Patients with gynecological diseases seek medical help most often due to the following complaints: pain in the lower abdomen, genital bleeding, fluorine (note, “white discharge”), detection of tumor-like formations. 1. Pain – what do its characteristics point to? Pain is a common symptom that reflects a woman’s subjective feelings and objective processes in her body. It is important to determine its strength, duration, time of appearance and irradiation. It is described as sharp, dull throbbing, burning, cutting or pulling. Acute pain is associated with acute conditions – rupture, torsion, etc. In this case, the following should be excluded: acute appendicitis, acute cystopyelitis, nephrolytic crisis. Dull pain is inherent in various static anomalies – descent or prolapse of the vaginal walls and uterus, hematomas, stasis, tumors in the small pelvis. Pulsating pain occurs during the development of a purulent process, burning pain – during inflammatory changes, most often in richly innervated organs, such as the vulva. Colic-like pain is characteristic of a tubal pregnancy, a foreign body is present, a submucosal myoma nodule. Lesser but persistent and recurring pain is associated with chronic inflammatory processes. Pain in the lower back and coccyx may be due to inflammation or a tumor. A specific pain in gynecology is dysmenorrhea. It is characterized as pulling pain in the lower abdomen of varying intensity and duration. It occurs during periodic menstrual bleeding and may be accompanied by general complaints such as headache, nausea and vomiting. The pain during ovulation is also specific. Initially, it is dull and is due to an increase in the Graafian follicle. The occurrence of the very moment of ovulation is registered by more sensitive women with a sharp pain, burning and spreading, fading over time and quickly transient. Sometimes it is so strong that it requires bed rest and painkillers. 2. Bleeding – the differences between physiological and pathological bleeding Genital bleeding in a woman during different periods of her life can be both physiological and a symptom of a genital disease. It is most often from the uterus. Depending on whether it is related to the menstrual cycle or not, it is defined as menorrhagia or metrorrhagia, respectively. Genital bleeding can be due to pathology of the vulva, vagina, fallopian tubes or ovaries. The absence of monthly bleeding is called amenorrhea. It is physiological – before puberty, during pregnancy, in menopause, and non-physiological – due to an underdeveloped genital apparatus, adhesions, etc. Abnormalities in the menstrual cycle are associated with deviations in its main parameters. The following terms are used to describe these cases: hypomenorrhea – scanty menstruation, hypermenorrhea – abundant menstruation, oligomenorrhea – infrequent menstruation, dysmenorrhea – painful menstruation. During menopause, periods become irregular with lengthening or shortening of the interval,increase or decrease of blood flow. When it is abundant and prolonged, it is referred to as climacteric. In this case, it is necessary to exclude myoma, glandular hyperplasia of the endometrium, polyps, neoplasias. Menopausal bleeding is a pathological phenomenon. It is necessary to exclude malignant diseases of the uterine body, cervix, vulva, ovarian tumors. Very rarely the cause of bleeding can be general diseases – hematological or arterial hypertension. 3. Genital fluorine – what the characteristics of vaginal discharge show. Any discharge from the genitals that is not blood is referred to as fluorine. With the anamnesis, it is necessary to clarify its characteristics – color, smell, quantity, impurities, connection with sexual contact. NEWS_MORE_BOX Usually, genital discharge does not stain underwear and is whitish in color, which is why it is often called “white discharge”. Physiologically, it is more abundant in women who have given birth, before and after menstruation, during pregnancy. Depending on the source, there are several types of genital fluoride. Vaginal fluorine is the most common genital discharge. Normal vaginal contents are composed of transudate from the vessels of the vaginal wall, epithelial cells, leukocytes, and microorganisms. It is characterized by Döderlein bacteria, which play a major role in maintaining the acidic reaction. Through enzymatic systems, these bacteria destroy the cell membrane of vaginal epithelial cells. Glycogen is released, which is metabolized to lactic acid. Violation of the number of lactic acid bacteria can become the cause of strengthening vaginal fluoride. Cervical fluoride is second only to vaginal fluoride. Its origin is from the cervical glands due to anatomical, functional and inflammatory changes. It can be the first sign of neoplastic disease of the cervix. Tubal fluoride is rare. Sudden discharge of a significant amount of fluid, often preceded by abdominal heaviness, relieved after discharge has been reported.during pregnancy. Depending on the source, several types of genital fluoride are distinguished. Vaginal fluorine is the most common genital discharge. Normal vaginal contents are composed of transudate from the vessels of the vaginal wall, epithelial cells, leukocytes, and microorganisms. It is characterized by Döderlein bacteria, which play a major role in maintaining the acidic reaction. Through enzymatic systems, these bacteria destroy the cell membrane of vaginal epithelial cells. Glycogen is released, which is metabolized to lactic acid. Violation of the number of lactic acid bacteria can become a reason for strengthening vaginal fluoride. Cervical fluoride is second only to vaginal fluoride. Its origin is from the cervical glands due to anatomical, functional and inflammatory changes. It can be the first sign of neoplastic disease of the cervix. Tubal fluoride is rare. Sudden discharge of a significant amount of fluid has been reported, often preceded by abdominal heaviness, relieved after discharge.during pregnancy. Depending on the source, several types of genital fluoride are distinguished. Vaginal fluorine is the most common genital discharge. Normal vaginal contents are composed of transudate from the vessels of the vaginal wall, epithelial cells, leukocytes, and microorganisms. It is characterized by Döderlein bacteria, which play a major role in maintaining the acidic reaction. Through enzymatic systems, these bacteria destroy the cell membrane of vaginal epithelial cells. Glycogen is released, which is metabolized to lactic acid. Violation of the number of lactic acid bacteria can become a reason for strengthening vaginal fluoride. Cervical fluoride is second only to vaginal fluoride. Its origin is from the cervical glands due to anatomical, functional and inflammatory changes. It can be the first sign of neoplastic disease of the cervix. Tubal fluoride is rare. Sudden discharge of a significant amount of fluid has been reported, often preceded by abdominal heaviness, relieved after discharge.