The main gynecologist of Moscow: “Children appear for love, but not on schedule!”

Should I be afraid of erosion? Do I need to treat endometriosis? Is IVF safe? These and other questions were answered by the chief freelance specialist in obstetrics and gynecology of the Moscow Department of Health, MD, Professor Alexander Konoplyannikov.

Cleanliness and beauty

Before traveling to the sea I want to prepare the skin for the sun. Is it harmful to visit a solarium and even sunbathe on critical days?
Alexander Konoplyannikov

- The main thing that you should remember: sunbathing in the sun or in a solarium should be in moderation, not for long and not in any case burning. With external heat on the beach, in the solarium, sauna, body bath, blood circulation is accelerated, and blood rushes to the pelvic organs. This can lead to heavy discharge, increase pain and increase the number of critical days.

Alexander Konoplyannikov
Photo: Sergey Djevahashvili
My gynecologist says that you can not always use cleansers for intimate places and daily pads. How do you think?
Alexander Konoplyannikov

“Now there are a lot of intimate hygiene products with a slightly acidic pH that does not disturb the natural environment of the internal genital organs and helps to make hygienic procedures comfortable. Pay attention to the composition, the pH should be 3,5−4,5. The advertised "gold standard" pH 5.5 is suitable only for body skin, but not for sensitive intimate areas. Ideally, there should not be perfumes and natural aromatic substances, they can cause allergies. Modern daily pads do not pose a threat, but their use does not eliminate the need to change clothes every day. And, of course, you should take a shower, paying special attention to the intimate areas at least once a day.

Is it dangerous to do laser hair removal in the bikini area?
Alexander Konoplyannikov

- No, not dangerous. But before conducting a course of laser hair removal to exclude diseases in this area, be sure to visit your attending gynecologist. There are general contraindications for laser hair removal,which relate not only to the bikini area: birthmarks and moles in the area of ​​laser exposure, varicose veins, acute and chronic skin diseases, acute infectious diseases, for example, colds, pregnancy, lactation, precancerous conditions and many others. A complete list of contraindications is better to check with a dermatologist.

Insidious virus

The 15-year-old girl still hasn’t come monthly. Should I worry?
Alexander Konoplyannikov

- The timing of puberty is blurred, and, as a rule, it is from 12 to 14 years. A young woman develops in two stages. First, the breast increases, hair appears on the body, and only then comes menarche - the first menstruation. The term of its occurrence may be influenced by female heredity, lack of sex hormones, hypothyroidism and other hormonal disorders, diabetes mellitus, bronchial asthma, chronic infectious disease, psychological stress, physical exhaustion. The girl should visit the pediatric gynecologist to schedule examinations.

As a student, due to erosion, they made me a cryodestruction. And then, before giving birth, doctors swore that in the West there wasn’t even such a diagnosis, and it wouldn’t be possible to cauterize the erosions of unborn girls because the cervix will not open well during birth. What do you think?
Alexander Konoplyannikov

- Indeed, a few decades ago it was decided to cauterize erosion, but medical science, including obstetrics, is constantly being improved. Now it is enough to make a cytological screening of the cervix of the uterus and be sure to test for HPV - human papillomavirus. Some types of HPV provoke genital warts and papillomas, while others can cause cervical cancer. If necessary, colposcopy is performed for further examination (examination of the cervix with a colposcope - a special magnifying optical device) with a biopsy of suspicious areas. HPV testing should be taken regularly to all women after 30 years every 3 years.

I was diagnosed with endometriosis, but there is no pain. Do I need to treat it?
Alexander Konoplyannikov

- This is a complex and serious disease in which endometrial cells (the inner layer of the uterus wall) grow beyond it. Due to regular blood loss, anemia (lack of hemoglobin in the blood), peritonitis (inflammation of the peritoneum), and nerve fibers in the foci of the endometrium, leading to neurological disorders, can develop.Also, endometriosis often causes infertility. Moreover, without treatment, the disease can progress. It is necessary for the gynecologist to determine the localization sites and the dimensions of the endometrium focus or foci and, depending on this, prescribe treatment to you. It may consist of hormone therapy, in some cases surgery is required, which is now done with a gentle method using laparoscopy.

Photo: iStock /

The Iron Lady

I have a little uterine fibroids, now it has begun to grow. Will I be able to bear and have a baby?
Alexander Konoplyannikov

- As in the case of endometriosis, you must first be examined to determine the location, size and number of myomatous nodes. Then the doctor will select the appropriate treatment plan for you. Now there are modern methods to preserve reproductive organs, the most common of them is EMA (uterine artery embolization). With the help of EMA, not only uterine fibroids are treated, but also other benign neoplasms of the uterus body. Through a puncture in the right thigh, a catheter is inserted into the patient, and a substrate that in a few hours causes a blockage of the vessels in the myomatous nodes and reduces the nutrition in them. The effectiveness of this procedure is very high.After it, in most cases, pregnancy begins, which ends with the parents of an absolutely healthy child. In Moscow, the EMA is performed free of charge in almost all city hospitals where there is a gynecological department.

I had a difficult menopause, then for four years I took a hormonal drug to treat menopausal syndrome, and now the nighttime flushes have returned. What to do?
Alexander Konoplyannikov

- Sensations of hot flashes can be not only in menopause, but also in other diseases. You need to go to the reception not only to the gynecologist, but also to the endocrinologist.

My hemoglobin falls all the time, there is hyperplasia with cystic expansion and a few nodes in the uterus. There was bleeding, curettage done. Doctors suggest removing the uterus. Could there be a low hemoglobin due to gynecological problems? Will it be necessary to drink hormones after surgery?
Alexander Konoplyannikov

- If you have anemia, then you should understand what it is: non-iron deficiency or iron deficiency. If not iron deficient, then most likely its cause is in the blood coagulation system. But iron deficiency anemia often happens because of heavy menstrual and intermenstrual bleeding, which can be 200−300 ml per day. Of course, this worsens health, and then tough measures are required.Endometrial hyperplasia - proliferation of the mucous membrane of the uterus - a serious disease that can provoke the appearance of oncology. When myomatous nodes lead to bleeding and anemia, and when the patient is in premenopause or menopause, the question is raised that the uterus can be removed. During the operation, colposcopy and ovarian biopsy are done, and if there is no erosive change of the cervix and suspicion of a poor-quality education, the uterus and tubes are removed, and the cervix and ovaries are left. In this case, hormonal drugs will not have to drink. In Moscow, such operations are done laparoscopically.

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