Women's Health Features
Numerous surveys of women aged 16 to 40 confirm: the so-called “female” diseases are younger.
Numerous surveys of women aged 16 to 40 confirm: the so-called “female” diseases are younger. Myomas, erosions, cysts, problems with the cycle - in every second or third young flowering woman. What is happening to us? And what do experts think about this?
Sergey Apetov, gynecologist-endocrinologist, Ph.D., associate professor of the Department of Endocrinology FPK MR RUDN medical workers
BEFORE: Now doctors very often give young women who are in no hurry to have children prescribe hormonal contraceptives. Does this affect the state of the endocrine system? CA: If they are correctly assigned, then this does not affect in any way. If a girl is healthy and has a normal regular menstrual cycle, then hormonal contraception is a good way to prevent an unwanted pregnancy.
BEFORE: But hormonal drugs are also prescribed for the treatment of dysfunction, in case of cycle disorders. CA: There is no such disease “dysfunction”, this term refers to a group of different diseases that have different causes. Sometimes a malfunction of the ovaries is a consequence of a malfunction of the thyroid gland, adrenal glands
It is very important to understand what the true reason is.
DO: What will help clarify the picture? Hormone test? CA: Analysis for hormones is also a very arbitrary indicator. The fact is that there is no concept of an absolute norm, there is a concept of reference values (this is an average indicator obtained as a result of a survey of a large number of healthy women). There, scatter is possible dozens of times. If you take at least one test result and look at the reference values, then the level of certain hormones can vary from 73 to 850. If a woman had estrogen levels earlier than 850, but decreased to 350, then naturally her condition worsens. In this case, her estrogens will be “normal”, that is, within the limits of reference values, and legally she can be considered healthy. Moreover, if she passes tests in different laboratories on different devices, then these figures can also vary, sometimes even several times. So the level of estrogen is also a very relative indicator. And precise instructions on what to do in such a situation do not exist either in domestic or in foreign medicine. There is such an expression: "Before the analysis, we take off our hat, not our head." Therefore, the doctor should always focus on the clinical picture, analysis is an additional research method.BEFORE: What recommendations for cycle violations do you give? CA: The only general recommendation is to see a doctor on time. And then the doctor will determine in which direction to act. After all, a menstrual disorder can be a clinical manifestation of about a hundred different diseases. And most of them have nothing to do with gynecology! But in general, proper nutrition, proper sleep and the ability to cope with stress are necessary.
Alla Pashkova, K. n., doctor obstetrician-gynecologist
DO: Do you agree that “female” diseases are younger? AP: Diseases such as cysts, for example, just usually develop at a young age, during the period of active activity of the ovaries. But judging by my practice, I can say that the number of young women with neoplasms in the ovaries has increased significantly in recent years. And endometriosis, fibroids, and cervical diseases are younger significantly. In young women, dysplasia, and even cervical cancer, can often be detected. And fibroids are already in fact for everyone. There are many teenage girls with menstrual irregularities.
BEFORE: What is the reason: lifestyle, ecology? AP: I think yes. Now even in schools there are heavy loads, it has become difficult to study, exhausting rhythm and lifestyle, the costs of urbanization.
DO: And what can be associated with such a wide spread of uterine diseases? AP: If we talk about endometriosis, then its causes are still not clear. This growth of tissue that is rejected during menstruation, it begins to grow either in the wall of the uterus - in the muscle, or due to improper peristalsis of the fallopian tubes during menstruation, enters the abdominal cavity and attaches to the peritoneum, to the ovaries - this is how external endometriosis develops. Why is it dangerous? The first is infertility. The second is severe pain. Its manifestations are painful sex life, severe pain in the lower abdomen and great blood loss during menstruation, painful sex,
Endometriosis by the mechanism of propagation is compared with a benign tumor. Endometriotic lesions can be found, for example, in the navel, if the patient underwent laparoscopy during menstruation and there are active cells. Or endometriosis of the postoperative suture, if after cesarean section the active endometrium has fallen into the suture area and its foci have formed there.
DO: What are the most accurate diagnostic methods for endometriosis? AP: If it is ovarian endometriosis or common uterine endometriosis, then it can be detected by ultrasound. But to a greater extent, the doctor should be guided by clinical signs: chronic pelvic pain syndrome, intermenstrual bleeding. Secondly, blood tests for tumor-associated antigens are necessary. There is such a marker CA 125, if its presence in the blood is detected, then laparoscopic diagnosis is recommended.
BEFORE: It used to be that uterine fibroids are an age-related disease. AP: No, there are a lot of myomas in young girls now. Moreover, even large fibroids are detected. But if earlier there was only one treatment option - removal of the uterus, since myoma was already detected when it reached a large size, now, thanks to ultrasound, even the smallest nodes can be detected in time. In addition, the uterus can now be saved, even if the site is large. A modern method is used - embolization of the uterine arteries, when a drug is injected through a blood vessel on the leg, which, through X-ray control, enters through the uterine artery to the vessels supplying the node and clogs them. And gradually this node dies and is removed from the uterus. After embolization, a woman may well become pregnant and give birth.
PHOTO: FOTOBANK / GETTY