Pregnancy is a special time, however there is a lot to understand about it, especially when it comes to planning a family, having a strategy for your life during pregnancy, and the sorts of changes you might experience once your baby is born.
Our bodies are complex systems, with all sorts of things that can naturally occur over our lifetimes. Gynacological problems arise, information and advice can be found. I can help you with any and all of the below. For convenience, links to statutory bodies have been provided below, but please feel free to book an appointment to talk to me and receive expert advice direct for your issue.
- Cervical screening
- Heavy or abnormal menstrual bleeding
- Abnormal cervical screening tests
- Laparoscopic surgery
- STI checks
- Chronic pelvic pain
- Pain with sex
- Pelvic pain
- Vaginal dryness after sex
- Polycystic Ovarian Syndrome (PCOS)
- Bacterial Vaginosis
- Any other gynaecological concerns; eg:
- Vaginal irritation
- Bleeding between periods
- Bleeding after sex
Sexually Transmitted Infections (STI)
If you are sexually active, a regular sexual health check is a good idea. Many sexually transmitted infections (STIs) often do not have any symptoms. It is therefore important that if you have had unprotected intercourse with a casual partner, recently ended a relationship or do in fact have symptoms of and STI such as discharge, pain with intercourse, bleeding after sex or between periods, then it is a good idea to get checked. Most STIs are treatable with antibiotics and if treated early do not have any effect on fertility.
What is tested?
An STI screen usually involves checking for:
- Hepatitis B and C
While herpes and genital warts are not technically STIs, these can also be treated.
What if an STI is not treated?
The biggest concern if an STI goes untreated is that it can cause pelvic inflammatory disease (PID) causing blocked fallopian tubes and even causing a pelvic abscess. Blocked tubes mean an inability to conceive naturally and therefore other fertility options such as IVF will be required to conceive. It may also lead to pelvic pain, sepsis and surgery may be required.
What are fibroids?
Fibroids are benign growths that form inside the walls of the uterus. It is not completely understood why fibroids form. It is believed there are several factors involved. They are more common in women over the age of 50. Most women who have fibroids will be unaffected by them.
What types of fibroids are there?
Fibroids are categorised according to their location
- Intramural- growing inside the wall of the uterus.
- Submucosal- growing inside the lining of the uterus.
- Subserosal- growing on the outside of the wall of the uterus.
What are the complications of fibroids?
The main concern of fibroids is if they change the shape of the cavity of the uterus, it can lead to infertility or miscarriage.
Pregnancy complications include: Preterm labour, growth restriction of the baby, malpresentation of the fetus.
Non-pregnancy related complications include: Pressure symptoms such as urinary frequency, vaginal pressure, bowel pressure and anaemia related to bleeding.
How are fibroids diagnosed?
Ultrasound or hysteroscopy
The treatment of fibroids is very much dependent on the type of fibroid and the symptoms. This is best discussed in the consultation.
Early Pregnancy scans
This ultrasound is a dating and viability ultrasound. It can also be used to diagnose ectopic pregnancies, molar pregnancies, and the unfortunate event of a miscarriage.
Deep Endometriosis Ultrasound
While not all endometriosis can be seen on ultrasound, this ultrasound can assess if endometriosis affects the bowel, ovaries as well as some of the spaces in the pelvis such as the pouch of douglas. This can assist the gynaecologist in planning surgery if it is necessary.
I use the IOTA and Adnex scoring systems to assess the likelihood of ovarian cysts being benign or requiring further assessment. Most cysts usually resolve spontaneously. The follow up ultrasound can be performed by myself at the follow up consultation.
3D ultrasound can be performed to assess the shape of the endometrial cavity. Different shapes may impact fertility and pregnancy.