Conditions & Treatments

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:

• Chlamydia
• Gonorrhoea
• HIV
• Hepatitis B and C
• Syphilis

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.

Fibroids

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

Treatment

The treatment of fibroids is very much dependent on the type of fibroid and the symptoms. This is best discussed in the consultation.

Ultrasounds

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.

Ovarian Cysts

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.

Uterine abnormalites

3D ultrasound can be performed to assess the shape of the endometrial cavity. Different shapes may impact fertility and pregnancy.