Examination by a gynecologist: everything about a gynecological examination

Gynecology includes a complex of tests and diagnostic methods that every woman will have to undergo more than once. An examination by a gynecologist is especially important for that category of women who suspect they have a gynecological disease, are planning motherhood, or are 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

The content of the article

External examination is a simple but very important gynecological examination, which is carried out both as a preventive measure and for direct diagnosis of pathology (in the presence of characteristic complaints or symptoms). During this examination, the doctor pays special attention to all organs located in the anogenital area - the pubis, external and internal labia, anus. After this, the internal condition of the vagina is assessed (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.);
the nature of the hairline (sparse or thick hair, condition of the 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 external labia and conducts a visual analysis of the state of the genital anatomical structures, assessing:

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 indicate some kind of disorder in the woman’s body. In such a situation, an additional bacterial culture test or smear microscopy is required. This will allow you to accurately determine the presence of the disease and find out its causative agent.

What to tell your doctor

The girl will have to discuss intimate moments with the gynecologist and demonstrate her genitals. For emotional comfort, it is better to consult a female doctor to remove unnecessary constraint and achieve maximum relaxation.

At the first visit, the doctor fills out a patient card, which includes information about:

the beginning of the menstrual cycle;
periodicity of menstruation;
complaints;
past urological diseases;
sex life;
methods of protection.

You need to report gynecological or urological diseases of a chronic nature, past illnesses, thrush, cystitis or allergic reactions to the external genitalia. Any discomfort in this area may indicate the presence of a developing pathology.

If a girl plans to become sexually active, you can also talk to your doctor about this. The specialist will competently answer all your questions and tell you about the specifics of defloration.

Gynecological examinations for women and girls are different!

Girls also make an appointment with a gynecologist. External gynecological examination for girls who have not begun sexual activity and women who have lost their virginity will vary. There are 3 options for examination: recto-vaginal, vaginal and rectal. As for the first two, they are capable of providing many times more information than the last, but, as you understand, they are not suitable for teenagers.

For an experienced gynecologist, an external examination of the genital organs can provide extensive information regarding the structure and development of the genital organs, diseases associated with changes in the skin and mucous membranes, discharge, etc.

During an external gynecological examination, hypoestrogenism is easily detected. When it occurs in a woman, the doctor will be able to observe a clear pallor of the labia majora and minora, which is most often accompanied by increased dryness of the mucous membrane of the vagina and uterus.
Another common pathology that can be detected through external examination is a significant increase in the amount of estrogen in a woman’s body. During the course of such a disease, as a rule, there is an increase in the humidity of the vagina and vulva. Sometimes the mucous membrane changes color.
The color of the mucous membrane can also indicate pregnancy - the longer the period, the brighter the vaginal mucosa looks. This is due to blood flow and hormonal changes in the body.
A rare disease that can be detected by external examination of the genital organs is hyperandrogenism. It is usually characterized by a significant increase in the size of the clitoris, and its noticeable distance from the urinary canal (more than 2 cm from its previous location). This pathology may be accompanied by pronounced hypoplasia of the inner labia. Such clinical manifestations of the disease are very similar to the manifestations of a virilizing tumor, which can pose a much greater danger to a woman’s health.
Condylomas, examination inflammations, injuries to the mucous membrane and genital organs, ulcers, etc. are clearly visible during an external gynecological examination.

Features of examination by a gynecologist after childbirth

If the patient undergoes an external genital examination of the genital organs immediately after childbirth, then the doctor, first of all, pays attention to the structure and condition of her perineum. After childbirth, damage to the pelvic floor muscles or significant stretching of the vaginal walls are often observed.

With such deviations in a woman’s body, the doctor will observe a stable open state of the genital slit. As a result, this feature can lead to prolapse of the uterus from the vagina when it is tense. Violation of the integrity of the pelvic muscles also leads to periodic involuntary emptying of the bladder in a woman - urinary incontinence. In this case, a timely examination by a gynecologist can protect you from major problems in the future.

