Gynaecologists specialize in diagnosing and treating diseases of the female reproductive system. Often working alongside obstetricians and urologists, gynaecologists offer comprehensive healthcare to women of all ages.
They conduct regular examinations of the uterus, ovaries, fallopian tubes and vagina. Furthermore, they screen for diseases like ovarian cysts, incontinence or prolapse of pelvic organs.
Menstrual cycle
Menstrual cycles are an essential step in women’s bodies that prepare them to accept fertilized eggs, with each month seeing the uterus shed its lining due to changes in natural hormones such as estrogen and progesterone levels.
Once this lining has been shed, ovaries begin to produce follicles – fluid-filled sacs containing an egg – as a response to FSH from the pituitary gland. One follicle becomes dominant and ovulates, leaving other smaller ones behind until eventually all its fluid dries up; along with it comes menstruation or period.
Menstrual cycles vary from person to person. If yours last longer than 28 days and/or are heavier than expected, or interfere with daily activities such as work or school, consult with a gynecologist. They will be able to pinpoint what may be causing abnormal cycles as well as provide treatment options.
Fibroids
Fibroids are abnormal growths of muscle in the uterus that can cause heavy bleeding and discomfort. Fibroids can form anywhere inside or under the uterine lining (submucosal), outside on a stalk of tissue outside (subserosal) or attached directly to a stalk on either side (pedunculated). Fibroids usually appear during periods when hormone levels are at their highest, and then tend to shrink following menopause when hormone levels have declined.
Gynaecologists can diagnose fibroids through either performing a pelvic exam or ordering an ultrasound of the uterus and related pelvic organs, respectively. Treatment options depend on the size and location of fibroids: medications to regulate hormone levels can cause fibroids to shrink, decreasing symptoms. Dietary changes, exercise and stress management may also help manage symptoms. Fibroids can inhibit conception or cause complications during gestation such as vaginal bleeding, preterm delivery or even breech birth (in which baby emerges buttocks first); however most women with fibroids experience uncomplicated pregnancies during gestation.
Urinary incontinence
Urinary incontinence (UI) is an embarrassing condition affecting women of all ages, often caused by chronic illness, childbirth or menopause. Women are twice more likely to be affected than men and it can result in social embarrassment, isolation and poor health outcomes.
Your gynaecologist will perform a physical exam and take a urine sample in order to diagnose your condition. They may also ask about its severity, frequency of leakage and what activities or situations trigger it; furthermore they may request you keep a diary about symptoms for further assessment.
A urogynecologist will then perform tests that assess your bladder and urethra function, such as bladder ultrasound or urodynamic testing, which measures how your sphincter muscles contract to store and release urine. He or she may suggest behavioral interventions like bladder training or pelvic floor exercises to address urinary incontinence issues.
Womb prolapse
Uterine prolapse occurs when the muscles and ligaments that support your uterus become weak, allowing it to drop into your vagina, creating a protrusion of sorts. It may be mild or severe depending on how far your uterus has moved; in rare instances bladder, bowel, or rectum may also bulge into your vagina with it.
Your doctor will ask about your symptoms and conduct a pelvic exam to detect possible uterine prolapse. They may recommend inserting a pessary, which is a silicone device, into your vagina to prop up any bulging tissue; for optimal performance it should be regularly removed and cleaned by you or removed altogether and repaired surgically as soon as possible for lasting relief from additional complications.
For severe uterine prolapse, your doctor may suggest performing a surgical procedure called hysterectomy to remove your uterus and avoid further complications. Although not recommended if you plan to have more children in the near future.