Planning a pregnancy: medical supervision, preparation, hormone therapy

General points: what to pay attention to

There is a list of tests approved by the order of the Ministry of Health that are recommended to be taken before planning a pregnancy. It is necessary to do this, because we may not know about some of our chronic diseases that do not manifest themselves for a long time. We have a saying: "Where it is thin, there it breaks." This is exactly what happens during pregnancy. Many say that pregnancy makes you healthy. But when a certain age limit is passed (35-40 years), it is imperative to get examined, because the child then needs a healthy mother, and not an unhappy one who will take pills and constantly run to doctors.

Remember that all diseases worsen during pregnancy, and most drugs cannot be used.

You have to think not only about the woman, but also about the fetus - and the doctor begins to rush between the patient and her future baby. This does not lead to anything good. The same thyroid pathologies are diseases that a person may not notice in themselves, but then they will affect the pregnancy, and the woman herself, and even the mental and physical abilities of the child. Therefore, it is very important to come to us at the stage of pregnancy planning. There are different periods for the first visit - from three months to six months.

At least three months before conception, you must come to the doctor and say: "I want to get pregnant."

And the doctor, talking with you, will individually select what exactly you need to undergo, because there is no need for everyone to take a hundred tests, but there are some basic, mandatory ones. During the conversation, everything is discussed in detail, because not every person realizes that the doctor can understand and assess the situation just from the conversation, from some hints.

Special attention should be paid to sex education of children. Early sexual life is, unfortunately, very common in our country, and this is generally bad. In our society, children are completely uninformed about anything, they learn everything on the street and on the Internet. Consequently, they have incomplete information. That is, they have no idea how to protect themselves from unwanted pregnancy, from infections - hence the high probability of getting one or the other. Therefore, naturally, early sexual life does not lead to anything good, since such a pregnancy is often interrupted, and abortion carries a risk of infertility, which is impossible to calculate.

When planning, it is also important to take into account a healthy lifestyle. This is also discussed at the reception, especially the topic of bad habits. They will definitely have to quit, because smoking, alcohol, and drug use - all of this has a detrimental effect on the child.

People with drug addiction also want to have children.

Such patients come to me when they are already pregnant, and the question of termination arises. In my practice, there has never been such a thing as outright drug addicts planning a pregnancy, but I do not know about others. Thank God, in our society this is not so common. I do not know how things are in Holland with this, because they have legalized a lot of things, unlike us. Maybe these issues are addressed somehow differently there. They have a European approach to life - I am not saying that this is right or wrong. They have a more planned approach. And here everything is at random.

However, modern girls are different from girls ten years ago, if you take them for comparison. Now is a more active generation. You do read, you travel around the world, you absorb information, so I would say that there is now a greater interest in planned action. Today, the exchange of information is more intense than in Soviet times. Who was there to exchange information with? And now you go online and find out everything. But only after you find out on the Internet, you still need to consult a doctor.

Pregnancy care at TrustMed

To be honest, I don’t really like pregnancy care programs, because they force the doctor into certain limits. For example, the program requires that you take a blood test five times, so be it. If for some objective reasons an additional test is needed that is not included in the program, the patient may not like it. Paid once - why should you pay more? Naturally, we follow the instructions of the Ministry of Health. But, again, the patient must trust his doctor, understand that the specialist is focused on success, and not on endless tests. People do not always perceive going beyond the program well, and this is unnecessary nerves, because pregnancy lasts for more than one month.

Modern methods of contraception: choosing the right one

Each method of contraception has its own indications and contraindications. Indications are the desire to protect yourself from unwanted pregnancy during a given period of time. Contraindications are revealed during the conversation. These can be absolute contraindications, when the use of contraception is prohibited, and relative ones. In the latter case, the doctor decides. And then the method of contraception is selected:

• hormonal;
• barrier;
• spiral;
• vaginal rings;
• pills;
• implants.

Again, all this is individual, what is convenient for whom. For example, if a woman constantly forgets to take pills, then it is better not to prescribe them to her.

