Questions and answers p. 5

Hello! I am 56 years old, and after the death of my husband, receing hair formed on my head. These bald spots are mostly on the back of the head, and no hair grows on them at all. I tried rubbing in garlic and pepper tinctures, took vitamins for hair growth, but nothing helped. Maybe you can tell me some remedy for baldness? I don't want to wear a wig all the time!
Answer: 27.05.2021

It is possible to suspect a diagnosis of alopecia areata, but to make an accurate diagnosis, you need to visit trichologist with undergoing the trichoscopy, further examination and consultation of related specialists.
 

Rozhkova Natalya Viktorovna
Doctor-dermatovenereologist, trichologist. The highest category. Work experience over 25 years.
Hello, doctor! I am 30 years old, I have fair skin and a lot of moles on my body. There are so many of them that I cannot track the possible changes that may occur to them. When I take sun bathes (I do this very rarely), new moles may appear, and this scares me. Please tell me, how often do I need to see dermatovenerologist to be calm about melanoma, and how does this examination go?
Answer: 27.05.2021

It is recommended for you to visit to dermatologist once a year, necessarily with examination (dermatoscopy) of each neoplasm. In the spring-summer period, you need to avoid sun exposure, and also use professional dermato-cosmetics with SPF protection 50+ for open areas.
 

Rozhkova Natalya Viktorovna
Doctor-dermatovenereologist, trichologist. The highest category. Work experience over 25 years.
Hello! Yesterday, during the pedicure, the pedicurist noticed that I had a wart on my sole. I didn’t even know about it, as it doesn’t hurt or itch, it doesn’t bother me to walk. But the pedicurist said that it is necessary to remove it, because if you accidentally touch it, there may be an overgrowth or warts can go all over the leg. She said that you can just buy a special plaster at the pharmacy and stick it on, and it will fall off by itself. But I'm a little bit scared to deal with this myself. Tell me, how do you remove warts?
Answer: 27.05.2021

Hello. You need an offline visit to dermatologist with dermatoscopy to make a diagnosis. Due to the depth of the warts, conservative treatment methods are ineffective and may even provoke the spread of the process. Removal is carried out by the device "Fotek". We work with modern equipment with minimal pain and trauma to the skin.
 

Rozhkova Natalya Viktorovna
Doctor-dermatovenereologist, trichologist. The highest category. Work experience over 25 years.
Hello! I need a consultation with a gynecologist. I am 32 years old, I recently finished breastfeeding my son and now I want to start taking hormonal contraceptives. Can you please tell me how to choose them correctly and what tests should be done beforehand? I have minor problems with excess weight and increased oily hair, can COCs somehow help me with this?
Answer: 27.05.2021

Hello! Hormonal contraception is a modern and reliable method of preventing pregnancy. Before prescribing hormonal contraceptives, it is necessary to consult a gynecologist. An individual approach is required, taking into account the age of the patient, her state of health. A gynecological examination, ultrasound of pelvic organs, mammary glands, smears for microflora and cytology are necessary, it is necessary to assess the blood coagulation system, measure blood pressure. All this will allow determining which method of contraception is right for you.

Yarkovaya Olga Valentinovna
Obstetrician-gynecologist. The second category. Work experience 9 years.
Hello. I had unprotected sex with a guy yesterday. This was on the 11th day of the cycle. Tell me, is there a chance that I got pregnant? I took Postinor and now I don't know what to do! My chest is a little swollen and I feel nagging pain on the lower abdomen. Should anything happen, will I be able to make appointment for a medical abortion and when is it better to do it?
Answer: 27.05.2021

Hello! You did the right thing by using emergency contraception after unprotected intercourse. Let's hope it will be effective. Medical abortion is the safest and most effective method of terminating a pregnancy. In case of unwanted pregnancy, it is important to consult a gynecologist at the slightest delay in menstruation in order to undergo the necessary examination. Medical abortion at our medical center is carried out up to 49 days from the first day of the last menstruation.

