The term ‘gynaecology’ comes from Greek and means ‘the science of women’. It is a branch of medicine that involves the treatment of women's diseases with a special focus on female reproductive health. This includes issues relating to the uterus, fallopian tubes, ovaries, and breasts.
Gynaecology and obstetrics are usually paired together as they are twin subjects. While obstetrics deals with pregnancy and its associated procedures and complications, gynaecology involves treating women who are not pregnant.
The History Of Gynaecology
The field of gynaecology has ancient beginnings. The Kahun Gynecological Papyrus is credited as the oldest medical record of Egyptian civilisation and is probably the earliest record we have of gynaecological care. This ancient text, which was composed in 1800 BC during the Twelfth Egyptian Dynasty, focuses on fertility, pregnancy, contraception, and gynaecological diseases. Considered primitive in today’s terms, this text demonstrates an early dedication to women’s health issues.
Gynaecology in the 19th Century
The 19th century witnessed much progress in the field of gynaecology. The American Dr. James Marion Sims is widely credited as the father of modern gynaecology. In the late 1880s, he pioneered surgical tools and techniques, including the repair of vesicovaginal fistula - a severe complication of obstructed childbirth. He is also remembered for inventing Sims’ speculum, Sims’ sigmoid catheter, and the Sims position. Sims admits his techniques were perfected by experimentation on black slave women. These women are now recognised as instrumental in the discovery of many medical advances.
Gynaecology in the 20th Century
The 20th century saw significant breakthroughs in gynaecology. This progress is at least partially due to the expansion and exposure of women’s rights, including more women becoming doctors, medical researchers, and gynaecologists. During the last century, oral contraceptives and safe IUDs have become freely available, in-vitro fertilisation has evolved from the early methods of artificial insemination, and tests such as Pap smears and ultrasounds have aided accurate diagnosis and treatment.
What Does A Gynaecologist Do?
Gynaecologists provide reproductive and sexual health services to women. They diagnose and treat reproductive system disorders such as endometriosis, infertility, ovarian cysts, vaginal infections, and reproductive cancers.
Many gynaecologists also practice as obstetricians and provide care during pregnancy and birth. If a gynaecologist is also qualified in obstetrics, they are called an OB/GYN. In the UK midwives perform most of the low-risk, uncomplicated childbirths while obstetricians deal with more complicated pregnancies and births and perform procedures such as caesarean sections.
Gynaecologists treat patients with a wide range of problems, including:
- Heavy menstrual bleeding
- Issues relating to pregnancy and overcoming infertility
- Family planning, including contraception, sterilisation, and pregnancy termination
- STIs & Pelvic inflammatory diseases
- Urinary and faecal incontinence
- Endometriosis and fibroids
- Uterine prolapse
- Cervical, endometrial and ovarian cancer
- Polycystic ovary syndrome
- Sexual dysfunction
Common Gynaecological Procedures
Gynaecologists are trained to carry out several diagnostic and surgical procedures.
Commonly performed diagnostic tests include pap smear tests and ultrasound scanning. Small procedures may include a colposcopy (a microscopic examination of the cervix), endometrial biopsy (taking a sample from the lining of the uterus) or hysteroscopy (the use of an endoscope to see into the uterus).
Laparoscopies (a keyhole abdominal procedure) are commonly used for both diagnostic and surgical purposes. Common surgical procedures include sterilisation, removing fibroids in the uterus, partial or full hysterectomy, ovarian cyst removal and removing adhesions and endometriosis
When Should You See A Gynaecologist?
Ideally, an annual visit to the gynaecologist for a wellness exam is recommended. This however will vary depending on your age and health.
Women should also visit their gynaecologist if they have abnormal or painful symptoms. These could include:
- Painful periods - monthly menstrual periods are uncomfortable for most women, but very painful periods could point to fibroids.
- Vaginal bleeding - unexpected and vaginal bleeding should be investigated, e.g. bleeding after menopause.
- Starting or resuming sex - a gynaecologist can make you aware of risks you should consider such as getting STIs or cancer-forming HPV infections.
- Bumps and blisters - these could be genital warts or lesions from genital herpes.
- Breast concerns - a gynaecologist can examine a new lump, sensitivity, or discharge in your breast to rule out the presence of cancer.
- Vaginal odour - unpleasant-smelling or lingering vaginal discharge might mean that you have bacterial growth or a vaginal infection that requires prescription medication.
- Discomfort during sex - pain during sex is may be caused by conditions such as vaginal dryness or endometriosis.
- Low libido - a gynaecologist can diagnose the cause of your low libido and recommend steps to help restore it.
- Incontinence - is most common in women in their 50s and 60s and after menopause, but can also be due to a difficult childbirth.
What To Expect During Your Consultation
What happens during your consultation depends on the reason for your visit and the individual’s situation. During a routine gynaecological visit, an examination and pap smear are usually done. An ultrasound might also be performed to examine the reproductive organs in more detail.
During your visit with the gynaecologist, it is important to provide the doctor with an honest account of your health concerns and lifestyle. This gives the gynaecologist a better idea of your situation and enables them to treat and advise you in the best way possible.
From a practical point of view, it is best to avoid sexual activity, using a vaginal douche, or using tampons for 2 days before a gynaecological examination. If you have your period and you do not have an urgent problem, it is best to postpone your appointment. It is not necessary to wax or shave before the visit.