Whether you are planning a family, finding it hard to conceive or living with a gynaecological condition, the first thing you need is a clear answer to what is going on. Our clinicians provide assessment, diagnostic testing and onward referral where it is needed, with discretion throughout.
Gynaecology: what we see
- Heavy, painful or irregular periods
- Pelvic pain, including pain that suggests endometriosis
- Polycystic ovary syndrome (PCOS): irregular cycles, acne, excess hair, difficulty with weight
- Fibroids, ovarian cysts and polyps found on a scan
- Abnormal bleeding: between periods, after sex or after the menopause
- Vulval and vaginal symptoms that keep coming back
Fertility: where to start
About one couple in seven has difficulty conceiving. It is usual to seek advice after a year of trying, or after six months if the woman is 36 or over, and sooner if periods are irregular or absent, or if either partner has a known condition, previous pelvic surgery or a history of infection. Fertility is a matter for both partners: in roughly a third of couples the main factor is male, in a third female, and in the rest it is shared or no cause is found. For that reason both of you are assessed where possible.
The first investigations
- A consultation covering your cycles, your medical and family history, medicines and lifestyle
- Blood tests for the hormones that drive ovulation, timed to particular days of the cycle, with thyroid and other checks where relevant
- A pelvic ultrasound scan to look at the womb and ovaries
- A semen analysis for the male partner
- Screening for infections that can affect fertility
What happens next
The clinician explains each result and what it means for you. Sometimes the answer is reassurance and advice on timing, weight, smoking, alcohol and folic acid. Sometimes a condition such as PCOS, a thyroid problem or endometriosis is found and can be treated. And sometimes the next step is a fertility unit or a consultant gynaecologist, for treatments such as ovulation induction, surgery or IVF, which are provided by those services and not by us. In that case you are given a referral with your results, so that the unit does not need to start again.
Good to know
Investigations take time, because some tests have to be done on set days of a cycle. Trying to conceive is stressful, and the stress is real even when every test is normal: say so, because support is part of the care. If you have severe pelvic pain, heavy bleeding with dizziness, or pain and bleeding in early pregnancy, do not wait for an appointment. Call NHS 111 or go to A&E.
Common questions
Do we both need to come? It is not essential at the first visit, but it helps.
I am not trying for a baby. Can I still be seen? Yes. Much of our work is gynaecology with no connection to fertility. See also women's health.
Is what I say confidential? Yes, including from your partner unless you choose to share it.
