Treatment of endometrial pathology by obstetrician-gynecologist Irina Ivanovna Kulbach in the city of Dnipro

When addressing menstrual cycle disorders, lower abdominal pain, or suspected problems with the uterine lining, patients seek clarification and assistance.

The physician conducts a thorough clinical evaluation, reviewing complaints and medical history, and, if necessary, orders additional examinations to clarify the condition.

The patient receives a clear and understandable action plan—from immediate measures to necessary tests and monitoring of changes over time.

A key aspect of the physician’s approach is careful attention to differential diagnosis, meticulous dynamic observation, and prevention of possible exacerbations.

When to See a Doctor

The appearance of discomfort or changes in the functioning of the reproductive system can cause concern. It is advisable to consult an obstetrician-gynecologist to determine the cause and receive professional help. Scheduling an appointment with a specialist is recommended if you notice the following with endometrial pathologies:

• periodic or constant lower abdominal pain
• irregular or excessively heavy menstrual bleeding
• intermenstrual bleeding or spotting
• discomfort during sexual intercourse
• general malaise associated with gynecological symptoms
• recurring symptoms or worsening of unpleasant sensations
• interference with work, sleep, or daily activities due to pain or discharge
• no improvement after self-care measures or previous treatment
• symptoms appearing for the first time and causing concern
• exacerbation of chronic conditions related to the reproductive system
• need to clarify your condition after stress or lifestyle changes
• planning further examination and monitoring of your health

Even if symptoms do not cause severe discomfort, their appearance or changes are a reason to consult a doctor. A specialist will help identify the causes, prescribe examinations if necessary, and offer an appropriate course of action. It is important not to delay the visit and receive qualified support regarding women's health issues.

Emergency Conditions or When to See a Doctor Immediately

• Sudden and heavy bleeding from the genital tract
• Sharp and increasing pain in the lower abdomen
• Combination of severe weakness, dizziness, and loss of consciousness
• Fever accompanied by intense pain in the pelvic area
• Sudden worsening of condition after an injury to the lower abdomen

If you experience any of these symptoms, do not wait for a scheduled appointment and seek medical attention as soon as possible. Our clinic offers a home visit service for prompt medical assistance.

Causes and Risk Factors in Endometrial Pathologies

Understanding the possible causes and risk factors helps to better comprehend why endometrial pathology develops. Accurate diagnosis requires medical evaluation and examinations that allow for the exclusion of reversible conditions and the selection of appropriate treatment.

Main Causes / Mechanisms (briefly)

• Hormonal disorders affecting the condition of the uterine lining
• Chronic inflammatory processes in the reproductive system
• Consequences of previous injuries or surgeries on the uterus
• Circulatory and tissue trophic disturbances in the endometrium
• Age-related changes affecting the structure and function of the mucous membrane

Risk Factors

• Age over 35, with increased likelihood of disorders
• Prolonged use of hormonal medications without supervision
• Presence of chronic gynecological diseases
• Excess weight and metabolic disorders
• Frequent stress and adverse environmental conditions
• Hereditary predisposition to gynecological pathologies
• History of abortions or curettage procedures
• Irregular menstrual cycles and ovulation problems

Reversible Causes to Rule Out

• Acute or chronic inflammation in the pelvic organs
• Hormonal imbalance related to medication use or health conditions
• Infectious processes affecting the condition of the uterine lining
• Reaction to intrauterine devices or contraceptives

Endometrial pathologies can develop for various reasons, and a comprehensive examination by a specialist is necessary to establish an accurate diagnosis.

Diagnosis

When seeking treatment for endometrial pathology, it is important to understand how the doctor approaches identifying the causes and developing a plan for further action. The diagnostic process is conducted step-by-step to ensure safety and obtain the necessary data.

