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Často kladené otázky gynekológom

Napísal femme 27. február 2018

Návšteva gynekológa nesmie byť stresom pre ženu, ale prirodzenou súčasťou jej zdravého životného štýlu. Kedy  navštíviť prvýkrát gynekológa, aké otázky majú nastávajúce mamičky  a prečo dodržiavať kontroly aj po radikálnom gynekologickom zákroku, nám zodpovedala MUDr. Radmila Sládičeková, MPH.

dievca v triede

1. Kedy je najvhodnejší vek na absolvovanie prvého gynekologického vyšetrenia?
Prvé gynekologické vyšetrenie by žena mala absolvovať v 18 rokoch a potom pravidelné prehliadky raz ročne.

2. Ako sa treba pripraviť na prvé gynekologické vyšetrenie?
Pred prvou gynekologickou prehliadkou sa treba pripraviť na dôležité otázky, ktoré bude gynekológ klásť:

- Kedy ste mali prvú menštruáciu?
- Je menštruačný cyklus pravidelný?
- Aké ochorenia sa vyskytujú vo vašej rodine – rodinná anamnéza (rakovina prsníkov, vaječníkov a ostatný výskyt onkologických ochorení v rodine, výskyt trombózy a embólie, mozgové príhody, infarkt, cukrovka, prekonané operácie, detské ochorenia – najmä osýpky, príjem transfúzie a fajčenie)?

3. Aký je stupeň ochrany prezervatívu pred otehotnením, ktorý je asi najvhodnejší pre tínedžerov?
Prezervatív je bariérová ochrana a je jediná spoľahlivá pred možným nakazením sa pohlavnými chorobami. Typ prezervatívu si musí vybrať každý muž sám podľa svojich preferencií.

4. Aký máte názor na hormonálnu antikoncepciu pre dievčatá mladšie 18 rokov? Čo by ste im poradili?
Vo všeobecnosti sa nedá radiť. Mladým dievčatám sa predpisuje HAK aj z iných ako z liečebných dôvodov, nielen ako ochrana pred nechceným otehotnením. Sú to napríklad problémy s menštruáciou sprevádzanou silnými bolesťami, nepravidelným cyklom alebo aknóznou pleťou. Vtedy hľadáme spoločne riešenia a volíme najvhodnejší variant, aby bola pacientka spokojná.

 

1. Kedy je najvhodnejší vek na počatie prvého dieťaťa?
Nemožno určiť presný vek, u každej ženy je to individuálne a podmienky sú rozličné. Dôležité je povedať, že na počatie musí byť žena gynekologicky dospelá, dozretá a s pravidelným menštruačným cyklom.

2. Je pravda, že keď je žena tehotná, nesmie prísť do kontaktu s mačkou?
Mačky sú pre tehotné ženy nebezpečné, pretože prenášajú ochorenie nazývané toxoplazmóza. Vplyvom toxoplazmózy môžu u tehotnej ženy nastať vrodené vývojové poruchy plodu. Našťastie, u nás na Slovensku každá tehotná žene absolvuje počas poradne vyšetrenia na toxoplazmózu.
Treba však povedať, že domáce očkované mačky by toto ochorenie nemali mať. Väčšie riziko plynie z domácej neumytej zeleniny a ovocia kvôli výkalom vlastných domácich zvierat. Najlepšie je kontaktovať sa s domácimi zvieratami ešte pred plánovanou graviditou, keď si telo v prípade prekonania toxoplazmózy vytvorí protilátky proti tomuto ochoreniu. Nie je vhodné hladkať cudzie mačky počas gravidity.

3. Ktoré vnútromaternicové teliesko je vhodné pre ženu, ktorá ešte plánuje mať deti?
Novinkou na trhu je vnútromaternicová loptička IUB, ktorá sa vďaka tvaru loptičky prirodzene dobre umiestni v maternici. Je vyrobená z nitinolu, ktorý telo dobre prijíma, keďže sa z neho vyrábajú napríklad aj srdcové chlopne. Táto loptička má ultra tenký aplikátor, vďaka čomu je vhodná aj pre ženy, ktoré ešte nerodili.

4. Podarí sa mi ešte otehotnieť po odstránení nehormonálnej loptičky?
Pokiaľ je žena zdravá a pravidelne absolvuje preventívne gynekologické prehliadky, jej plodnosť bude obnovená po vysadení antikoncepcie – či už pôjde o HAK alebo odstránenie loptičky.

