General Gynecology

Overview

Gynaecology, sometimes spelled gynecology, is the branch of medicine concerned with the treatment of women's disorders, particularly those affecting the reproductive organs. It is frequently linked with the field of obstetrics to form the combined field of obstetrics and gynecology (OB-GYN).

The name derives from Greek and means "women's science."

Andrology, on the other hand, is concerned with medical disorders pertaining to the male reproductive system.

Cervical cryosurgery, colposcopy, D&C, hysteroscopy, LEEP, and pelvic laparoscopy are all common gynecological treatments. Many of these treatments can assist healthcare personnel in getting a better view of the uterus, cervix, and vagina as well as collecting samples for a biopsy. Some of them can also be used to treat certain disorders.

What is Gynecologists?

A gynecologist is a physician who focuses on female reproductive health. They detect and treat problems with the female reproductive system. The uterus, fallopian tubes, ovaries, and breasts are all included.

Anyone having feminine organs should consult a gynecologist. 80% of those who see one are between the ages of 15 and 45.

What Does a Gynecologist Do?

Gynecologists provide reproductive and sexual health treatments such as pelvic examinations, Pap tests, cancer screenings, and vaginal infection diagnosis and treatment.

Endometriosis, infertility, ovarian cysts, and pelvic discomfort are among the reproductive system disorders they identify and treat. They may also provide care to those suffering from ovarian, cervical, and other reproductive malignancies.

Some gynecologists also work as obstetricians, providing care throughout pregnancy and childbirth. An OB-GYN is a gynecologist who also specializes in obstetrics.

• Education and Training:

Gynecologists are doctors who have had advanced training in the female reproductive system. A gynecologist, like any other medical practitioner, must first complete medical school, followed by a residency. Obstetrics and gynecology are covered in combination by residency programs and the certification process in the United States.

The process involves:

• Four years’ worth of medical school
• Four years of residency
• Successful completion of the Qualifying Exam, a written test
• Documented experience in patient care
• Successful completion of the Certifying Exam, an oral test

After becoming board-certified, a gynecologist may have advanced subspecialty training. Areas of training include:

• Breast care
• Family planning
• Minimally invasive surgery
• Pediatric and adolescent gynecology
• Pelvic medicine and reconstructive surgery

What is the Difference Between OB/GYN & Gynecology?

Many individuals confuse OB/GYN and gynecology. This is not true! An OB/GYN practices both obstetrics and gynecology, whereas gynecologists solely practice gynecology. While a physician can have both medical specialties, there are distinctions between the two.

A woman's requirements fluctuate throughout her life, and it's critical to know who to visit for certain ailments and difficulties.

• Obstetrics

An obstetrician is a doctor who specializes in pregnancy care, which includes everything from prenatal care through post-natal care. A gynecologist does not deliver babies, but an obstetrician does. An obstetrician can also recommend fertility medications to help you get pregnant. If you have a preterm baby, an obstetrician can help you in the Neonatal Intensive Care Unit (NICU). An obstetrician will ensure that you have a good pregnancy and that your baby is born healthy.

Obstetricians are also trained to handle pregnancy complications, such as:

• Ectopic pregnancy, in which the fetus grows outside of the uterus
• Signs of fetal distress, in which the fetus is not doing well for various reasons
• Placenta issues
• Preeclampsia
• Delivery through Cesarean section

An obstetrician can also help you after you have delivered your baby and are dealing with issues such as postpartum depression.

• Gynecology 

A gynecologist specializes in caring for a woman's reproductive health from the time she receives her first period until she reaches menopause.

A gynecologist diagnoses and treats disorders affecting the reproductive system, such as those affecting the cervix, uterus, ovaries, fallopian tubes, or vagina. Breast examinations, pap smears, and pelvic exams are also routinely performed by gynecologists. They also conduct tubal ligations and hysterectomies. Human papillomavirus (HPV) injections can also be given by a gynecologist to protect against cancer-causing HPV.

Gynecologists can also advise on sexual issues such as responsible sexual practices, contraception, and sexually transmitted infections. Overall, if it is a non-pregnancy condition relating to female reproductive health, a gynecologist can help.

A gynecologist may diagnose and treat issues, such as:

• Irregular menstruation
• Vaginal infections
• Conditions that cause pain during sex
• Cancers of the reproductive system
• Prolapse of pelvic organs
• Endometriosis
• Cervical and vaginal polyps
• Ovarian cysts
• Uterine fibroids

To offer complete treatment to patients, many physicians specialize in both obstetrics and gynecology. This allows them to meet the complete range of their patients' healthcare demands. These doctors are known as OB/GYNs.

Qualifications

All gynecologists in the United States must first complete a "approved medical school." This indicates they are properly qualified medical professionals with a practicing license.

Fully certified gynecologists have completed at least eight years of medical school and training. To become a gynecologist, one must first complete four years of medical school, followed by a four-year obstetric-gynecology residency program.

