Paediatric gynaecology is limited to cases in which the doctor recommends a gynaecologist’s evaluation for a very specific problems (physical alterations diagnosed in childhood, vaginal fluids, breast disease, abdominal pain, etc.).
Another significant stage in a woman’s life is ADOLESCENCE, a period of transition between childhood and adulthood manifested by multiple physical and psychological changes. Adolescence is typically considered ages 10 to 19. The first stage of adolescence is PUBERTY, when physical changes take place as the result of increased levels of sex hormones. These changes include: growth of pubic and underarm hair, growth and development of breasts, changes in the skin (greasier), more active sweat glands, and especially the onset of menarche (first period).
All of these changes cause significant psychological and emotional disorders that must be properly channelled in order to avoid self-esteem issues and ensure a smooth transition to adulthood.
It is important to visit the gynaecologist during puberty to learn about possible and normal changes that may occur: amenorrhea (absence of menstruation), dysmenorrhea (menstrual pain), metrorragias, etc., as well as to receive information on the importance of avoiding sexually transmitted infections and pregnancy.
An annual gynaecological exam is recommended once teens begin having sexual intercourse.
Adult gynaecology focuses on the woman’s childbearing years, that is, the period from menarche (onset of the first menstrual period) to menopause (end of menstruation). An annual gynaecological exam or check-up is recommended during this period; these vary from woman to woman and the issues that each woman has, but generally consist of a breast exam, cervical cytology with colposcopy, pelvic exam and a pelvic ultrasound.
Other diagnostic tests or specific studies like bloodwork, mammograms, urodynamics, etc., may sometimes be performed.
It is important to remember that the best treatment for gynaecological cancer and other chronic diseases is based on early diagnosis and that regular visits to the gynaecologist are the cornerstone of prevention.
Menopause is a natural physiological event for women that is characterised by the permanent end of menstruation and ovarian activity, which is defined as the absence of menstrual periods for 12 months. It commonly occurs around age 50, but can occur as early as age 42. If develops earlier it is considered EARLY MENOPAUSE and typically requires treatment.
Menopause is not a disease that requires treatment, but sometimes the physiological changes that occur may affect everyday life and require treatment.
The changes need not occur in all women, but 80% suffer temporary symptoms with varying degrees of intensity.
The most significant include:
- Hot flushes (earlier and more frequently)
- Sleeping problems
- Vaginal dryness (in general all mucous membranes and the skin)
- Mood changes
- Lower metabolism (weight gain)
Many menopausal women do not require treatment or only require specific treatment for a particular symptom. Other women need comprehensive treatment.
Treatments are based on:
- Dietary measures
- Physical exercise
- Vaginal creams (moisturizing or with oestrogen)
- Hormone replacement treatments (patches, creams, oral tablets, implants)
- The new BIOIDENTICAL HORMONE replacement therapy
Menopause should not be considered as a period of decline for women but a stage of life that requires adaptation and specific treatments, if needed, in order to continue enjoying a high quality of life.
It is very important to continue with annual pelvic exams during menopause and to discuss all changes and symptoms with your gynaecologist in order to receive information on the various treatments available.
This is the transition period from a woman’s child-bearing to non-fertile years, and is characterized by hormonal changes due to lower oestrogen levels that may lead to irregular periods and sometimes heavy bleeding.
This period lasts for approximately 10 years and is divided into two stages:
- Premenopause (lasts for 3 to 5 years, up to the last menstrual period). Contraception during this stage is necessary because a risk of pregnancy still exists.
- Postmenopause (period of 7 to 10 years after the last menstrual period).
For most women the gynaecological exam (GE) is the first visit between the gynaecologist and the patient. These exams should be annual and start when a woman becomes sexually active.
Many women consider the GE an annual check-up and consider the gynaecologist as their primary doctor, making a good doctor-patient relationship important.
GEs normally include a breast exam, a cervical cytology and colposcopy, a pelvic exam and in most cases a pelvic ultrasound.
Exam results or patient comments may make other gynaecological tests (mammogram, urodynamics, bone densitometry, bloodwork, etc.) necessary.