5. Musím sa počas tehotenstva vyhnúť fitnescentru a cvičeniu so závažiami?
Ak je žena zvyknutá na pravidelnú telesnú aktivitu, v tehotenstve sa odporúča 1/3 zaťaženia oproti aktivite netehotnej ženy. Počas návštevy fitnescentra v gravidite nie je vhodné zdvíhanie závaží ani pestovať športy ako bicyklovanie a lyžovanie z dôvodu rizika úrazu. Vhodné sú aktivity typu strečing, dlhá chôdza či gravid joga.

 

1. Pred začatím menštruácie ma vždy pobolieva vpravo v podbrušku. Je to normálne?
Pri bolesti v podbrušku je nutné ženu gynekologicky vyšetriť. Pokiaľ lekár nenachádza žiadnu patológiu, vyšetrovací proces pokračuje u gastroenterológa. Ďalej sa uberá podľa nálezov špecialistov.

2. V prípade, že žena neplánuje deti alebo ich z nejakého dôvodu nemôže mať, je lepšie si dať vybrať maternicu, aby sa v budúcnosti vyhla zdravotným problémom?
Jednoznačne nie. Maternicu nemožno odstrániť len tak. Každý orgán v tele človeka má viacero funkcií, ktoré sú prospešné pre celý organizmus. Ak je aj nejaký orgán chorý, lekári ho liečia a snažia sa ho vždy zachrániť. Aby sa žena udržala zdravá a vyhla sa zdravotným problémom, mala by dbať na pravidelné preventívne gynekologické prehliadky.

3. Moja gynekologička mi odporučila vnútromaternicové teliesko, je to bezpečné, keď už mám dve deti?
Áno, je bezpečné a prináša najmä komfort pre užívateľku, keďže je vhodné ho ponechať v maternici až po dobu piatich rokov. Vaša gynekologička pozná najlepšie váš zdravotný stav a na základe vyšetrení vie správne vybrať aj vhodný typ antikoncepcie šitej na mieru práve pre vás.

4. Môžem používať kalíšky a tampóny, ak mám zavedené v maternici nehormonálne teliesko?
Ak máte v maternici zavedený akýkoľvek typ hormonálneho či nehormonálneho telieska, či už v tvare T alebo loptičky, môžete používať všetky pomôcky ako doteraz.

5. Aká antikoncepcia je pre mňa vhodná, keď mám poruchu štítnej žľazy a ešte som nerodila?
Akákoľvek porucha štítnej žľazy nie je prekážkou indikácie antikoncepcie, konkrétny typ posúdi váš gynekológ podľa nálezu.

6. Ako často treba robiť samovyšetrenie pŕs? Stačí samovyšetrenie alebo je lepšie navštevovať preto gynekológa?
Vplyvom hormónov môžu byť pred menzesom prsné žľazy zdurené, a preto sa odporúča samovyšetrovanie prsníkov realizovať 1-krát mesačne, vždy po menštruácii. Ak je žena zdravá, sonografiu prsníkov stačí absolvovať raz ročne.

7. Z akých dôvodov musia chodiť na preventívne vyšetrenia ženy po radikálnej hysterektómii (odstránenie maternice a vaječníkov)?
Ženy aj po hysterektómii musia absolvovať gynekologické prehliadky kvôli predchádzaniu nádorových ochorení. U týchto žien lekár sleduje, či nenastala progresia nádorového procesu.

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    axes in boys with constitutional delay of growth and puberty.
    (2) Schimrigk, Häusler, G., Blümel, P., Plöchl, E., Waldhör, T., &
    Frisch, H. The influence of progress hormone monotherapy and
    development hormone in combination with oxandrolone or testosterone
    on thyroxid hormone parameters and thyrxine binding globulin in patients with Ullrich- Turner syndrome.
    We have discovered that valerian root dietary supplements could additionally be effective
    for delicate insomnia, reducing the time taken to fall asleep and the quality of sleep (36, 37).
    In one research, individuals reached sleep 36% quicker after a single dose of valerian (38).
    If a consumer has no choice and equally needs to build
    muscle and burn fat at the identical time, maintenance calories may be optimal.

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