Specialty training includes:

• care of patients before, during, and after pregnancy
• genetics and genetic counseling
• female general health, including hormones, the reproductive system, breast health, and sexual function
• screening for cancers that affect women
• diagnosing and treating female hormone disorders and infections

Many gynecologists undergo surgical training to correct female pelvic, reproductive, or urinary tract problems, including cancers of the reproductive system.

Many women in the U.S. consult their gynecologists with questions about their overall wellbeing, and gynecologists are trained to carry out:

• routine examinations and health screening
• immunizations

At What Age Can I See a Gynecologist?

A gynecologist can treat both girls and women of any age. ACOG recommends seeing a gynecologist between the ages of 13 and 15 years. Building a connection with a doctor allows a girl or woman to feel more comfortable asking questions about menstruation, sexuality, and other topics, and it also serves as a point of contact if problems arise in the future. It also allows the doctor to help a woman's overall well-being in the long run by advising her on crucial health and lifestyle concerns. general medical care for women, regardless of whether it is related to the reproductive system

Specialization might take up to three years. Among the options are gynecologic oncology, pediatric gynecology, and maternal fetal medicine.

What to Expect?

What happens in the gynecologist's office is determined by the purpose for the visit as well as the individual's condition.

If it is a young woman's first visit, she may just talk to the doctor, obtain some basic health information, and learn what to anticipate in the future.

It is important to remember during any visit to the gynecologist: 

• An honest explanation of your health issues and lifestyle offers the gynecologist a better understanding of your condition and allows them to serve you more effectively.
• A gynecological checkup, including a pap smear, might be uncomfortable, although it is seldom painful.
• It is not necessary to wax or shave before the visit.
• Body odor is normal. If it signals an issue, the gynecologist should be informed.
• If you have a period when the appointment is planned, you can still go, but it may be best to postpone unless you have symptoms that require immediate treatment.
• It is preferable to avoid sexual activity, vaginal douche, and tampon use for at least two days before a gynecological checkup.
• A patient might request to have someone accompany them throughout their appointment, either in the room or outside the door.

Screening

The ACOG recommend visiting a gynecologist at least once a year for an annual checkup.

This will include:

• screening, evaluation and advice
• immunizations based on age and risk factors
• a physical examination, which will include measuring standard vital signs, body mass index, palpating the abdomen and inguinal lymph nodes, and assessing overall health
• a pelvic examination and a breast examination, as appropriate for the patient’s age
• You may have to give a blood or urine sample for a screening test.

Regular visits to a well-woman clinic allow an individual to stay current on how to maintain a healthy lifestyle and minimize health risks at any age.

Other yearly health checks may include mammography, colonoscopy, blood pressure monitoring, vaccinations, and calcium and folic acid recommendations.

What Conditions Can Gynecologist Treat?

Menstrual Disorders:

• Heavy menstrual bleeding.
• Menstrual pain and irregularity.
• Pre-menstrual syndrome (PMS).

Family Planning: Contraception – temporary and permanent

• Mirena insertion.
• Implanon insertion.
• Essure sterilization.

Papsmear abnormalities:

• Routine papsmears and follow-up of abnormal smears.
• Colposcopy
• HPV vaccination

General Gynaecological issues:

• Ovarian cysts
• Pelvic pain
• Endometriosis
• Uterine fibroids
• Polycystic ovarian syndrome (PCOS)
• Acne and abnormal female hair distribution
• Genital tract infections
• Vulva and vagina skin disorders

Menopause:

• Symptomatic treatment including hormone replacement therapy.
• Osteoporosis prevention, screening and treatment.
• Post-menopausal bleeding.

Pelvic floor disorders:

• Pelvic organ prolapses.
• Urinary incontinence.
• Recurrent urinary tract infection.
• Knowledge of and referral for urodynamics testing.

Infertility:

• Thorough infertility assessment
• Complete infertility investigations
• Assisted conception and ovulation induction

Other:

• Assessment for and diagnosis of gynaecological cancers
• Treatment of pre-cancerous gynaecological lesions

What Procedures Can Gynecologist Do?

Cervical Cryosurgery

Occasionally, abnormal cervical cells are detected after a regular Pap smear (screening for cervical cancer). Although abnormal cells may not necessarily signify cancer, your healthcare professional will most likely want to do some more tests or treatments.

Cervical cryosurgery, often known as cryotherapy, is one method they may prescribe. This is a highly successful gynecological therapy that involves freezing a portion of the cervix.

Precancerous cells are abnormal cervical cells that indicate alterations that might develop to cancer. Cryosurgery eliminates these cells, preventing cancer from growing.

Cervical dysplasia is a term used by gynecologists to characterize this disorder.

Colposcopy

A colposcopy is a non-surgical diagnostic technique used to look more carefully at the cervix, vagina, and vulva. It is sometimes utilized when a Pap smear is abnormal.

A colposcope, a magnification tool, is used by a healthcare practitioner during the process. If they see anything suspicious during the operation, they may take a sample and submit it to the laboratory for examination.

Curettage and dilation (D&C):

One of the most popular gynecological treatments is dilation and curettage (D&C). During this surgery, a healthcare practitioner removes a part of your uterine lining using a suction device or a sharp curette (a surgical instrument used for scraping).