Why should you choose MEDIONA PARNAS?

Professionalism of the staff.

The doctors of the multidisciplinary clinic “MEDIONA PARNAS” have extensive experience in the field of gynecology. Constantly improving their professional level allows specialists to achieve significant success in their activities.

Modern equipment.

The clinic’s high-tech equipment helps doctors diagnose any, even the most minor, disturbances in the functioning of a woman’s reproductive system, which can subsequently lead to serious health problems.

Individual approach.

The activities of MEDIONA PARNAS employees are based on the principles of responsibility and attentive attitude towards each patient. Before prescribing treatment, doctors carefully study the clinical picture and select methods taking into account the structure and functioning of the woman’s body.

Internal inspection

The subsequent examination is an internal gynecological examination, which is mandatory for all women. It includes a detailed study of the condition of the uterus, cervix, and vaginal mucosa. Upon examination, the doctor sees:

Discharge
. They can be transparent, white, mixed with blood or in the form of pure blood, odorless, odorless, foamy, etc. The gynecologist necessarily takes a smear and sends the analysis for examination.
Significant anatomical defects of the uterus
. Depending on their nature (congenital or acquired), their effect on reproductive function and the possibility of treatment are determined.
Inflammation, tumor
. In addition to changes in the anatomical structure, during an internal gynecological examination, the doctor can visually notice foci of inflammation or small tumors, which clearly indicate serious disorders. However, it should be noted that many symptoms are similar in different gynecological diseases, therefore, to clarify the problem, various tests and additional examination are used, for example, if cancer is suspected, a biopsy will be required.

Previously, it was believed that pathology could be determined simply by discharge. This is how oncology, cervicitis, and benign tumors were calculated. Modern gynecologists prefer to use accurate diagnostics - tests, ultrasound and other methods.

Instruments used by a gynecologist for internal examination

An examination by a gynecologist is carried out using special mirrors, which differ in design and purpose.

Paderson mirror. It is used for those categories of patients who have an active sex life.
A more versatile mirror is the Cusco mirror. It has a folded shape.
Grave's Mirror. In fact, it is no different from the Cusco mirror: neither in design nor in efficiency.

All of the above mirrors used for internal gynecological examination are carefully sterilized in special devices - sterilizers. Therefore, when visiting a good clinic, you don’t have to be afraid of picking up an infection. Nowadays there are also disposable mirrors. They are more often used for examining women with a known dangerous infection or for gynecological examination of patients with low immunity. Also, any woman can buy a disposable gynecological kit at the pharmacy and bring it with her.

When performing a procedure for examining the cervix, the doctor selects the smallest speculum and inserts it into the vagina at an oblique angle. Approximately halfway through the length, the mirror is stopped and turned so that the gynecologist can clearly see the surface of the uterus. When the correct angle is achieved, the vaginal gynecological instrument is fixed in the required position. Mirrors are used not only to examine the uterus, but also to perform operations on it.

When examining the vagina from the inside, using a speculum, the doctor evaluates criteria such as:

general condition (are there any defects in the cover, violation of the integrity of the shell, folds of different sizes, etc.);
color of walls and mucous membrane;
changes in vaginal anatomy;
presence of tumors (any type);
shape and size of the cervix;
the presence of discharge of any character and color;
the presence of cervical tears, uterine defects.

Using a mirror, the doctor will be able to visually observe multiple polyps. Such formations are removed.

Don't forget to prepare for the inspection

Before going to the doctor, you should prepare:
• if the girl is not sexually active, then before the examination it is worth emptying her bowels, since the doctor will palpate the rectum; • if a girl is sexually active, then a day before the examination she should refrain from intimate contacts; • before visiting the office, you must wash yourself and empty your bladder.

a diaper and disposable gloves with you

. If the girl has already had sexual intercourse, then she will need a disposable gynecological speculum.

