Gynaecology refers to the health of a woman's reproductive system including the uterus, vagina, and ovaries. It typically goes hand in hand with obstetrics, which deals with issues concerning pregnancy and childbirth. Gynaecology covers both medical and surgical procedures to diagnose and treat reproductive conditions. Common gynaecological conditions include ovarian cysts, fibroids, endometriosis and polycystic ovarian syndrome.
Common Gynaecological Conditions
- Ovarian Cysts - These are fluid-filled sacs that develop in or on the ovaries, usually during ovulation and menstrual cycles. Ovarian cysts are common and mostly harmless, and typically go away on their own without treatment. For large, persistent or potentially malignant cysts as well as cysts that are associated with severe pain, surgical removal is advised.
- Fibroids - Also known as myomas, fibroids are non-cancerous growths that develop in the uterus. Untreated, they can increase in size and number, causing pelvic pain, heavy menstrual bleeding and frequent urination. Fibroids are treated via hormone therapy, myomectomy, hysterectomy and endometrial embolization.
- Endometriosis - This condition occurs when the endometrium (uterine lining) forms outside the uterus, causing pain especially during periods and sex. If left untreated, endometriosis can increase the risk of infertility. Treatment options include medications, hormone therapy, hysterectomy and conservative surgery to remove endometrial tissues.
- Polycystic Ovary Syndrome (PCOS) - PCOS is a hormonal condition that results in missed or irregular periods, high levels of male hormones and ovarian cysts. As the issue progresses, it increases a woman’s risk of infertility, premature birth, pregnancy loss, and other health complications such as diabetes, high-blood pressure and metabolic syndrome. Medications and lifestyle modifications are the primary treatments for PCOS.
The mode of treatment will depend on the type and severity of the condition.
- Watchful Waiting - Most gynaecological issues, such as ovarian cysts, go away on their own without treatments. Upon initial assessment, the patient is first advised to undergo further testing and wait for a prescribed period before being re-examined to check for any progress or development in symptoms. Watchful waiting is important if the gynaecologist concludes that immediate medical intervention will result in more risks than benefit for the patient. No treatments are given at this point.
- Medications – Treating gynaecological problems involves providing relief for any of its more serious symptoms that negatively affect quality of life. Pain medication and nonsteroidal anti-inflammatory drugs (NSAIDs) may be given for patients who have uterine fibroids or ovarian cysts, not to shrink the fibroid or cyst, but simply to help ease discomfort and pain. Vitamins and supplements may also be taken to reduce the risk of anaemia.
- Hormonal Therapy - Gynaecological problems are often linked to hormonal issues, thereby making hormonal therapy one of the most prescribed and effective treatments. Similar to medicines, hormonal therapy may not be able to remove certain cysts, fibroids or endometrial tissues. However, they can help relieve symptoms, and prevent the progression of such conditions. They are also used to regulate the body’s hormone levels, which reduce the risk of PCOS, ovarian cysts and uterine fibroids. Contraceptive pills or implants like the Mirena intra- uterine device are prescribed to control heavy menstrual bleeding and alleviate pelvic pressure.
- Surgery - Surgical procedures are usually performed to treat larger ovarian cysts and fibroids, and endometriosis. Whether done traditionally or laparoscopically, the goal of the operation is to remove the abnormal growths without affecting the reproductive system and nearby organs. Hysterectomy (removal of the uterus) and oophorectomy (removal of one or both ovaries) are considered permanent solutions to treat and prevent the recurrence of fibroids, cysts, endometriosis, and even cancer. However, both procedures permanently prevent pregnancies and are generally seen as a last resort.