Yarkovaya Olga Valentinovna
Obstetrician-gynecologist. The second category. Work experience 9 years.
Hello! I would like to consult. I read that the intrauterine device is one of the most modern and almost 100% methods of contraception. COCs are not suitable for me due to hormonal disorders and the risk of thrombosis. Please tell me about the installation procedure of this device and what examinations do I need to undergo for this? Thank you!
Answer: 27.05.2021

Hello! Yes, an intrauterine device is a reliable and convenient method of contraception. But there are a number of contraindications for its use. These are inflammatory and oncological diseases of female genital organs, cervical dysplasia. The intrauterine device is inserted into the uterine cavity during menstruation. Before the introduction, it is necessary to undergo an examination. This is a gynecological examination with taking smears for microflora and cytology, ultrasound of pelvic organs, examination for hepatitis B and C, HIV, syphilis, complete blood count (it is necessary to determine the level of hemoglobin).

Yarkovaya Olga Valentinovna
Obstetrician-gynecologist. The second category. Work experience 9 years.
Hello! I have such a situation: about three months ago, I was diagnosed with deep cervical erosion. The doctor has already cauterized it 2 times with some kind of drug, but the erosion does not go away. There are unpleasant sensations during intercourse with my boyfriend. Please tell me if there are any alternative methods of treatment, since cervical cautery did not help?
Answer: 27.05.2021

Hello! In your case, it is difficult to answer the question and give recommendations without visit to a doctor and examination. After clarifying the diagnosis, it will be possible to give you an answer. A cytological examination, examination for oncogenic human papillomaviruses (HPV), colposcopy (examination of cervix under a significant increase) is necessary.

Yarkovaya Olga Valentinovna
Obstetrician-gynecologist. The second category. Work experience 9 years.
Hello. My husband and I are trying to get pregnant. The gynecologist prescribed ultrasound of pelvic organs to confirm corpus luteum. Tell me, on what day of the cycle is it better to do it?
Answer: 27.05.2021

Hello. The corpus luteum is formed after the rupture of the dominant follicle and the release of the egg from the ovary. This process is called ovulation. It occurs in the middle of the menstrual cycle. For example, with a 28-day cycle, ovulation can occur on the 14th day of the menstrual cycle, therefore the corpus luteum should be controlled on the 15-16th day. BUT ovulation may not occur every month and not necessarily clearly in the middle of the cycle, so folliculometry is the best option to do. Folliculometry is an ultrasound observation of ovarian activity. The ultrasound specialist monitors in which ovary the dominant follicle begins to form (the one where the future egg cell will mature), how it behaves during the first phase of the cycle, and then, in the second phase, fixes the fact of the presence or absence of the corpus luteum. With a standard 28-day menstrual cycle, the first ultrasound is usually prescribed on the 7-10th day. Then ultrasound is performed every 2-3 days or as agreed with the doctor until the fact of ovulation is established.

Koboleva Anastasia Evgenievna
Ultrasound diagnostics (ultrasound) doctor. Work experience 4 years.
Hello, doctor! Ultrasound of ovary is needed to determine the presence or absence of a cyst. Tell me, on what day of the cycle is it better to do it?
Answer: 27.05.2021

Follicular cysts occur due to the accumulation of fluid in the follicle as a result of hormonal disorders and are found mainly in childbearing age. Such cysts usually disappear within 1-2, less often 3 menstrual cycles.

If the fact of the presence of a "cyst" has already been established earlier, then it is better to conduct examination after menstruation (on the 3-5th day of the cycle).

Paraovarian cysts account for 8 to 16.4% of all ovarian masses and are diagnosed mainly between the ages of 20 and 40. Cysts can be either small (5-6 cm) or gigantic. The main and almost the only ultrasound sign of paraovarian cysts is visualization of a separately located ovary.

Endometrioid or “chocolate” cysts, named after the old blood they contain, are a form of external genital endometriosis. Endometrioid cysts not only do not disappear during dynamic observation, but can increase.

 A corpus luteum cyst occurs due to the accumulation of fluid in the place of a bursting follicle, sometimes it can contain blood. Such cysts occur between the ages of 16 and 45. To eliminate errors, a dynamic ultrasound is required in the 1st phase of the next menstrual cycle. With a corpus luteum cyst, observation is indicated for 1-3 menstrual cycles, since its reverse development is not excluded.