Bimanual examination by a gynecologist

The third type of gynecological examination, which is carried out for every woman, involves palpating formations on the walls of the vagina, uterus and periuterine tissue. You can also evaluate the condition of the uterus itself.

A bimanual gynecological examination is carried out as follows: the doctor penetrates the vaginal opening with two fingers, and with the other hand, from the outside, gradually presses the groin area, pressing the inner walls against the fingers located in the vagina. With the help of this examination, the doctor can easily determine the condition of the woman’s arches (whether they are thickened or, conversely, narrowed).

For a detailed examination of the condition of the uterus, the doctor inserts one hand into the vagina and the other into the anus, pressing the walls of both anatomical passages against each other. This allows the doctor to determine the size and shape of the uterus, as well as the presence of any defects or tumors on it.

Why is it better to consult a gynecologist at Swiss-Clinic?

In our Center you can undergo a comprehensive gynecological examination and treatment (both conservative and surgical) of detected diseases, which significantly saves patients’ time.
When diagnosing several diseases of the pelvic organs and peritoneum in our clinic, it is possible to perform simultaneous (simultaneous) operations, when the patient gets rid of a whole “bouquet” of diseases during one surgical intervention.
In our clinic, to diagnose diseases, we use the most effective examination methods, which are successfully used in the best European clinics: video colposcopy, hysteroscopy, ultrasound, diagnostic mini-laparoscopy, etc. It is also possible to take biological material for a biopsy followed by histological and cytological examination.
Our clinic is equipped with the most modern expert-class equipment produced by leading global companies.
If necessary, each patient can count on consultation with other specialists who are also seen at our Center: endocrinologist, mammologist, urologist, surgeon, etc.
Among the doctors of our Center there are only experienced specialists, many of them are known for their skills in domestic and foreign clinics.
When diagnosing diseases that require surgical treatment, our surgeons will do everything possible to perform an organ-preserving and low-traumatic operation; thanks to the innovative techniques used, the recovery period is minimal.
Our clinic practices only an individual approach to each woman; we can treat both sexual partners.

Normal indicators of the uterus during examination by a gynecologist

In normal conditions, the length of the uterus is up to 7 cm if the woman was not pregnant. If there has been childbirth, then its length reaches 10 cm. Any deviations in size, both smaller and larger, indicate problems, for example, a tumor, menopause, etc. If a tumor is suspected, a gynecologist necessarily prescribe additional diagnostics to the patient, usually an ultrasound of the uterus. If the ultrasound results show anatomical abnormalities, the diagnosis will be disappointing. You will have to undergo additional examination to determine the type and size of the tumor. The uterus can enlarge in an absolutely healthy woman. This indicates the approach of ovulation or pregnancy.

By the location of the uterus, the doctor can also judge the woman’s health status. Normally, it should be located opposite the entrance to the vagina and located strictly in the center. If, upon examination, its displacement or tilting at any angle is observed, then this may indicate either the presence of a tumor or the occurrence of an inflammatory process. To find out the diagnosis in more detail, the woman will need to undergo a number of additional studies.

In normal condition, the uterus has sufficient elasticity, and may well move slightly in different directions. In cases where a woman has undergone childbirth, the mobility of the uterus increases significantly, and the organ may fall out. This indicates severe damage to the internal muscles of the vagina. If the uterus, on the contrary, is inactive, this is also bad. The patient may, for example, have tissue infiltration or a tumor.

Other female organs examined bimanually

In addition to a gynecological examination of the uterus, during a bimanual examination, the gynecologist also examines the condition of the fallopian tubes and ovaries. Of course, he cannot look inside, but he can feel it. If they are in normal condition, there will be no noticeable deviations. However, if a disease such as sactosalpinx is present, the doctor will feel lumps.

The last organ identified during a bimanual examination is the uterine ligaments. In a normal state they cannot be felt, but in the presence of fibroids they become clearly visible. The exception is pregnancy. If tears or scars are felt on the ligaments, the presumptive diagnosis is parametritis or infiltration.

