Preventive 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 associated with the growth of the general gynecological morbidity and the difficult demographic situation in Russia. According to statistics, every tenth girl is diagnosed with gynecological disease.

Preventive examinations of children by gynecologists at certain age periods are of great importance in the prevention and early detection of problems in reproductive health.

The Ministry of Health of Russia has approved the following terms - 3 years, 6, 14, 15, 16 and 17 years.

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

At the age of 6, an examination before the start of school life and an assessment of hygiene skills are mandatory. During this period, the doctor informs parents about the upcoming sexual development, explains 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 a violation of sexual development are revealed: premature enlargement of the mammary glands, a change in   the appearance of the external genitals, hair growth in this area.

At the age of 14, the main attention is paid to the assessment of sexual development and the analysis of menstrual function. The growth of mammary glands begins after 8 years, in some children after 10-11 years. In the timing of the onset of puberty, heredity, genetic predisposition to accelerated and delayed sexual development is of great importance. Physical activity, professional sports can also cause a delay in puberty. The sequence of the appearance of secondary sexual characteristics, the timing and nature of the first menstruation is 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 onset 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 assessed. The duration is more than 8 days, the menstrual cycle is shorter than 21 days and more than 45 days, the absence 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 dysfunction, pathology of the mammary glands, tumors of the genitals – 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 are the main goals and objectives of preventive examinations of children by gynecologists.

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