The procedure can diagnose uterine conditions, including: 

• Uterine cancer.
• Uterine polyps (overgrowth of tissue in the uterine lining).
• Endometrial hyperplasia (an abnormally thick uterine lining).

In addition, D&Cs are commonly used for abortion procedures, miscarriage, molar pregnancy, and retained placenta (when a placenta does not come out after childbirth).

Hysteroscopy

Hysteroscopy is a procedure that your healthcare provider may use to diagnose or treat uterine problems. This procedure might be used to:

• Remove adhesions (scar tissue).
• Locate an intrauterine device.
• Determine the cause of repeated miscarriage.

During this process, a healthcare expert inserts a hysteroscope, a narrow, illuminated, telescope-like equipment, via the vagina into your uterus. The images of your uterus are then sent to a screen for additional evaluation.

LEEP Procedure:

When a PAP smear reveals abnormal cells on the cervix's surface, a healthcare physician may advise a loop electrosurgical excision technique (LEEP).

During the process, an electrically charged, thin wire loop is utilized to cut away the aberrant tissue.

The operation is quick and is done in a doctor's office under local anesthetic.

Laparoscopy of the Pelvis:

Laparoscopy is a surgical technique that is often done under general anesthesia. However, it may be done while you are awake using various forms of anesthetic. It serves the following purposes:

Tubal ligation (tying the fallopian tubes for permanent birth control)

• Gallbladder removal.
• Hernia repair.
• Treating endometriosis and uterine fibroids.

The typical pelvic laparoscopy involves a small (1/2- to 3/4-inch) incision in the belly button or lower abdomen. A surgeon then pumps carbon dioxide into your abdomen to help them see your organs more easily.

Depending on your condition, they may also:

• Take tissue samples
• Remove scar tissue
• Repair your uterus
• Remove your ovaries

Hysterectomy

The uterus is removed during a hysterectomy. Your doctor may potentially remove one or both ovaries as well as the fallopian tubes. Other components of the reproductive system may be removed in some situations.

The following are the several forms of hysterectomy:

• Total hysterectomy. The whole uterus, including the cervix, is removed, but the fallopian tubes and ovaries are not. It is the most often performed type of hysterectomy.
• Salpingo-oophorectomy and hysterectomy. Your doctor will remove one or both ovaries, as well as the fallopian tubes and uterus.
• Radical hysterectomy. Your provider removes the uterus, cervix, and the top part of the vagina. The pelvic lymph nodes may also be removed. Some cases of cancer call for this surgery.
• Supracervical hysterectomy (partial or subtotal hysterectomy). Your provider removes the body of the uterus while leaving the cervix whole.

Hysterectomy techniques include:

1. Abdominal hysterectomy. Your doctor creates a huge incision in your abdomen and removes the uterus. When the uterus is big or illness has spread to the pelvic cavity, such as in endometriosis or cancer, they utilize this procedure to remove the fallopian tubes. The incision can be done from the navel to the pubic bone, or it can be made along the top of the pubic hairline.
2. Vaginal hysterectomy. The uterus is removed through the vaginal orifice using this procedure. It's most commonly utilized to treat uterine prolapse or vaginal repairs. There will be no need for an incision. This indicates that there is no apparent scarring.
3. Laparoscopic-assisted hysterectomy.  This approach is performed by your physician using a laparoscope, which is a thin, flexible tube equipped with a video camera. They introduce small tubes into the abdomen using tiny incisions near the navel. The uterus is removed in pieces through the laparoscope tube or through the vagina. A robot is used to aid in a type of laparoscopic hysterectomy.

Your healthcare provider will decide the best method based on your situation. If you have not yet reached menopause, having a hysterectomy means you will no longer have a period. You will also not be able to get pregnant.

What are the Risks & Side Effects?

Every surgery has risks. Risks and complications of gynecological surgery depend on the type of procedure. These include:

• Major bleeding
• Uterine perforation or damage to the wall of the uterus, which can cause bleeding at the time of surgery or after surgery
• Damage to a nearby part of the body like the bowel because the parts of a woman’s reproductive system are very close to other organs
• Urinary tract (kidney or bladder) infection
• Damage to the urinary tract, which can cause incontinence
• Temporary difficulty with going to the bathroom
• Pain with sexual intercourse
• Allergic reaction to anesthesia
• Infection
• Blood clot
• Nausea and vomiting after surgery
• Belly pain and pressure after surgery

Conclusion

A gynecologist is a doctor who specializes in female reproductive health. They diagnose and treat female reproductive tract problems. This comprises the uterus, fallopian tubes, ovaries, and breasts.

Gynecologists provide reproductive and sexual health treatments such as pelvic examinations, Pap tests, cancer screenings, and diagnosis and treatment for vaginal infections.

They detect and treat reproductive system diseases such as endometriosis, infertility, ovarian cysts, and pelvic discomfort. They may also treat patients with ovarian, cervical, and other reproductive malignancies.