Recto-vaginal examination by a gynecologist

This type of diagnosis is considered additional and is carried out only in postmenopausal patients or if diseases of the uterine appendages are suspected. In terms of its effectiveness, such a study is close to a bimanual examination.

During a recto-vaginal examination, the doctor examines the internal walls of the vagina, colon and the condition of the genital septum. The examination is carried out as follows: one finger is inserted into the vaginal opening, and the second into the anus. With the help of light pressure, the walls of the two anatomical passages are pressed against each other.

During a recto-vaginal gynecological examination, the doctor can determine the degree of mucous membrane of each membrane, the presence of tumors, and deformities. After the fingers are removed from both holes, the gynecologist examines the gloves for traces of blood, pus, and discharge. With the help of a recto-vaginal examination, if there is a tumor inside the vagina, it is possible to determine whether it belongs specifically to the reproductive system.

Rectal examination

Doctors use the rectal method more often for patients who have not yet entered into sexual relations. Sometimes for virgins or those who are not actively involved in intimate relationships, vaginal instrumental examination using reduced speculum is used.

However, the rectal method guarantees the preservation of the integrity of the hymen and the complete absence of discomfort. The specialist inserts one finger into the anus and probes the organs of the reproductive system through the anterior wall - the rectal-uterine space.

As in the case of the bimanual method, the physician clearly determines the structure, size of the ovaries, ligaments of the uterus, its tubes and the hollow organ itself. Due to the fact that the wall separating the anus and vagina is thin, the doctor can even feel the accumulation of fluid in one of the organs.

The rectal examination method is usually used if there is a possibility of serious pathology in the girl’s body. Typically, gynecologists try to avoid any penetration with teenagers.

Bacteriological examination during examination by a gynecologist

This type of examination by a gynecologist is fundamentally different from all of the above, since the doctor does not study the structure of organs and their appearance, he is interested in the composition of the mucus and flora of the mucous membrane, taken by smear. This analysis provides extensive information about the presence of a particular disease in the patient’s genital area. What is especially important is that the doctor receives information about the pathogen, so he can quickly take effective measures. Another function of bacteriological analysis is to identify the sensitivity of microorganisms to antibiotics. Knowing what can be used to destroy the infection, it will be easy to cope with it.

How a gynecologist takes a smear for examination

To conduct any of the above tests, the gynecologist takes a smear from the subject. A smear can be taken from the vagina, cervical canal, or urethra.

Smear collection is carried out in the following sequence:

Discharge from the urethra
. Before taking a smear, the gynecologist prepares the urethra by massaging it for 5 to 10 minutes with one finger from the side of the vaginal opening. Next, an absorbent tampon is inserted for 30 seconds. The immersion depth of a sterile swab is up to 2 cm.
Vaginal discharge
. In this case, no preliminary preparation measures are required - the vagina is always moisturized. The gynecologist collects discharge from the posterior vaginal vault with a special spatula.
Discharge from the cervical canal
. The gynecologist uses speculums to expose the uterus. The surface of the uterus is treated dry with a sterile absorbent swab. After this, a special probe is inserted into the uterus - it collects fluid from the cervical canal.

The resulting material is studied under a microscope. Depending on the symptoms and complaints, the research method is selected.

What does a gynecologist determine in a smear?

During bacterioscopic analysis, the doctor determines:

Leukocytes
. Particular attention is paid to their quantity and concentration. At the first stage of density, the smear will be quite clean, and the number of leukocytes will not exceed 5 pcs. In the second stage, the number of leukocytes is from 5 to 15. At the third stage, the smear is very thick and contains up to 25 leukocytes. In the fourth stage, the number of leukocytes exceeds 25. In the last two cases, the gynecologist prescribes additional tests for the patient, since all signs indicate a strong inflammatory process.
Microflora.
According to the state, the microflora can be bacillary (considered the generally accepted norm, in which the patient does not experience abnormalities) and coccal (clearly indicating the presence of an infection in the body);
Gonococci, fungi, trichomonas
. There will be no pathogenic microorganisms in a smear of a healthy woman, and opportunistic microorganisms (candida fungi, commonly called thrush) do not exceed the norm.

