Category Archives: Gynaecology

Pelvic congestion syndrome

I distantly remembered reading something about this many years ago; when a patient’s ultrasound showed pelvic varices, I realised I’d need to refresh my memory. Presentation Dull aching or throbbing pain, typically on one side of the pelvis although can … Continue reading

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The physiology of PCOS

Another one from the archives. This one is an article in the July 2014 JFPRHC explaining the physiology behind PCOS and our treatments, by W. Colin Duncan, clinical fellow and consultant in reproductive medicine at the University of Edinburgh. It’s … Continue reading

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Postponing menstruation, and amenorrhoea with contraception

Like most GPs, I’ve happily dished out prescriptions for norethisterone when a woman wanted to postpone her period, on a basis of hey, what harm can it do? More than I thought, it turns out; according to an article in … Continue reading

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Treatment of pregnancy-induced nausea

Today, I was prescribing for a pregnant woman with vomiting and thought it worth checking what the latest recommendations were. According to the RCOG guidelines, the two main classes of drugs recommended are: Antihistamines Phenothiazines (e.g. prochlorperazine) (If neither does … Continue reading

Posted in Credits 2016, Gynaecology | Leave a comment

FSRH guidance – intrauterine contraception

Both the IUS & the Cu-IUD are thought to work primarily through prevention of fertilisation, but the IUS seems to have more of an anti-implantation effect as part of its effectiveness than the Cu-IUD does. Both are extremely effective, with … Continue reading

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Vaginal discharge

In women of reproductive age, the commonest causes of vaginal discharge can be categorised thus: Infective: non-sexually transmitted Bacterial vaginosis Candida Infective: sexually transmitted Chlamydia trachomatis Gonorrhoea Trichomonas Herpes simplex (occasional, when the herpes has caused cervicitis) Non-infective Foreign bodies … Continue reading

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Problematic bleeding in women on hormonal contraception

Things to look for include: Pregnancy STIs Cervical cancer Possibly polyps/fibroids/ovarian cysts – debatable whether these could cause irregular bleeding. History Duration of use of the hormonal method – irregular bleeding normal initially Compliance with the method if not LARC … Continue reading

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