Is it worth taking extra tests and drinking expensive vitamins? Which infections and diseases do not need to be treated?
1. How to cure human papilloma virus? Is it the reason for cancer?
There is no drug that kills the virus, so do not take expensive pills or injections. There is a vaccine that creates immunity, which is already included in the immunization schedule in Europe and the United States. Basically, it is only for girls, who have not had sex yet. There is no other anti-virus solution. A condom does not always save from papilloma virus. However, not everything is so bad. Do you have the virus? This is not an indicator, and certainly not a symptom of cancer. Physicians should pay attention not to analyses, but to the state of the cervix cells. How should you know if everything is all right with them? You can rely on cytology or a more modern analysis – liquid-based cytology, which allows you to determine not only the presence of the virus, but its concentration as well. What is the probability that a woman infected with HPV will develop cancer diseases? It is not as great as some doctors tell their patients. Cervical cancer is a disease of those who do not go to the gynecologist for years. It does not develop over a year or two. It is a long gradual process. Unexpected cancer can happen only under the condition that a woman has not visited her doctor for five to seven years. If you visit a gynecologist constantly, you will not have any “surprises”. Even the precancerous stage can be stopped.
2. It is spoken much about the epidemic of genital herpes. How to protect yourself?
There is no epidemic as such. If a doctor sees patients with herpes for five days in a row, he/she may get a false impression that the infection incidence has increased recently. But such conclusions will be accidental. The infection is the same as always. It is impossible to protect yourself from herpes. Almost all people have antibodies to the virus; that is the majority of us have encountered it. But the virus develops only in those whose immunity is weakened by stress or any other factors. Herpes can be called a disease of poor immunity. Although it can be transmitted sexually via genital and oral sex, not everyone gets infected, and human cell-mediated immunity is the main defender against the virus.
3. Gynecologists often prescribe very expensive vitamins to women. Are they really needed?
The effect of using such drugs is observed, if you are a person suffering from vitamin deficiency. In case of a balanced diet, one gets all the essential vitamins and minerals from food and does not need any supplements. If doctors prescribe vitamins without the beriberi diagnosis, they probably do this merely for the sake of prescribing something. Since you have come to the doctor, how can you leave him/her without a prescription? The only exception is the situation when the patient is planning pregnancy. Then vitamins are necessary.
4. You go to the doctor complaining of menstruation pain, and she says it will disappear after you give birth. Is this true?
Painful menstruation is called dysmenorrhea. It can be primary and secondary. Primary dysmenorrhea has no cause and occurs due to the fact that the uterus incorrectly accumulates prostaglandins in its layers. Prostaglandins are substances which, on the one hand, lead to muscle fiber contractions, and on the other hand, cause pain. In other words, this form of the disease means a kind of uterus immaturity, and it will really disappear after the birth. Secondary dysmenorrhea is associated with the presence of other diseases: endometriosis, fibroids, inflammation of the uterus or uterine appendages. This form of the disease violates the rule that the disease will disappear as soon as you give birth because the pain is caused by an undiagnosed disease. Primary dysmenorrhea is treated with medicines from the category of non-steroidal anti-inflammatory drugs. They will block the accumulation of prostaglandins. You need to take them before the pain gets unbearable, that is two days before menstruation. Secondary dysmenorrhea can be cured only if you eliminate the cause.
5. Many gynecologists advise women to haste with pregnancy. What is the age when you should not give birth anymore?
The doctor has no right to insist on pregnancy and make you hurry. The doctor’s mission is to provide you with reliable information about the situation and give some recommendations after an inspection. In assessing the opportunities to get pregnant, one should take into account not only the patient’s actual age, but biological age as well. There are women who have excellent ovaries at the age of 30 years. The doctor sees that there is still plenty of time before menopause comes, and therefore, there is a good chance to give birth at 40. Sometimes the opposite happens – at the age of 32, a woman can have just a couple of follicles, so there is a strong possibility that menstruation will simply disappear in such a patient at the age of 40-42 years as preconditioned by genetics or the consequence of surgeries and illnesses.
One should not be afraid of late delivery. Yes, the frequency of genetic abnormalities gets higher, and the condition of the uterus may worsen over the years. There is a new blood test that indicates the genotype of the fetus during the 8th-9th week with a high probability, and if anything is wrong, it lets you terminate pregnancy at an early stage. But, of course, one should not postpone the first delivery till the age of 35 for the reasons mentioned above; late childbirth is also a risk factor for breast cancer and other diseases.
6. How to choose the right hormonal contraception? Do you need to take any tests?
Today, pills differ from each other only due to different combinations of components. A woman’s body will accept this or that combination. It is like choosing shoes. The size may be yours, but the shape is inappropriate; on the contrary, there can be shoes that fit like a glove. It is only empirically or by means of trying that you can check whether your shoes or pills are suitable. Therefore, no analysis should be done, as it will not indicate your doctor or you what specific medicine to choose. Each new contraceptive that appears on the market is not completely new; it is like a new cell phone that does not radically change the understanding of these devices – it is merely a new combination, just as another shade of lipstick. The doctor can help you find hormonal pills only after finding out whether the patient has contraindications to them. That’s all. The next thing is to decide what to use – pills, patches or vaginal rings. How do you know what contraception to choose? You should not feel bad, and you should not notice anything either. If the medication causes side effects during the first months of use, it must be replaced.
7. Does one have to cauterize cervical erosion?
In general, erosion, or ectopia (this is the right way to name the disease) needs treatment in just two cases. The first one is when ectopia is quite extensive, and the woman has abundant secretion that causes discomfort. And the second case is when the surface ectopia vessels are injured during a sexual intercourse, which leads to blood spotting. If you have been diagnosed this disease, but it occurs without symptoms and there are no atypical cells, there is nothing you should do – just watch.