Gynaecology

Heavy menstrual bleeding can be caused by an imbalance in the sex hormones or conditions affecting the womb, such as fibroids, endometriosis, pelvic inflammatory disease. Rarely it can be a sign of womb cancer. You may have heavy periods if your periods last for more than 7 days with passage of clots. You may feel tired, short of breath or avoid daily activities. Often women who suffer with heavy periods may need to take time off work because of their periods.

At Haven Medical, your Gynaecologist will undertake the necessary investigations which may include a vaginal scan or hysteroscopy and discuss the various treatments. This can all be undertaken as a ‘One Stop Clinic’

Endometriosis is a condition where tissue similar to the lining of the womb grows in other areas, such as the ovaries or the abdominal cavity.

You may experience pain in your lower abdomen or back. Sex can become uncomfortable, and you may find passing urine or stool painful during your period. There can be difficulty getting pregnant.

Endometriosis is a long-term condition that can have a significant impact on your life, but there are treatments that can help. Your Gynaecologist will discuss the various treatments which may include hormone or non-hormone medication or surgery to remove endometriosis tissue.

Infertility is when a couple are unable to get pregnant despite having unprotected sex.

• Common causes of infertility include: Lack of regular ovulation (the monthly release of an egg)

• Poor quality sperm

• Blocked or damaged fallopian tubes

• Endometriosis

• Unexplained infertility

At Haven Medical, your Fertility Specialist will take you and your partner through the necessary investigations. These may include hormone tests, semen analysis for your partner, tubal patency test and an ultrasound scan.

Your Fertility Specialist will discuss the various treatments, which will be tailored to you based on your age or period of infertility. Sometimes you may need medications to help ovulation and this can be monitored by ultrasound. Other treatments such as intra-uterine insemination (IUI) or in vitro fertilisation (IVF) may be required, and your Fertility Specialist will manage you down the most appropriate pathway.

PCOS is a common condition which affects how women’s ovaries work. It is caused by abnormal hormone levels in the body, including high levels of insulin. If you have signs and symptoms of PCOS, they will usually become apparent in your late teens or early 20’s. These may include:

• Irregular periods or no periods at all

• Difficulty in getting pregnant

• Excessive hair growth

• Weight gain

• Oily skin or acne

Your Gynaecologist at Haven Medical will advise you on lifestyle changes and may recommend medications to lower the insulin levels, treat abnormal bleeding, and reduce excessive hair growth. She may offer treatment to help with ovulation if you are seeking to become pregnant.

Pelvic organ prolapse is when one or more of the organs in the pelvis slip down from their normal positions and bulge into the vagina. It can be the womb (uterus), bowel, bladder or top of the vagina.

At Haven Medical you will be supported with various treatments including pelvic floor physiotherapy, hormone treatment, vaginal pessaries or surgery.

Menopause is when your periods stop due to lower hormone levels. Perimenopause is when you have symptoms of menopause but your periods have not stopped. Menopause and perimenopause can cause symptoms like anxiety, mood swings, brain fog, hot flushes, irregular periods and low sex drive. These can have a big impact on your life, including relationships, and work.

At Haven Medical you will be managed by a British Menopause Society accredited Gynaecologist. She will discuss the options and help you decide on the best treatment for you based on the severity of symptoms and your personal preference. In addition to lifestyle modification, you will be offered hormone replacement therapy (HRT), which may include testosterone for low sex drive. You may be offered alternatives to HRT if you cannot have or do not want to be treated with hormone-based medications. Your Gynaecologist will discuss with you if contraception is required and when to stop them.

Menopause is usually diagnosed in women who have not had a period for more than a year. Any bleeding from the vagina after this needs to be investigated. Postmenopausal bleeding is not usually serious but can occasionally be a sign of cancer. Cancer is easier to treat if it is diagnosed early.

Tests may include a vaginal ultrasound scan, hysteroscopy (a thin, telescope-like camera being passed up the vagina, and into the womb) and a tissue sample biopsy.

Cervical screening (a smear test) is a test to help reduce the risk of cervical cancer. During the screening appointment, a small sample of cells will be taken from the cervix. The sample is checked for certain types of human papilloma (HPV) and may need to be analysed for changes in the cells of the cervix. These can be treated before they get a chance to turn cancerous.

Hirsutism is where women have thick, dark hair on their face, neck, chest, abdomen , buttocks or thighs. Hirsutism is linked to hormones called androgens. The condition may be caused by certain medications, some hormonal conditions or less commonly, a tumour affecting hormone levels. Often, there is no obvious cause.

At Haven Medical your Gynaecologist will perform the necessary investigations which may include blood tests and ultrasound scan. She will recommend treatments accordingly, which may include hormone-based medications or creams.

Urinary incontinence is the unintentional passing of urine. There are different types and causes for incontinence. At Haven Medical your Gynaecologist will make the appropriate assessment to reach the correct diagnosis. Treatments will be made accordingly and may involve lifestyle changes, medications, pelvic floor exercises and bladder retraining.

Premenstrual syndrome is the name for the symptoms women can experience in the weeks before the periods. The most common symptoms include mood swings, trouble sleeping, bloating, breast tenderness and headaches. A small number of women may experience more severe symptoms of PMS known as premenstrual dysphoric disorder (PMDD).

Symptoms are much more intense and can have greater negative impact on your daily activities and quality of life. PMDD can make it difficult to work, socialise and have a healthy relationship. It is important that you get the support you need and deserve to help you manage the effects of PMDD on your life. Our Gynaecologist will discuss these with you to allow you to decide on the best approach for you based on the severity of the symptoms and your personal preferences.

Bacterial Vaginosis is a common cause of unusual vaginal discharge. Other causes are Thrush, which is a yeast infection and usually accompanied with itching and vaginal soreness. Your Gynaecologist will examine you and may take a swab to test for infection. You will usually need a treatment with tablets or vaginal pessaries. Sometimes you may need prolonged treatment to prevent recurrence.

Chlamydia is one of the most common sexually transmitted infections (STI) in the UK. If you are sexually active and under 25, it is recommended that you have a Chlamydia test once a year. Most women with Chlamydia do not notice any symptoms and do not know they have it. Sometimes you may experience pain when passing urine, unusual vaginal discharge, abdominal pain, bleeding after sex and bleeding between periods. If you think you are at risk or have Chlamydia symptoms, you should get tested and treated. Chlamydia can be serious if untreated. The infection can spread into the pelvis leading to pelvic inflammatory disease, ectopic pregnancy and infertility.

Lichen sclerosis is a skin condition that causes itchy white patches on the vulva. Treatment can help relieve the symptoms. You may need a skin biopsy taken to confirm the diagnosis. Your Gynaecologist will recommend a potent steroid cream which you may need to use regularly for few months. Lichen sclerosis increases the risk of getting cancer on your vulva. The risk is low, but it is a good idea to be checked regularly.

Vulvodynia (Vulval pain) is persistent, unexplained pain in the vulva. It can be a long-term problem that is very distressing to live with, but much can be done to help relieve the pain. Your Gynaecologist at Haven Medical will discuss with you treatments which may include vulval gels, lubricants or prescription medications to make sex more comfortable.