Thursday, 23 February 2017

6 Things Gynaecologists Wants Women To Know


“I once saw a woman who presented with ‘a bit of tummy ache’,” says Dr Narendra Pisal, a consultant gynaecologist at the London Gynaecology Ltd who has been in the field for 27 years.

“She thought she was putting on weight in her middle age. On examination and scan, she was found to have a 55cm ovarian cyst weighing 19kg. Fortunately, the cyst turned out to be benign and the operation went well.”

Cases like this, he and other gynaecologists hope, highlight how women should head to the doctor however minor a problem may seem. But many studies show that women find it embarrassing to talk to their doctor about problems “down there”. So, if women are reluctant about visiting the gynaecologist, what would the healthcare professionals want their would-be patients to know?

“If I had to say one thing to women it would be 'if you're worried enough to Google it go and see somebody,” says Dr Josephine Senior, who is six years into training to specialise in obstetrics and gynaecology.

“The strangest thing I've ever seen was a girl with an entire McDonald's cheeseburger, still in the wrapper, in the vagina,” she recalls. “The most interesting case I've seen is probably a teenager who hadn't started her periods and we diagnosed her with Mayer Rokitansky Kuster Hauser syndrome.

“This is a rare birth defect where girls have an absent or blind-ending vagina, a very small or absent uterus and absent or very small ovaries that don't function normally. From the outside they appear like totally normal girls so this is mostly diagnosed when they try to have sex or don't start their periods. A fascinating case and I hope she is doing well.”

However, most of the cases Dr Senior deals with are relatively minor and easy to solve, yet can debilitate a woman's life.

“Don't put up with horrible periods, incontinence or prolapse,” she stresses. “Some will tell you it's a normal part of being a woman but it doesn't have to be. You will find an understanding listening ear and there is almost always something that can be done.

She adds: "If you spend more on feminine hygiene products than food come and see us. Most of the time, problems are benign but some things require further investigation, especially bleeding after sex, bleeding after menopause or severe pelvic pain. “There is nothing we haven't seen before and no we are not bothered if you haven't waxed or shaved your legs. And, probably most importantly, if I see you in Tesco I won't remember what your vagina looked like.”

Dr Anne Henderson, a Consultant Obstetrician and Gynaecologist based in Kent, meanwhile, stresses all women should be taking bio-identical or natural hormone replacement therapy (HRT) until the age of 60, almost without exception, due to the health benefits.

“These include a 50 per cent reduction in cardiovascular and cerebrovascular mortality, as well as the benefits of symptom control, improved mood, energy and libido," she says.

“This really is the single most important thing women can do to improve their health, quality of life and life expectancy in the second part of their lives. In my view, it is extremely disappointing that the guidelines have not received wider publicity and that many GPs and specialists are still failing to implement them,” she adds.

Obesity is another issue that women do not realise affects their gynaecological health, adds Dr Senior. Being extremely overweight or obese increases the risk of cancer of the lining of the womb, issues with periods, polycystic ovaries and infertility. Pregnancy can also become harder, putting women at higher risk of developing diabetes, problems with blood pressure, placental abruption. Women are more likely to bleed after delivery, experience shoulder dystocia, where the baby's shoulders get stuck, and suffer blood clots in legs or lungs.

"Several of these can be potentially very serious for mother and baby and are preventable," says Dr Senior, but adds: "I am also very very aware that not all of us [medical professionals] have mastered the best way to discuss this with our patients so that is something I strive to discuss sensitively and empathetically. Especially as I struggle with my weight myself."

"Gynae problems are embarrassing, there's no getting away from that," she admits. However, she stresses that women need to talk their GP, or even friends and family if they are worried about their health.

"You might find someone else is having the same problems you are. And please don't Google. Ask us the question, and the answers may surprise you."



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