Girls should make an appointment, and see a gynaecologist even before their period starts - at the age of 12-13 to receive professional information on the changes that their bodies are soon to undergo. The doctor would discuss and explain the changes taking place in a girl’s body and the meaning of these changes. When arriving at the doctor’s office the girl should be aware that the doctor is going to ask many personal questions. The reason for this is to openly discuss and clarify the inquiries put forth by the girl, or her parents, as comprehensively and precisely as possible.

All women should schedule a preventive visit to a gynaecologist at least once a year. During such a visit the Pap smear from the cervix uteri (to eliminate the risk of cervical carcinoma) is frequently administered. Outside of the yearly visit, when indications of a gynaecological nature do appear, a visit to a gynaecologist should be scheduled ASAP (notwithstanding the yearly mandatory visit). There could be a wide variety of reasons for a gynaecologist visit, such as genital discomfort, unwelcome discharge, pain, irritation, lump on the breast, and so on.

The gynaecologist uses a special tool called the medical gynaecological mirror to visualize the cervix uteri and then collects a sample of cells from the outer aperture of the cervix uteri with a specifically-made spatula or a small brush. Occasionally a collection of a urogenital smear is required, as well (with the purpose of examining vaginal micro flora to eliminate the presence of pathological microbes). The smear then is placed on a glass slide to be examined under a laboratory microscope.

It is advisable to examine breasts after every period, as then the breast structure would be most effectively palpable. Firstly, consider any possible changes, for example, symmetry. The self-exam should be performed with arms lowered, and then raised. You have to carefully palpate each breast moving your fingers from the outward edge of the breast towards the nipple, palpating thoroughly.

Ultrasonography, or ultrasound, is a gynaecological procedure which is completely harmless, and painless. The purpose of the procedure is to examine and diagnose the organs in a female’s pelvis minor. During the examination a patient lies on a couch. The ultrasound probe is coated with a translucent gel. Use of the gel is necessary to improve a contact between a patient’s body and the aforementioned ultrasound probe.

Yes. Dr. Vija Plume treats psychosomatic illnesses. Though before setting off to treat psychosomatic disorders in gynaecology one should rule out any disease afflicting relevant organs. Psychosomatic problems can manifest themselves in, say, menstrual disorders possibly signalling an imbalance on a psycho emotional and corporeal level. Psychosomatic disorders may have a significant adverse effect on a quality of a female’s daily social endeavours.

Endometriosis is a gynaecological condition in which the endometrium-like cells (the endometrium is the internal layer of the uterus which degenerates during menstrual periods) appear and flourish, not just inside, but also outside of the uterine cavity. It can be present anywhere in the female’s pelvic cavity, as well as in other organs. It is a condition that tends to worsen as time progresses; furthermore a relapse after medical treatment is possible.

Endometriosis may develop inside the organs and form cysts (endometriomas or endometriotic cysts) as well as on the surfaces of organs. Regarding the progress of the disease, the endometriosis can be divided into 4 stages. During the first stage of endometriosis, a comparatively small number of endometriotic foci are to be found in the pelvis minor while during the fourth stage which is the most severe one, there is a multitude of endometriotic foci and endometriotic adhesions. Usual symptoms of endometriosis are pains in the pelvis during menstrual periods, though the pain intensity may differ from case to case. Other symptoms may include pains during intercourse, ovulation, heave and irregular haemorrhage, infertility, and so on.

Uterine myoma is the most common benign tumour of the female reproductive system. It is usually caused by hormone fluctuations in the female body. Fission of the uterine cells results in the development of muscle tissue nodes that settle in the uterine muscle layer. The size and placement of these nodes within the uterus determine whether a female would suffer from symptoms of myoma. Husked myomatous node does not rule out the possibility of reappearance after some time.

Adhesions of the pelvis minor may appear as a result of tissue reacting to the damage inflicted upon it. Depending on the type of tissue and the scale of damage, the tissue may be completely regenerated. When the tissue does not fully regenerate, a scar tissue may appear. The damage to the tissue most often occurs as a result of surgical operations, infections, haemorrhage (severe internal bleeding), or trauma.

The adhesions of the pelvis minor are the scar tissue of the thin (membrane-like), or thick band connecting two or more inner surfaces of the body, thus enveloping adjacent organs and cavities. Pelvic adhesions are mainly diagnosed during surgical intervention. Pelvic adhesions that affect the uterus, ovaries, oviduct or urinary bladder, may result in chronic pelvic pains, infertility, pangs during intercourse and increase the risk of an extra uterine pregnancy.

Ovarian cysts are any collections filled with a liquid or any contents of a more dense consistency. Such cysts range in size from as small as a pea to larger, the size of tens of centimetres. It is still unclear exactly why the ovarian cysts affect women (they may be caused by hormonal disorders, changes in ovarian cells etc.).

