Diagnosis and management of common and complex gynecological conditions

Irregular periods may occur with pregnancy, the early years after menarche, PCOS, thyroid or prolactin disorders, major weight or exercise changes, some medicines, perimenopause and uterine or ovarian conditions. Persistent, very frequent, widely spaced or otherwise concerning bleeding needs assessment.

No. Many fibroids cause no symptoms or can be observed or managed medically. Treatment depends on bleeding or pressure symptoms, anaemia, size and location, whether the uterine cavity is affected, fertility goals and personal preference.

An ovarian cyst is a sac or pouch containing fluid or other tissue that forms in or on an ovary. Most are benign and many resolve, but management depends on age, symptoms and ultrasound features. Sudden severe pain, vomiting, faintness or worsening symptoms needs urgent assessment.

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus is found outside the uterus. It can cause period pain, pelvic pain, pain during sex, bowel or urinary symptoms and fertility difficulty. A normal ultrasound does not completely exclude it.

Endometriosis can affect fertility, but many people conceive without assisted treatment. Planning considers age, semen, fallopian tubes, ovarian reserve, symptoms and previous surgery. Options may include continued trying, selected surgery, IUI or IVF.

Seek gynecology review for new or persistent abnormal bleeding, pelvic pain, discharge or vulval symptoms, fertility or contraception needs, pregnancy planning, menopause concerns or screening questions. Preventive visits are individualized, and not every visit requires a pelvic examination, ultrasound or laboratory panel.

Painful periods may be primary dysmenorrhoea or may be related to endometriosis, adenomyosis, fibroids, pelvic infection or ovarian conditions. New, severe or worsening pain, pain between periods, pain during sex or symptoms affecting daily life deserves assessment.

Menopause is confirmed after 12 consecutive months without a menstrual period when no other cause explains the absence. Perimenopause is the transition beforehand. Any bleeding after menopause should be assessed.

Yes. Options may include lifestyle measures, non-hormonal treatment, vaginal therapies or menopausal hormone therapy depending on symptoms, medical history, risks and preferences. Bleeding after menopause requires evaluation rather than being treated as a routine symptom.

Many people benefit from regular preventive review, often annually, but the exact timing depends on age, health and local practice. A preventive visit does not mean every year requires a pelvic examination, ultrasound, hormone panel or screening test. Each is selected according to symptoms, risk, previous results and the applicable screening programme.