Koboleva Anastasia Evgenievna
Ultrasound diagnostics (ultrasound) doctor. Work experience 4 years.
Hello! I have appointment for ultrasound of pelvic organs, but tell me what they examine there? I have had my period delay for two weeks and all my tests are negative. There is also a small discharge and nagging pain in the lower abdomen. Will ultrasound be useful in this case?
Answer: 27.05.2021

An ultrasound examination (ultrasonography) of pelvic organs allows obtaining an image of the tissues and organs located in the lower abdomen and pelvis. In gynecology, this examination is most often used to assess the condition and structure of the uterus, cervix, ovaries, uterine (fallopian tubes), peri-ocular space and bladder (if it is sufficiently filled).

Ultrasound examination in gynecology is carried out in the following ways:

  • Transabdominal ultrasound of pelvic organs - examination of internal organs through the anterior abdominal wall. The procedure is performed with a full bladder and allows determining the size of the genitals, their structure and the presence of large pathological formations (tumors, cysts).
  • Transvaginal ultrasound - examination using a special probe inserted directly into the vagina. The method allows examining in more detail the structure of organs, determine the size, shape and structural features of pathological formations.
  • Combined - transabdominal scan with a full bladder and after emptying the bladder, switch to transvaginal examination. These two methods complement each other. 

Preparation for ultrasound of pelvic organs in women will differ depending on the method of examination.

Transabdominal ultrasound is done when the bladder is full. For examination to be the most informative, it is necessary to drink about 1 liter of liquid 1.5-2 hours before the examination.

For a transvaginal ultrasound, some preparation is also required. It is recommended to exclude foods that contribute to gas formation from the diet before the examination. The procedure is carried out with an empty bladder, therefore, it is necessary to urinate before the examination.

In your case, ultrasound will be useful and informative, because tests sometimes give a false negative or false positive result. An ultrasound specialist will assess the condition and structure of pelvic organs, then you need to contact a gynecologist, who, based on examination, ultrasound and additional tests (if required), will determine the exact reason for the delay and prescribe the necessary treatment.

Petrov Sergey Vladimirovich
Ultrasound diagnosis doctor (ultrasound). Work experience is 18 years.
Hello! Can you please tell me what preparation is needed for ultrasound of abdominal cavity? I’m going to make appointment and thinking when it’s more convenient.
Answer: 27.05.2021

Examination of abdominal organs requires a little preparation to ensure good visibility and to obtain reliable results.

Preliminary preparation includes the following:

  • special diet for 3 days;
  • before the examination, complete abstinence from food for 10-12 hours, for children - 8 hours (preparation is needed to prevent gas formation and collapsed gallbladder).

For three to four days, eliminate from your diet the food causing gas production: black bread, dairy products, nuts and mushrooms, fresh vegetables and fruits, legumes, sauerkraut, coffee, alcohol, carbonated drinks. Try to also limit your intake of fatty meat and sweets.

You can eat: lean poultry and fish, beef, baked apples without sugar, cereals, a small amount of eggs, hard cheese with a low percentage of fat.

On the doctor’s recommendation, drugs that improve digestion and reduce gas production can be added to the diet.

Such a diet for this type of ultrasound lasts until the evening before the examination (if the procedure is carried out in the morning). If your appointment is after 15:00, a light breakfast is allowed.

Petrov Sergey Vladimirovich
Ultrasound diagnosis doctor (ultrasound). Work experience is 18 years.
Hello. A year ago, I had a very difficult natural birth - narrow hips, a large baby. During childbirth, there were multiple ruptures of the muscles and ligaments of the pelvic floor. Of course, they sewed everything up and promised that with time everything would go away, but I developed urinary incontinence. I tried treatment with pills and folk remedies, but none of this helped. Tell me, is it possible to solve my problem surgically and what is needed for this?
Answer: 14.05.2021

There is a possibility that the birth injury has not completely disappeared and the normal position of pelvic organs is impaired. In such cases, it is necessary to be examined by a gynecologist and urologist. If indicated, operations are performed to restore the typical location of pelvic organs.

Vovk Valeriy Anatoliyovych
Surgeon. Doctor of Medical Sciences. The highest category. Work experience 26 years.

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