Diagnostic Approach

• taking medical history with a review of complaints and past illnesses
• gynecological examination to assess the overall condition of the reproductive system
• ordering basic laboratory tests as indicated
• performing additional instrumental studies if necessary
• analyzing the collected data and creating a plan for examination or treatment
• discussing results and recommendations with the patient
• referring to specialists or for further examination if needed

Typical Investigations as Indicated

These may include:

• ultrasound examination of the pelvic organs
• laboratory tests for hormones and general health status
• histological studies to clarify tissue condition
• endoscopic procedures if necessary

What to Bring to the Appointment

• results of previous examinations and tests
• list of medications and supplements being taken
• menstrual cycle and symptom diary
• medical documentation of past gynecological procedures
• questions and notes about current condition

Diagnosing endometrial pathology requires a comprehensive approach and attention to detail, which helps to develop a clear plan for subsequent steps.

Treatment

Treatment of endometrial pathology is aimed at eliminating the causes of discomfort and normalizing the functioning of the uterine lining. The therapy plan is individualized, taking into account the patient's specific condition and needs.

Goals of Therapy

• reduce unpleasant symptoms and improve overall well-being
• correct factors affecting the condition of the endometrium
• restore normal functioning of the reproductive system
• prevent possible complications and recurrent exacerbations

Main Approaches to Treatment

• may include medication methods to regulate hormonal balance as indicated
• use of non-medication methods aimed at improving general condition
• conducting therapeutic procedures when indicated
• individualized adjustment of the plan according to the body’s response and comorbidities
• monitoring and controlling the progression of the condition during treatment

What the Doctor Does

• selects and adjusts therapy considering individual characteristics
• assesses comorbid conditions and potential risks
• monitors treatment effectiveness and side effects
• explains how to evaluate results and what is important to report to the doctor
• coordinates interaction with other specialists if necessary

What to Expect: Plan and Monitoring

• evaluation of changes and plan adjustments are performed as indicated
• timing of improvement and physiological response may vary depending on the situation
• follow-up visits are important for monitoring results and therapy adjustments
• the doctor provides guidance on necessary steps to maintain health

Detailed information about treatment options can be obtained during a consultation with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention is important in endometrial pathologies to reduce the risk of development and complications. The prevention plan is selected individually, taking into account the characteristics of the body and health status.

Main primary prevention measures

• monitoring hormonal balance and timely consultation in case of changes
• maintaining a healthy weight and a proper lifestyle
• quitting smoking and minimizing exposure to harmful factors
• regular monitoring in the presence of chronic gynecological diseases
• timely treatment of inflammatory processes when indicated
• avoiding stressful situations and caring for mental health

Screening and secondary prevention / regular monitoring

• scheduled gynecological examinations as recommended by the doctor
• ultrasound examinations to assess the condition of the endometrium when indicated
• laboratory tests of hormonal profile if necessary
• monitoring changes in the menstrual cycle and symptoms
• control of concomitant conditions affecting reproductive health

Practical advice

• discuss any changes in well-being and menstrual cycle with your doctor
• maintain physical activity within your capabilities and recommendations
• follow a diet that includes a variety of nutritious foods
• avoid self-discontinuation of medications and adjust treatment only with a doctor
• schedule regular visits to a specialist for health assessment and prevention

Preventive measures help better control the condition in endometrial pathologies and support overall women's health.

Important to Know

Treatment of endometrial pathology requires careful and comprehensive assessment of the condition. The main task is to identify the causes of the changes, not just to eliminate the symptoms. Early consultation helps to choose the appropriate approach, reduce the risk of complications, and prevent disease progression. Sometimes monitoring over time is necessary to adjust the treatment plan based on the body's response. Various factors can influence the course of the condition, including stress levels, quality of sleep, and the presence of comorbidities. Self-medication can complicate diagnosis, cause unwanted side effects, and delay necessary examinations. Our clinic provides a full cycle of support — from diagnosis to ongoing monitoring.

• Identifying the cause of the pathology is more important than just eliminating symptoms
• Early assessment helps reduce the risk of progression and complications
• Adjustment of treatment is possible if the condition changes over time
• The condition is influenced by factors such as workload, stress, and comorbid diseases
• Self-medication can obscure the clinical picture and delay diagnosis
• A comprehensive approach and follow-up with one specialist simplify the process

For detailed information about causes, diagnostic methods, and treatment options, we recommend reviewing our main page on endometrial pathology.

Self-Care Before the Appointment: What You Can and Cannot Do

Before seeing the doctor, it is important to take only safe steps to avoid worsening your condition and not complicate the diagnosis of endometrial pathology. If you experience any deterioration in your well-being, you must urgently contact Dr. Irina Ivanovna Kulbach.

What You Can Do Before the Appointment

• Write down when and how the symptoms appeared, what helps or worsens them
• Bring a list of all the medications you are taking and their dosages (if known)
• Measure your temperature, blood pressure, and pulse if you know how, and record the results
• Keep a symptom diary: note the time of onset, intensity, and possible triggers
• Try to reduce physical activity and ensure you get rest before the examination
• Drink enough water to avoid dehydration (unless contraindicated)
• Record any changes in your menstrual cycle or discharge
• Stay calm and avoid stress and anxiety as much as possible
• Don’t forget to bring the results of previous tests and examinations with you

What You Should Not Do Before the Appointment

• Do not stop taking prescribed medications without consulting your doctor
• Do not start combining new medications or treatments on your own
• Do not use unverified folk remedies or recipes without your doctor's approval
• Do not ignore worsening symptoms or the appearance of new alarming signs
• Do not postpone your visit to the doctor if your condition worsens or if you have severe pain
• Do not try to interpret tests and imaging results by yourself
• Do not change your diet or therapy regimen without consulting a specialist
• Do not neglect regular check-ups and consultations, even if you feel better
• Avoid using painkillers on your own for severe pain without medical advice

If any urgent signs or a sharp worsening of your condition arise, immediately seek help from Dr. Irina Ivanovna Kulbach.

How I Can Help as a Doctor with Endometrial Pathology

During a consultation regarding endometrial pathology, I can assist you in the following ways: assess your current condition, identify the causes of your symptoms, and propose a plan of action to improve your well-being and manage your health.

• Review your complaints and medical history to identify possible causes
• Evaluate the severity of symptoms and potential health risks
• Analyze current treatments and their tolerability, making adjustments if necessary
• Develop a plan for further steps: examinations, treatment, and monitoring
• Take into account any comorbidities and medications to ensure safe therapy
• Provide lifestyle and regimen recommendations based on your condition
• Explain how to monitor progress and when to seek follow-up consultations
• Conduct initial diagnostics with differential analysis to determine causes of changes
• Adjust the treatment plan if there is no improvement or if side effects occur

My goal is not only to provide a preliminary diagnosis but also to organize a comprehensive approach to your treatment and follow-up care. If needed, I can offer a second opinion on your examination results and help with prevention of exacerbations.

This approach helps minimize risks and achieve better control of your condition.

What Questions Can I Ask the Doctor Regarding Endometrial Pathology?

During your consultation about endometrial pathology, you can discuss the following concerns with Dr. Irina Ivanovna Kulbach:

• Experiencing lower abdominal pain or discomfort
• Irregular or heavy bleeding
• Spotting or intermenstrual bleeding
• Symptoms that recur or worsen over time
• Previously prescribed treatments that have not yielded expected results
• Questions regarding accompanying gynecological conditions
• Need for review of test results or a second opinion from a specialist

In case of sudden and heavy bleeding, severe pain, or loss of consciousness — seek emergency assistance immediately rather than waiting for a scheduled appointment.

• What is happening to me and what could it be?
• Why have these symptoms appeared now?
• How can I tell if this is related to endometrial pathology or another condition?
• What tests are necessary specifically in my case?
• Which analyses and examinations are mandatory, and which can be skipped?
• How should I prepare properly for the tests and the consultation?
• What treatment or management options are available, and how do they differ?
• Is it possible to completely resolve the problem, or is this a chronic condition?
• Why is the prescribed treatment not effective, and what should I do next?
• Can the problem be managed without surgery or other invasive procedures?
• How long does treatment usually take, and how often should follow-up checks be done?
• What signs indicate improvement or worsening of the condition?
• What should I do if my condition suddenly deteriorates or there is an acute episode?

This list of questions will help you prepare better for your appointment and get the most comprehensive information. Dr. Irina Ivanovna Kulbach reviews each case attentively, ensuring safety and a holistic approach. In emergency situations, she will refer you to the appropriate specialist or arrange urgent care.