Even this information is enough for an examination by a gynecologist to be considered effective.

When to go to the gynecologist?

First of all, you need to go to the gynecologist on time. The first visit should take place before the onset of sexual activity, immediately after the end of puberty. After this, it is advisable to visit a gynecologist at least twice (at most once) times a year. The postmenopausal period should not be an exception; at this age, the risk of cancer increases and regular monitoring is more important than ever.

The key point is the choice of your personal gynecologist and the medical institution where you will be observed (obviously, the first determines the second - the gynecologist’s place of work cannot be changed at your sole request). The latter is of no small importance. Even a highly qualified specialist is unlikely to be able to provide you with a good level of service in the absence of proper “technical support”. The availability of modern laboratory and instrumental research methods largely determines the possibilities of diagnosis and, as a consequence, correct treatment.

Ideally, you should be treated by the same doctor, chosen by you once and for all and who knows thoroughly all the features of your body.

Gynecological examination with colposcopy

During this procedure, a gynecologist examines the woman's internal organs - 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 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 on 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 threat to the health of the 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 on the genitals, the woman is strictly recommended to refrain from treating them with suppositories and other vaginal remedies. Treatment can be continued after a gynecological examination.
If you are hypersensitive to pain, you can take a painkiller tablet before the examination. 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. An examination by a gynecologist in a 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 prevent subsequent discharge, the surface of the cervix is lubricated with a 3% solution of 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 the structure and color of the epithelial cells of the vagina, which means it is able to detect any ailments at an early stage of development.

One of the most common diseases detected by a gynecologist with a colposcope is cervical erosion. Characteristic symptoms of erosion are 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 of different sizes and shapes. 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 detected by colposcopic examination during examination by a gynecologist is cervical cancer. If this disease is detected, a biopsy is performed immediately without fail.

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 light bleeding.

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.

What's next?

Upon completion of the gynecological examination, a crucial moment for you comes. After the doctor has finished filling out the medical record, it is your turn to ask questions - the actual consultation with the gynecologist, a dialogue with the doctor.

You can finally ask the gynecologist about what he saw and felt, what is your supposed diagnosis and the causes of the disease. It is often difficult to remember everything your doctor has told you. In our clinic, each doctor is required to issue you an official medical report after each visit. In it, the gynecologist will write down examination data, necessary tests, diagnosis, all recommendations and medications that should be taken.

You must have complete information about your health, so all the finished results of tests and examinations will definitely be given to you. Don’t be afraid of visiting a gynecologist, don’t put off your visit, follow the recommendations you receive, and you can be sure that everything will be fine in this one of the most important areas of your health.

Your gynecologist is your friend, and together you can solve any problem.

Examination by a gynecologist with biopsy

The most important test prescribed for girls and women in gynecology is a biopsy. A biopsy is not considered a mandatory test during a gynecological examination, and is carried out on 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

Diagnostics does not require additional preparation and involves taking biomaterials from the 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.

In total, there are about 13 different types of 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

A biopsy performed by a good gynecologist under sterile conditions is 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 refrain from strenuous physical activity and intimate contact for several days. 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!

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How to prepare for a consultation?

Ideally, the doctor is provided with all the results of previous examinations: mammography, blood test, last smear. It is not necessary to undergo waxing before consulting a gynecologist. A daily shower is sufficient and it is not recommended to use personal toiletries before your visit.

A gynecologist at the KDL Clinic will examine you to check your organs and check for possible infections and diseases. The test lasts about 10 minutes, is painless and can be done if you have your period, with the exception of a smear test. The examination in the chair, as already mentioned, is not systematic during the first visit, unless the gynecologist considers it necessary.