizes, the presence of the necessary adhesions, as well as the possibility of developing the disease. Unfortunately, even after such an examination, slight bleeding or discomfort in the lower abdomen is possible.
Any intervention can be dangerous, especially for a pregnant woman. Therefore, take the examination of a gynecologist seriously, in particular, the choice of a specialist.
What to do if there is bleeding after a gynecological examination?
First, it is necessary to determine the nature of the bleeding. If the blood is scarlet and smears only a little, then this may not be a cause for concern. IN in this case you just need to relax and lie down a little, which will calm your body a little.
Secondly, you need to determine the bleeding time, or rather its duration. Discharge is allowed after examination on the first day. Anything that has passed on the second or third day is dangerous. In this case, it is better to go back to the doctor. Perhaps a characteristic disorder has arisen or this is how your disease manifests itself.
There are cases when the bleeding is so strong that it is quite similar to menstruation. Then it's better to call ambulance, otherwise you may lose a lot of blood. As a result of the examination, injury to the mucous membrane of the cervix or the vagina itself could occur.
Diseases that appear after examination by a gynecologist
The first case is difficult to call a disease, but it really exists. It's a miscarriage. There are quite a lot of situations when early pregnancy is about 10 days old, the gynecologist himself may not notice this and with sudden movements provoke a miscarriage. Thus, after examination, blood appears, perhaps not immediately, but only on the second day. In such cases, it is too late to engage in treatment.
If you know you are pregnant and after a gynecological examination you experience spotting or nagging pain in the lower abdomen, this is a clear signal of the presence of significant deviations in the course of pregnancy. As for specific diseases, this could be cervical erosion, the presence of papillomavirus, endometriosis and others. Such diseases may well be the cause of spotting after examination. Therefore, it is important to start treatment as quickly as possible.
As for cervical erosion, this disease can occur for a variety of reasons, but you need to seriously think about other diseases.
Symptoms of diseases
In addition to the fact that after examination, if there is a disease, bloody discharge occurs, some symptoms may be characteristic of a specific disease. For example, with endometriosis there is It's a dull pain lower abdomen. Most often this happens after a gynecological examination, and during menstruation the pain is sometimes simply unbearable.
As for blood impurities, they occur with endometrial hyperplasia. It is worth noting that such manifestations can be provoked not only by an examination by a gynecologist, but also hormonal disbalance, excess estrogen, obesity or presence diabetes mellitus. Therefore, before making hasty conclusions, you need to consult a doctor.
The cause of the appearance of blood can be uterine polyps, which consist of endometriotic cells. Such benign neoplasms in the initial stages they do not cause any discomfort and most often do not manifest themselves at all. With a professional examination, the doctor can determine their presence. Symptoms of the presence of polyps may include extramenstrual bleeding, pain in the uterus or after sex, regular delays in menstruation, and others. If you do not get rid of this problem in time, infertility may develop in the future.
All sexually transmitted infections can manifest as itching in the vagina, discomfort in the groin, burning, pain during or after sex, cramps or rotten smell. If you have such symptoms, you should immediately consult a doctor. There are more serious illness, which influence reproductive system and can cause complications. These are chlamydia, ureaplasmosis and trichomoniasis.
Diagnosis of diseases due to bleeding
During heavy bleeding It is very difficult to conduct a gynecological examination, so they resort to ultrasound examination. It does not cause any harm even to a pregnant woman. Using an ultrasound, you can determine the gestational age, the presence of certain pathologies in the uterus or other diseases. This examination is most often prescribed after a routine examination by a gynecologist for the most accurate results. It's kind of comprehensive examination, with which you can determine the whole picture of the course of the disease or a successful pregnancy. Most often, such examination is prescribed during regular brown discharge without any complaints from the woman. This allows you to determine the cause.
Regular gynecological examination every 6 months is the norm modern woman. Regardless of the reason for visiting the gynecologist, a visual examination on the gynecological chair is mandatory procedure. But what should you do if, during pregnancy, after an examination by a gynecologist, spotting appears without any visible reasons. In what cases is this phenomenon dangerous, and in what cases is it an unnecessary cause for concern? You can draw a conclusion by understanding probable reasons their appearance.
Purpose of gynecological examination
From the moment of the onset of physiological maturity, girls are required to undergo preventive examinations at the gynecologist. With the onset of sexual activity, this rule should become the norm. However, most women do not pay due attention to this fact. If there are no complaints about reproductive function they may not visit their doctor for years, even if they have unpleasant symptoms. The main reason for this behavior is the banal attribution of illness to premenstrual syndrome.