"Implanon" is a hormonal contraception, a modern drug with a minimal range of contraindications, it is innovative medicine. A capsule is inserted under the skin, and a person is reliably protected for three years. It is suitable for young girls who have no time to think about contraception, or women after childbirth (especially with a cesarean section, that is, with a scar on the uterus) - it is undesirable for them to get pregnant for two years. Moreover, it can be used during breastfeeding. We also put such capsules in women who have some extragenital diseases, fibroids, endometriosis, etc.

I am not a supporter of the IUD in general, because it is a foreign body in the uterus. Especially for those who have not given birth, and this is a common opinion, not mine personally. There are many women with chronic inflammation now, because they do not always go to the doctor on time due to lack of time due to work and home - such is life today. As a result, a sluggish inflammatory process occurs, and against the background of the IUD it worsens, up to the development of complications, after which it is necessary to undergo treatment for a long time. Our people may not immediately come to the doctor, even if they notice not very good discharge. They will go until they stop, until it becomes really bad.

About hormones: are they so scary

Personally, due to a certain age (I am no longer 25), I understand that in our country the topic of hormone replacement therapy is little covered. And, unfortunately, there is a fear of hormones among the population. In the West, entire anti-age programs are in place before menopause, when a woman is just entering a certain phase of changes, and these changes can be different. Normally, menopause occurs at 48-50 years, but a woman may have early menopause or hormone deficiency, which often affects her general condition. And when we select hormone therapy individually, observing all contraindications, we give a woman the opportunity to live long and healthy. Not to be a patient of a neurologist, cardiologist, not to take a bunch of pills, not to become hypertensive, not to have ischemic heart disease.

Hormone therapy is essentially a prevention of cardiovascular diseases and skeletal disorders, because with age, the level of estradiol drops and calcium is washed out of the bones. That is, all these fractures at an early age indicate that a person does not have enough hormones. This is prevention at a level that we do not see with the eye, because we already observe the disease when there is pressure, changes in the ECG, but at this level the disease already exists, it has arrived.

The age when it is necessary to start hormone therapy cannot be clearly defined, everything is individual.

Hormone therapy is hormone replacement therapy. In our society, it is customary to treat climacteric symptoms when a woman is already feeling bad, when there is menopause, hot flashes, problems with pressure. Then time can no longer be turned back, and we have to rid her of these problems, from the same diabetes, which can be due to age. And if we start early, when a woman is approaching a critical date and is in the risk group, but not yet in menopause, but in premenopause, and suffers from hormone deficiency, then we can play ahead - there are all the opportunities for this now.

Hormone prophylaxis: at what age is it recommended to undergo it

I recommend after 35 years of age to periodically, at least once a year, visit a gynecologist, preferably even a gynecologist-endocrinologist, to assess your hormonal status, because hormone therapy is selected individually. But, for example, with early menopause, this issue must be resolved unequivocally, because if a woman stops menstruating at 42, this is not good, since the entire body goes downhill: the heart, kidneys, bones begin to suffer. And if we do not compensate such a woman in time, then we will treat her later with the involvement of a large number of specialists.

There is no need to be afraid of hormonal prophylaxis. They broadcast about it on TV screens and write articles, but we have a society of hormone-phobes. Such a phobia has deep roots, it is a persistent stereotype, which, nevertheless, must be overcome.

People do not always understand that they are afraid of the wrong hormones.

If you tell a person the word "hormones" at an appointment, he immediately takes a pose, resists with all his might. We cannot exist without hormones anyway, our body is a huge spectrum of hormones, an entire endocrine system, if we are broken down into chemicals. And when a woman approaches the age of menopause, her hormone levels gradually begin to decrease. For some it is slower, for others faster, for others prematurely. There is even such a diagnosis - premature exhaustion of ovarian function, which occurs against the background of poor ecology, stress and illness. When menopause should happen at 50, but it happens at 42 - there is a sharp drop in hormonal levels. Naturally, its influence extends to the entire body - and it is important for us to prevent this.

I always tell my patients: "Imagine a skier sliding down a mountain. If he has gone too far, then we will also have to go far and help him there. And if we catch him at the start, then he will still be sliding down this mountain for a very long time."