Ovarian cysts may be present without any significant symptoms, though when symptoms do appear, these could include pelvic pain, disorders of menstrual cycle, and pangs during intercourse, fatigue, flatulence, discomfort in the lower belly etc. Sometimes malignant cysts do develop (ovarian cancer). On occasion ovarian cysts may cause internal bleeding, sudden abdominal pains, nausea or vomiting. An ultrasound may be used to identify ovarian cysts.

Treatment of ovarian cysts depends on their size and type, accompanying symptoms and the patient’s age.

A menstrual cycle is a physiological process of females of a reproductive age. Hormones are directly affecting the menstrual cycle. A menstrual cycle is paramount to ensure the reproductive function. The average period of the menstrual cycle is 28 days, though it might differ with various women. Menstruation constitutes an essential part of a female’s monthly menstrual cycle with the blood and endometrial tissue being shed from the uterine cavity through the vagina.

The following signs serve to indicate disorders of the menstrual cycle: menstruation does not occur during the specific period of the menstrual cycle; menstruation is too frequent; unpredictable time of menstruation and painful menstruations. When the menstrual cycle has not been disrupted by pregnancy, disorders in the regular occurrence of the menstruation may signal a gynaecological problem. Women, both at the beginning and the end of their reproductive age, may indeed experience the absence or irregularity of menstruations. There are several reasons for disorders of the menstrual cycle.

Menopause is the cessation of a woman's reproductive ability (the end of the fertile phase). The ovaries stop producing ova, and the estrogen (female hormone) level decreases considerably with the disappearance of the menstrual cycle as a result. The average menopause age for women is 51, 52 years though many women could see menopause symptoms appearing some time after they reach the age of 45. Some women may face their menopause earlier (premature menopause) as a result of, say, gynaecological treatment or surgical operations. Research indicates that smokers may get their menopause earlier than non-smokers.

Polycystic ovary syndrome (aka PCOS) is the most common endocrine condition (15-20 %) affecting females of a reproductive age. The presence of small cysts filled with liquid in the ovaries as discovered during an ultrasound is known as PCOS and can exist on its own irrespective of any complex syndrome. To establish a diagnosis of PCOS at least two of the three criteria need to be present:

• Numerous small cysts (8-10 mm in diameter) on one or both ovaries. One or both ovaries can be diagnosed as enlarged.
• Clinical symptoms, or results of a blood test, showing an increased androgen level (male hormones) for example, testosterone
• Irregular menstrual periods or an absence of ovulation (anovulation)

Intrauterine adhesions, or the Asherman’s syndrome, may occur as a consequence of intrauterine inflammation or frequent intrauterine manipulations.  Asherman’s syndrome manifests itself by infertility, disorders of the menstrual cycle, etc.

Modern couples may face problems in conceiving a child. Effective pregnancy requires the couple to be fertile. There is range of recommendations one needs to comply with in order to protect the fertility: eat healthy and varied foods, have an adequate body weight, avoid excessive alcohol consumption, do not smoke, avoid contracting sexually transmitted diseases.

Infertility is the inability of a person to reproduce by natural means. There are couples who are infertile, and there are couples who are partially infertile and face certain difficulties with conceiving a child and require medical assistance. There are two forms of  infertility of couples:

       1) primary infertility: couples who have never conceived a child or reached pregnancy;

       2) secondary infertility: couples who after one or two pregnancies are unable to conceive a child. Reasons behind the infertility are to be sought with both - the female and male organisms.

Pregnancy complications usually occur as a result of the pregnancy itself. Problems with pregnancy may also affect women who are generally healthy. Certain pre-birth tests may help prevent or promptly identify pregnancy disorders. It is vital to comply with the recommendations of the doctor given after the identification of possible abnormalities so that the expectant mother would confidently give birth to a strong and healthy baby. The most common pregnancy disorders are as follows: anaemia, depression, ectopic pregnancy, problems with fetus, gestation diabetes, high blood pressure, spontaneous abortion, premature birth, etc.

Expectant mothers frequently have to face a miscarriage which means that the pregnancy is terminated prior to a fetus reaching the viability. The most widespread sign of the miscarriage is vaginal bleeding. Most women who have experienced a miscarriage are going to have their next pregnancy normal and successful. Only one in hundred females experiences a repeated miscarriage (three or more times in a row).

Endocrinology is the field of medicine that treats diseases of the endocrine system and deals with their effects on female reproductive health.  Gynaecological endocrinology, also known as reproductive endocrinology, focuses on issues of fertility disorders, issues associated with menstruation and menopause. Gynaecological endocrinology deals with a wide range of reproductive disorders, like recurrent miscarriage, inability to conceive, irregularity of menstrual periods or unusually severe menstrual periods, discomfort associated with menopause, etc. Gynaecological endocrinology encompasses tests and a range of analyses, as well as consultations of the most effective form of medical treatment.