The observation of a pregnant woman deserves special attention. From the moment pregnancy is established, regular consultations with a gynecologist must be attended according to the schedule suggested by the doctor. Observing a woman as her pregnancy progresses, the gynecologist collects data on age, presence systemic diseases, previous pregnancies (births), evaluates general state body.
After registration at the antenatal clinic, examinations in the gynecological chair are carried out by the attending physician according to the indications. Understanding the responsibility for the likelihood of injury to the cervical canal and the risk of miscarriage, gynecologists resort to vaginal examination only in special cases.
A gynecological examination poses a certain danger in the following cases::
- cervical incompetence;
- previous miscarriages at any stage of pregnancy;
- any bleeding of unknown etiology;
- threat of termination of a real pregnancy.
In such cases, the doctor conducts a careful examination in compliance with the necessary safety precautions. Competent actions by the doctor will help avoid bleeding and other complications after a gynecological examination during pregnancy.
Causes of bleeding
Normally, every woman has vaginal discharge, regardless of age. They may be clear or slightly whitish. Their natural physiological consistency and light shade are given by lactobacilli, leukocytes, squamous epithelium and other microorganisms that represent the microbial landscape of the vagina.
Discharge during pregnancy changes somewhat as the period increases. In the first trimester, thickening of cervical mucus is observed. This phenomenon is due to increased production of progesterone. Viscous mucus prevents infection of the fertilized egg. From the second trimester, the discharge begins to change. They become more liquid due to the dominant effects of estrogen. Just before the start labor activity a mucous plug with bloody streaks comes out. Due to the presence of blood, women may mistake them for an abnormality.
Bloody discharge after examination by a gynecologist occurs quite often. This phenomenon does not always indicate a real danger, but it is exciting and requires additional consultation with a gynecologist.
Among the main reasons for the appearance of blood in the discharge are the following circumstances:
What is a cause for concern?
Minor bleeding observed after a gynecological examination usually ends within 24 hours. It is not dangerous, but always requires supervision. If this happens, then the next visit to the gynecologist begins with a discussion of this issue.
However, there are circumstances that indicate immediate appeal for medical care. These include:
- increased vaginal discharge mixed with scarlet blood;
- the appearance of blood clots in vaginal discharge;
- discharge continues to smear for more than 3 days;
- appeared bad smell, color has changed (yellow-green or brown);
- increased body temperature;
- itching in the intimate area;
- the appearance of pain of varying intensity in the lower abdomen and lumbar region;
- disturbance of general health (nausea, vomiting, fainting);
- premature release of the mucus plug;
- the discharge has become watery and profuse;
- slowing down or increasing fetal activity (relevant after 24 weeks).
If these symptoms appear, the help of a qualified specialist will be required in any case. Attempts to independently eliminate unpleasant symptoms threaten the development of complications and termination of pregnancy. In most cases, women are hospitalized. A complex approach to eliminate pathological condition under the guidance of an experienced specialist will reduce the risk of adverse events.
First aid
If a woman notices a deterioration in her health or bleeding, the following measures must be taken:
- call emergency medical assistance;
- limit physical activity;
- maintain bed rest;
- prepare a change of hygiene products (gauze or synthetic pads);
- observe drinking regime to prevent fluid loss in blood vessels;
- a cup of sweet coffee will slightly increase your blood pressure;
- Dydrogesterone, taken in a single dose of 40 mg, will prevent miscarriage;
- take antispasmodic drugs orally or in the form of suppositories (No-spa, Viburkol, belladonna extract).
After admission to the hospital department, the patient will be examined:
- colposcopy - examination of the cervix under magnification - to detect erosion, polyps and other conditions;
- Ultrasound of the pelvic organs to exclude pathology of the placenta;
- CTG (after 32 weeks) to assess the condition of the fetus.
After the examination, the following therapy will be prescribed:
- intravenous administration of a solution of glucose and sodium chloride is indicated for severe blood loss and a sharp drop in blood pressure;
- intravenous or intramuscular injection Vikasol solution is included in the composition complex therapy to prevent blood loss;
- appointment hormonal drugs according to indications.
Further treatment tactics depend on the cause of the pathological condition. Complex diagnostic measures will answer what contributed to this phenomenon.
Bloody discharge that appears after examination on the gynecological chair does not always turn into bleeding. However, it is exciting and requires attention. To eliminate unnecessary worries, you will need additional consultation attending physician.
