Gynaecology

Gynaecology

As a specialist gynaecologist, I am experienced in managing a broad range of gynaecological conditions.

Abnormal periods

The majority of women have a regular period every 25-35 days. Some women will experience irregular, infrequent or even absent periods and require further assessment. Potential causes can include stress, changes in weight, thyroid abnormalities, pituitary gland problems, polycystic ovarian syndrome and premature failure of ovarian function. Treatment is tailored to the underlying cause and any associated, non-menstrual symptoms.

In some women, periods are excessively heavy. Although it can be difficult to quantify the amount of blood loss during a period, a woman’s subjective feeling of heaviness is in itself an indication for investigation and treatment. Many potential conditions can contribute to heavy periods including: bleeding disorders, anovulation, uterine fibroids or polyps and rarely but importantly, cancers of the uterine lining or endometrium. A thorough assessment including examination and investigation can identify any of these potential causes and direct the most suitable treatment. Treatments for heavy periods can be conservative, medical or surgical depending on the underlying cause, your preference and plans for future fertility.


Painful periods and pelvic pain  

Many women experience pain with their period and in some women pain impacts on their ability to work and enjoy other aspects of their lives. One in ten women are affected by endometriosis, a condition where endometrial cells (lining cells of the uterus) are present outside of the uterus. Endometriosis can cause period pain, pelvic pain, bladder and bowel symptoms, painful intercourse and difficulties conceiving. In some women it can also be completely asymptomatic. Treatment will be individualised to best treat your symptoms.

In addition to endometriosis, pelvic pain may be caused by many other abdominal and pelvic conditions. These may be gynaecological such as pelvic infection, ovarian cysts and uterine fibroids or may be non gynaecological in origin arising from the gastrointestinal or urinary tract.


Surgery 

Sometimes the best way to investigate and or treat your symptoms will involve a surgical procedure. I help patients make an informed and considered decision about their treatment after understanding the available options, likely outcomes and alternatives. Surgery can be performed hysteroscopically, laparoscopically or by open abdominal incision depending on the condition and other surgical factors. I will be able to advise on the most suitable procedure taking your symptoms, examination and investigation findings and preferences into account and where possible would advocate for a minimally invasive approach to reduce pain, time in hospital and post operative recovery.

Hysteroscopy is performed by guiding a small camera through the cervix into the uterus. The inside of the uterus can be directly visualised and the lining of the uterus can be biopsied to assess for any abnormalities. It is also possible to remove polyps, fibroids, septums, uterine adhesions and ablate the endometrium through the hysteroscope.

Laparoscopy involves guiding a camera (laparoscope) through an incision made at the umbilicus (belly button). This allows a full view of the abdominal cavity and pelvic structures to diagnose and treat many gynaecological conditions.  An additional one to three small incisions may be required to complete the surgery depending on the condition and procedure. In addition to the cosmetic benefits of the small incisions over a larger open incision, patients who have laparoscopic surgery experience less pain, are often able to go home the same day and take less time to recover and get back to their normal activities.

There are some cases in which an open procedure is preferable or when a minimally invasive approach is not appropriate. An open approach to surgery will be preferable in some conditions and for some patients to achieve the best results.