Gynaecological consultations and check-ups
In the course of a visit, a medical history is taken and completed, various examinations are carried out such as observation of the genitalia with vaginal specula or vaginal speculum, bimanual examination of the internal genitalia and pelvic organs (uterus, tubes and ovaries, intestines) and breasts, and cervico-vaginal cytology. Depending on the needs of the case, complementary examinations such as abdominal and transvaginal ultrasound or various analytical tests may be performed.
Cytology and ultrasound
Cytology
Gynaecological cytology is a technique for screening and early diagnosis of pre-cancerous and cancerous lesions of the cervix and endometrium (uterine mucosa).
It is advisable to take it after menstruation and without previous treatment or vaginal washings. It is performed without any additional preparation.
Cytology also allows the presence of human papillomavirus (HPV), the main cause of cervical cancer, to be suspected due to certain cellular alterations. Complementary analyses should be carried out on the same or subsequent samples to confirm the presence of this infection in the woman (detection and typing of HPV).
Cytology also enables, although it is not its main purpose, a hormonal diagnosis and a bacteriological diagnosis:
- Hormonal diagnosis: Assesses the appearance and size of cells in the different phases of the menstrual cycle, helping to identify hormonal disorders.
- Bacteriological diagnosis: This allows identification of the vaginal microbiota (microorganisms such as lactobacillus or Doederlein flora, haemophilus, cocci, fungi and candida, trichomonas, protozoa, etc.) and detection of other infections.
Ultrasound
Ultrasound or ultrasonography performs diagnostic imaging using a technology that emits ultrasound waves through a probe or transducer to different areas of the human body, which then collects the echoes that bounce back from the tissues and transfers them to the ultrasound machine, which processes them digitally and displays them on a screen or monitor.
There are different probes adapted to their function, such as abdominal, vaginal and linear probes, used in gynaecology and obstetrics.
Contraceptive Methods
Family planning enables individuals to make informed decisions regarding their sexual and reproductive health and thus control the number of children through the use of contraceptive methods.
There is a wide variety of contraceptive methods that allow couples to use the method that best suits their bodies and needs.
- Barrier methods.
- Birth control pills.
- Vaginal ring.
- Subcutaneous implant.
- Intrauterine devices (IUDs).
- Injectable contraception.
The best method of contraception is the one that is used regularly, creates the most confidence for the woman and her partner, and does not cause bothersome side effects.
Pregnancy monitoring and control
The purpose of the medical control of pregnancy is to monitor the evolution of the pregnancy, focusing on all aspects that influence the health of the pregnant woman and the foetus. In this sense, it is advisable to make monthly medical visits as soon as the pregnancy is confirmed (urine/blood test or ultrasound), which generally occurs after the first or second miscarriage.
At the first visit, a gynaecological examination with cytology is recommended (if it has not been done in the last year) and at subsequent visits, an obstetric examination, weight and blood pressure control, certain analytical tests are routinely carried out, and information is also provided on nutrition and healthy habits with regard to pregnancy.
In some cases, closer follow-up is advised due to family and personal history (medical-surgical and gynaecological-obstetric) or clinical findings (high-risk pregnancy).
Postpartum Treatment
This treatment corrects vaginal hyperlaxity that can appear after childbirth, strengthening and toning the vaginal walls.
It is a laser procedure, without the need for anaesthesia, which allows immediate return to daily life.
Climacteric and menopause
Climacteric is the phase of life comprising the transitional years between the reproductive and non-reproductive phases.
Menopause is known as the last menstrual period (a term often confused with climacteric) and usually occurs around the age of 50, although in some cases it occurs before the age of 40 (early menopause) or, conversely, over the age of 55 (late menopause).
A recent review reveals that the life expectancy of women in Spain, thanks to improved living conditions and the constant improvement in the quality of health systems in developed societies, stands at 86 years.
When the menopause arrives, a woman still has a third of her life ahead of her. In this new stage, menstrual periods and the symptoms that can accompany them cease, the use of a contraceptive method is no longer necessary and it is possible to experience sexuality without the fear of an unplanned pregnancy. The independence of children, professional fulfilment and acquired experience can turn this stage into an opportunity to enjoy more free time for oneself and to fulfil desires that were postponed.
It is time for new challenges.
To maintain a good or acceptable quality of life at this stage, it is important to know the principles of healthy living and the achievements and advances of medicine (available to anyone at the doctor's office or health centre) in order to learn to live naturally and positively with the changes in body and mind that occur gradually with increasing age.
Symptomatology
At this stage hormonal changes appear, specifically the gradual decrease in oestrogen levels, which has a negative impact on different levels: the genitals, the urinary system, the bones, the cardiovascular system, and even the emotional and cognitive sphere.
The main symptoms, apart from menstrual cycle irregularities and definitive amenorrhoea (menopause), are mainly three:
Vasomotor disorders
Mainly hot flushes and sweating. They are due to dysregulation of the thermoregulatory centre and occur with varying frequency during the day and at night, causing insomnia and tiredness.
Urogenital atrophy or syndrome
Changes occur in the vulva, vagina and lower urinary tract (bladder and urethra), producing:
- Dryness, burning, itching, thinning of the vaginal walls (and in the longer term vaginal narrowing), which can lead to dyspareunia (pain during penetration).
- Urine leakage due to weakening of the pelvic floor, both exertional and emergency.
Osteoporosis
The decline in bone mass is associated with age in both men and women, however, in women, the decline in oestrogen produces a significant increase in the incidence of bone loss. osteoporosis in relation to each other which creates an increased risk of osteoporotic fractures (hip, vertebrae, forearm, etc.).
The main symptoms, apart from menstrual cycle irregularities and definitive amenorrhoea (menopause), are mainly three:
