Gynaecology is the branch of medicine that deals with the female reproductive system; its structure, function, and the many conditions which could potentially disrupt ‘normal’ life for women. Gynaecological conditions can begin as soon as a young woman reaches puberty, right through to menopause and beyond.
Below, you’ll find some of the more common issues, how they present, and the treatments available to deal with them. It helps when you’re informed and confident if you need to seek help.
Routine cervical smears and HPV testing can help show changes in cervical cells before they progress to cancer. Some women get results that show ‘abnormal cells’, which can range from mild to more serious dysplasia. Minor changes can often be monitored with repeat screening, but more significant changes could need further investigation via a colposcopy and biopsy. Treatments options for more advanced changes involve removing the abnormal cells either by surgical procedures like LLETZ, where a thin wire loop heated by electricity is used to remove the abnormal area of the cervix, or Cone Biopsy where a cone-shaped piece of tissue is removed from the cervix.
Adenomyosis is when cells from the inner lining of the uterus invade into the muscle wall. It can cause heavy and painful periods, pelvic pressure, and sometimes an enlarged uterus. Treatment will usually begin with symptom control – anti inflammatory drugs and hormonal therapies. In more severe cases, surgical options like hysterectomy might be considered, but that would depend on the patient, their goals, and age.
Fibroids are benign muscular growths in or on the uterus, and depending on their size and position, and the number of them, they can cause heavy bleeding, pelvic pain, urinary symptoms, and fertility challenges. Sometimes, women with fibroids are asymptomatic and don’t need any medical intervention, but for those that have significant symptoms treatment options can include hormonal treatments to reduce bleeding or shrink fibroids. There are also minimally invasive procedures, where it’s possible to block the fibroid blood supply, and in more severe cases fibroids can be removed surgically. This is called myomectomy, and the uterus is preserved – hysterectomy is the removal of the uterus and may be needed in appropriate cases.
In endometriosis, tissue similar to the uterus lining grows on the ovaries, fallopian tubes, pelvic lining or elsewhere. Symptoms can include painful periods, chronic pelvic pain, pain with intercourse and infertility issues. Diagnosis is usually made though ultrasound scan or MRI and is often confirmed by laparoscopy. Treatment is dependent on the severity of symptoms, and the patient’s fertility aspirations, but includes analgesics, hormonal suppression, and surgical removal of lesions. Pain Specialist and Fertility Specialist intervention may also be needed.
Polycystic Ovary Syndrome also know as PCOS is a hormonal disorder characterised by hormonal imbalance, ovulatory dysfunction, and polycystic ovaries on ultrasound. It’s one of the most common endocrine disorders and up to 1 in 10 women in the UK may have it. Many with PCOS have no symptoms at all, and it has also been linked to insulin resistance. Management includes lifestyle care (diet, exercise and healthy weight) insulin sensitising medications, hormonal contraception to regulate cycles, and ovulation induction for women trying to conceive.
Women can experience hormone related conditions at different life stages from puberty through to perimenopause and menopause. Symptoms can differ from person to person, but range from irregular periods, hot flushes, night sweats, low mood, low libido, weight gain, and joint pain. Hormone replacement therapy is an option which relieves menopausal symptoms, though careful assessment must be carried out first. There are other things that can be done, including non-hormonal therapies, lifestyle support, and treatments such as bone health monitoring.
Pelvic pain can be caused by several different conditions, and the pain level can also differ. Endometriosis, adhesions, pelvic inflammatory disease, ovarian cysts, or non-gynaecological issues such as gastrointestinal or urological conditions can all be attributed to pelvic pain. Careful diagnosis is needed, using patient history, imaging, and sometimes laparoscopy. Management will depend on the cause and may combine medical, surgical, physical therapy, and pain management.
Menstrual issues are very common. Heavy bleeding, irregular bleeding, or painful periods can affect quality of life, but there is help available. Treatment can range from NSAIDs (non-steroidal anti-inflammatory drugs) and tranexamic acid (which reduces bleeding) to hormonal control (contraceptives, intrauterine devices), and sometimes surgical intervention. PMS involves emotional and physical symptoms in the lead up to menstruation, and can give the sufferer mood swings, irritability, bloating, and breast tenderness. A healthy lifestyle, dietary supplements, SSRIs (Selective Serotonin Reuptake Inhibitors), and hormonal therapies may help alleviate these symptoms.
Vaginal prolapse is a condition where pelvic organs, such as the bladder, uterus, or rectum, weaken and sag or slip down into or out of the vaginal canal. It is caused by the weakening of the pelvic floor muscles and tissues that normally support these organs. Childbirth, aging, obesity, chronic coughing, or constipation can all contribute to this weakening. Treatments for vaginal prolapse range from no intervention at all for mild cases, to pelvic floor exercises, hormone therapy, vaginal pessaries, and surgery for more severe symptoms. The treatment will also depend on the severity of the prolapse, the patient’s quality of life, and other health factors.
While all of the above is for information to show the signs and symptoms to look out for and the possible treatment options, The Surrey Park Clinic can support patients through diagnosis and treatment, as our team of consultants and specialist nurses are experts in assessing and caring for a full range of gynaecological conditions. Helping people feel their best is at the forefront of what we do. For many, gynaecological problems can be worrying, impact both physical and mental well-being, and in some instances, people may be reluctant to seek help.
The earlier you seek advice for any concerning symptoms, often the quicker and easier these are to resolve, and you can go back to feeling like yourself again. Book an appointment at The Surrey Park Clinic here.