How the Consultation Proceeds

A consultation with an obstetrician-gynecologist for endometrial pathology includes discussing complaints, assessing the current condition, and developing a plan for further action. The scope of necessary examinations is determined individually and depends on indications. During a single visit, the specialist performs a preliminary evaluation and forms a plan for examination and treatment.

1. Clarification of complaints and the purpose of the visit: the doctor finds out what exactly is troubling the patient, how long the symptoms have been present, and what the patient expects from the appointment.
2. Collection of medical history and risk factors related to the endometrial condition and overall health.
3. Analysis of previous treatments and examination results, if any; it is recommended to bring documents and a list of current medications.
4. Conducting an examination and basic tests as indicated, aimed at assessing the current condition.
5. Preliminary conclusion with explanations of possible causes and the importance of excluding serious conditions.
6. Development of an individual examination plan, which may include ultrasound, laboratory tests, histological and other methods as needed.
7. Discussion of general treatment principles and management strategies focused on symptom relief and complication prevention.
8. Determination of control timelines, recommendations for monitoring, and information about signs that warrant earlier medical consultation.

If it is a first-time visit, primary attention is given to a detailed information gathering to understand the causes of the symptoms. If previous treatment has been ineffective, the consultation helps clarify causes and adjust the therapy plan.

This approach ensures comprehensive and safe patient care with remote monitoring of condition dynamics and timely therapy adjustments as necessary.

Preparation for the Appointment

Preparing for an appointment with an obstetrician-gynecologist for endometrial pathology will help speed up diagnosis and treatment planning. Following simple recommendations will improve the quality of the consultation.

• Bring a list of all current medications with their names and dosages, if known
• Take results of previous examinations, ultrasound images, and lab tests
• Write down your main complaints: when the symptoms appeared, and what makes them better or worse
• Do not stop taking prescribed medications without consulting your doctor
• If special preparation is required — avoid using cosmetics and creams before the appointment
• Arrive 10–15 minutes early to complete registration calmly and without stress
• Check with the reception whether any special preparation is needed for specific examinations
• If fasting is required — do not eat or drink for 8–12 hours before the appointment (unless otherwise advised)
• Bring questions and notes you want to discuss with the doctor
• Try to describe your symptoms and how they have changed over time as accurately as possible

If you have doubts about preparation or medication intake — it’s better to clarify in advance when making your appointment. Do not change your treatment regimen without consulting a specialist.

About the Doctor

Irina Ivanovna Kulbach is an obstetrician-gynecologist of the highest category with over 40 years of experience. She works with patients who have endometrial pathologies, including those seeking initial consultation, dealing with chronic conditions, or experiencing ineffective previous treatments.

Her approach is based on a thorough analysis of complaints and dynamic monitoring, which helps to adjust therapy and prevent exacerbations.

During the consultation, you will receive a clear explanation of the current situation and recommendations for further actions.

Why Patients Choose Dr. Irina Ivanovna Kulbach

Choosing a doctor for endometrial pathology is crucial for comprehensive diagnostics and effective disease management. Dr. Irina Ivanovna Kulbach offers a systematic and step-by-step approach, focusing not only on treating symptoms but also on identifying underlying causes, which is especially important in complex and recurrent cases. Patients appreciate the clear action plan and the opportunity to come with existing examinations for analysis and therapy adjustments.

• Clear treatment plan with steps: what we do now, how we monitor, and when the next visit is scheduled
• Examinations are prescribed strictly based on indications, avoiding unnecessary burden on the patient
• Consideration of comorbidities and medications for safe and compatible therapy
• Monitoring the progression of the condition and timely adjustment of therapy when necessary
• Review of previous prescriptions, assessment of tolerance, and possible side effects
• Interpretation of already conducted examination results to gain precise understanding of the situation
• Emphasis on diagnosing causes of symptoms and differential diagnosis in complex cases
• Ongoing management with prevention of complications and exacerbations, taking individual characteristics into account

This approach helps patients not only achieve temporary relief but also manage their condition comprehensively, considering all factors and adjusting treatment promptly. It is important for the doctor to ensure transparency and consistency throughout the process so that you feel confident at every stage.

