Gynaecology

Gynaecology literally means 'the science of women', but in medicine this is the specialty of diseases of the female reproductive system (uterus, vagina and ovaries).

Examination

Gynaecology is a consultant specialty. In most countries, women must see a general practitioner first. If their condition requires knowledge or equipment unavailable to the GP, they are referred to a gynaecologist.

As in all of medicine, the main tools of diagnosis are clinical history and examination. Gynaecological examination is special in that it is quite intimate, and that it involves special equipment -- the speculum. The speculum consists of two hinged blades of flat metal or the disposable plastic kind, which is much preferable, which are then used to open the vagina, to permit examination of the cervix uteri. Gynaecologists may also do a bimanual examination (one hand on the abdomen, two fingers in the vagina), to palpate the uterus and ovaries. .

Investigations

1. abdominal ultrasound, to give a low-power view of the pelvic organs.
2. vaginal ultrasound. A probe is passed into the vagina, which allows a detailed view of the uterus and its contents. Good in early pregnancy.
3. blood tests. Levels of hormones such as estradiol, lutenising hormone, follicle-stimulating hormone and progesterone are measured.
4. hysteroscopy -- a fine tube is passed into the uterus via the cervix under a general anesthetic.
5. laparoscopy-- tubes are passed into the peritoneal cavity, which is then insufflated with carbon dioxide. This is commonly used to diagnose endometriosis.