Gynecological examinations of girls and adolescents

Special attention is paid to the reproductive health of children in our country. The urgency of the problem is connected with the growth of the general gynecological morbidity and with the difficult demographic situation in Russia. According to statistics, every tenth girl is diagnosed with a gynecological disease.

Of great importance in the prevention and early detection of problems in reproductive health are examinations of children by gynecologists in certain decreed age periods. The Ministry of Health of the Russian Federation approved the following terms - 3 years, 6, 14, 15, 16 and 17 years.

At the age of 3, the doctor evaluates the structure of the external genitals, mammary glands, and informs the mother about proper hygienic care. During this period, synechiae (fusion) of the labia minora, inflammatory diseases of the external genitals are most often detected. During this period, doctors sometimes detect an increase in the mammary glands, which may be the first symptom of the pathology of puberty.

At the age of 6, an examination before starting school life and an assessment of hygiene skills are required. During this period, the doctor informs the parents about the upcoming sexual development, explains the changes in the hygienic care of the girl. During the examination, the condition of the mucous membranes of the external genitals, the size of the mammary glands, and physical development are evaluated. During this period, early signs of sexual development disorders are detected: premature enlargement of the mammary glands, changes in the appearance of the external genitals, hair growth in this area.

At the age of 14, the main focus is on assessing sexual development and analyzing menstrual function. The growth of the mammary glands begins after 8 years, in some children after 10-11 years. In terms of the beginning of puberty, heredity, a genetic predisposition to accelerated and delayed sexual development is of great importance. Physical activity, professional sports can also be the cause of delayed puberty. The sequence of the appearance of secondary sexual characteristics, the timing and nature of the first menstruation are evaluated. The period of puberty begins with the growth of the mammary glands, after a year there is hair on the pubis and in the axillary areas. After 2-2. 5 years from the moment of growth of the mammary glands - the time of the first menstruation. According to statistics, the average age of menarche in Russia is 12-13 years.

At the age of 15, the nature of menstrual function is evaluated. The duration of more than 8 days, the menstrual cycle is shorter than 21 days and more than 45 days, the lack of cyclicity are symptoms of a possible pathology of the reproductive system. The analysis of the severity of pain during menstruation, the condition of the mammary glands, the nature of secretions from the genital tract is carried out.

At the age of 16 and 17, this is an examination before entering adulthood. Girls have the opportunity to receive individual advice on hygienic and reproductive behavior directly from specialists. In this age period, the highest percentage of detected gynecological pathology in children is from 20 to 40%. Inflammatory diseases, menstrual disorders, breast pathology, genital tumors – this is the main thing that gynecologists face at this age in adolescents.

Early detection of pathology, awareness of parents and adolescents, referral to a specialized appointment-these are the main goals and objectives of preventive examinations of children by gynecologists.

Chief Freelance Specialist
gynecologist of children and youth
health departments of the Lipetsk region
Marinina E. I.