Case Studies

Initial consultation for irregular bleeding

A middle-aged patient presented with complaints of irregular and heavy menstrual bleeding, which adversely affected her well-being. It was important to rule out serious causes such as tumors or inflammations. After a thorough medical history and necessary examinations, an individualized monitoring and treatment plan was developed. Over the course of several weeks, bleeding decreased and symptoms stabilized. The patient continues to be monitored with regular check-ups to assess the progression of her condition.

Therapy adjustment due to lack of effect from previous treatment

A young woman came after a course of treatment that did not lead to the expected improvement in symptoms of endometrial pathology. It was important to analyze previous prescriptions and possible reasons for the lack of effect, including non-compliance and comorbid conditions. Therapy methods were reviewed and alternative approaches were selected considering individual characteristics. At a follow-up visit, improvement in well-being and a reduction in symptom severity were noted. Observation continues with possible treatment plan adjustments as needed.

Chronic course with concomitant gynecological diseases

An elderly patient presented with long-standing complaints of lower abdominal pain and intermittent bleeding, as well as existing concomitant inflammatory processes. The physician's task was to consider all accompanying diagnoses and select the safest and most effective management option. Diagnostics helped clarify the condition and exclude complications. Partial stabilization of symptoms and improvement of overall well-being were observed. Regular monitoring and preventive care continue.

Symptom exacerbation following stress and physical exertion

A middle-aged woman presented with a sharp increase in symptoms, including pain and bleeding, after a period of stress and physical strain. It was crucial for the physician to quickly exclude dangerous conditions and develop a supportive plan combining pharmacological and non-pharmacological methods. Following the start of comprehensive therapy, the condition stabilized, and unpleasant manifestations decreased. The patient received recommendations on prevention and regular monitoring to avoid recurrent exacerbations.

Recurrent symptoms and request for a second opinion

The patient had sought medical help multiple times with recurring symptoms without prolonged remission and wanted a second opinion regarding her treatment. The physician conducted a comprehensive review of symptoms, analysis of examination results, and previous prescriptions. Discrepancies in therapy approaches were identified, and a treatment plan adjustment was proposed taking into account the identified factors. After several months of observation, a decrease in symptom severity and improvement in quality of life were noted. Regular supervision is ongoing to adapt therapy as necessary.

How long does the consultation last?

The consultation usually takes 30–60 minutes; please confirm the exact time when booking.

How can I prepare for the appointment?

Prepare by noting your symptoms and bringing all necessary documents; details are provided below.

What should I bring to the appointment?

Please bring any existing test results, scans, medical records, and a list of your current medications.

Do I need to come fasting or are there any restrictions?

Usually no, unless otherwise specified at the time of booking.

How many visits are usually required?

The number of visits depends on the specific situation and the stage of the condition.

When can I expect the first results from the treatment?

Results are assessed individually and depend on the chosen treatment approach.

What should I do if my condition worsens before the appointment?

If you experience dangerous symptoms, seek emergency care immediately and do not delay your visit.

Can the treatment be combined with my current medications?

This will be discussed during the appointment; do not change medications without consulting your doctor.

Is it possible to have an online consultation?

Yes, online consultations are available upon prior booking and evaluation of your situation.

Can I come with tests I have already done?

Yes, please bring any existing test results for assessment.

Do I need to come for follow-up visits and how often?

Follow-up visits are scheduled individually based on your progress.

Can I get a second opinion from a doctor?

Yes, you can request a second opinion regarding your tests and treatment.

What should I do if symptoms return after improvement?

Consult your doctor to adjust the treatment plan and for additional testing.

What tests are usually prescribed?

Testing is tailored individually depending on the cause and condition.

Can I have a doctor’s appointment during pregnancy?

Discuss your condition with the doctor to choose a safe treatment plan.

What should I do if I cannot come at the scheduled time?

Please notify the clinic in advance to reschedule your appointment to a convenient time.

Can I come without an appointment?

It is recommended to book in advance to avoid waiting and to ensure quality care.

How do I know if the treatment is effective?

Effectiveness is evaluated by the improvement of symptoms and follow-up test results.