As a young girl blossoms into a woman and ages gracefully, her body will undergo various changes and require special care and attention. In this section, we will cover some of the common gynaecological problems faced by women and how they can be prevented and/or tackled.
#1 Ovarian Cysts
What it is:
Ovarian cysts are sac-like structures that are filled with a liquid or contain semi-solid substances and are found within the ovary.
Not all ovarian cysts are harmful – most of them go unnoticed and resolve on their own. However, a common symptom is pain in the abdomen or pelvis. The pain can be caused by a rupture, rapid growth of the cyst, torsion, etc.
Diagnosis & Treatment:
Your doctor can detect an ovarian cyst with a pelvic examination. Your doctor may notice swelling on your ovaries and order a test with an imaging tool to confirm the presence of a cyst. Imaging tools that can be used to diagnose ovarian cysts are CT scan, MRI and ultrasound. Ultrasound tests can help to determine the location, shape and composition of a cyst.
Treatment methods include birth control pills and surgery. Birth control may help to relieve the pain from ovarian cysts because they prevent ovulation which then, reduces the chances of formation of new cysts. If the cyst does not go away, grows even bigger and causes pain, your doctor might suggest surgery instead. There are two types of surgery – laparoscopy and laparotomy. Laparoscopy is conducted using a very small incision and inserting a tiny, lighted telescope-like instrument. This instrument is inserted into the abdomen to remove the cyst. Laparotomy is done by a bigger incision on the stomach. If your cyst is large, doctors might use this technique instead.
Every patient’s symptoms and cause of problem differ. Hence, the treatment methods that the doctor will take on is likely to differ across patients as well.
What it is:
Endometriosis is the abnormal growth of cells that are similar to cells inside the uterus, but in a location outside the uterus. These growths may lead to pain and infertility. Up to 50% of women who have endometriosis may experience infertility.
Many women do not experience any symptoms but some symptoms include:
• Pelvic pain
• Painful menstrual cramps
• Heavy menstrual bleeding or bleeding between period cycles
• Pain after sexual intercourse
• Bladder problems
• Painful bowel movements
Due to the fact that many women do not experience symptoms, it is imperative that you get examined by a gynaecologist annually to allow him/her to detect any changes.
Diagnosis & Treatment:
A laparoscopy is the only way to diagnose endometriosis. A laparoscopy is a surgical procedure that involves making tiny incision on your abdomen and inserting a laparoscope into your body to look for endometrial tissue growing outside the uterus.
Endometriosis can be treated with medication and/or surgery. The treatment options vary among patients depending on factors such as, the extent of endometriosis, if you are experiencing pain, age and whether the patient wants to get pregnant in the future.
Pain medications and hormone therapy may help to relieve the symptoms of pain. Hormone therapy might be effective because the rise and fall of hormones during the menstrual cycle causes endometrial tissues to thicken, break down and bleed. Hence, hormone therapy may slow the growth and prevent new endometrial tissue from growing. However, both pain medication and hormonal therapy are not permanent cures for endometriosis and the symptoms might recur after stopping medication.
The patient can consider undergoing laparoscopic surgery to remove endometrial growths, scar tissue and adhesions caused by endometriosis. Some women have increased fertility for up to 9 months after surgery. However, endometriosis and pain may return as well. If you do not intend to get pregnant, you can consider hysterectomy. Hysterectomy involves removing the uterus, cervix and both ovaries and is typically considered as a last resort.
#3 Uterine Fibroids
What it is:
Uterine fibroids are benign tumors that develop in the uterus. There is no definitive cause for the development of fibroids but factors such as hormones and family history may have an influence. Risk factors for fibroids include pregnancy, a family history, older than 30 years old and having a high body weight.
Symptoms depend on the location, size and number of tumours. If you are going through menopause, you might not have any symptoms. Fibroids may shrink during and after menopause.
- Heavy menstrual bleeding or between periods and includes blood clots
- Intense menstrual cramping
- Extended menstrual periods
- Pelvis pain and/or lower back pain
- Increased urination
- Pain during intercourse
- Abdomen swelling
- Pressure or the sense of fullness in lower abdomen
Diagnosis and Treatment:
A gynaecologist will conduct a pelvic exam to check the condition, size and shape of your uterus. An ultrasound test over your abdomen will allow your Gynae to see your uterus and if there are any fibroids present. A transvaginal ultrasound (conducted by inserting the transducer into the vagina) would probably present clearing pictures as it is closer to the uterus. A hysteroscopy is conducted by inserting a small telescope and examining the inside of the uterus. A biopsy can be taken of the lining of the uterus if necessary during this procedure.
There are many treatment options for uterine fibroids and if you have any of the symptoms, it is best to consult your doctor about symptom relief and the best treatment option.
If you do not experience any symptoms and your fibroids are not affecting your daily life, you can opt for no treatment and wait to see if your fibroids will shrink in size or disappear.
If you are experiencing mild symptoms, you can take over-the-counter medication that will relieve your symptoms. You can consult your doctor about the medications available for the various symptoms.
If you are experiencing moderate to severe symptoms, surgery may be the best treatment option. Myomectomy is a surgical approach to remove fibroids without taking out the healthy tissue of the uterus. This approach is the best for women who wish to conceive after treatment. However, new fibroids can still grow after myomectomy. Hysterectomy is a surgical approach and involves removing the uterus. This approach is the only way to cure uterine fibroid and is used when the fibroids are large and if there is heavy bleeding. Endometrial Ablation is the removing of the uterus lining to control very heavy bleeding. This can be carried out using laser, wire loops, boiling water, electric current, microwaves, freezing, and other methods. Most women recover quickly after this procedure and have no more or lighter menstrual bleeding. However, a woman is unable to conceive after this procedure as well.
What it is:
Menopause is defined as the absence of menstrual periods for 12 months continuously. It marks the end of menstrual cycles for a woman and can happen in your 40s or 50s. After menopause, women tend to have higher risk of osteoporosis and cardiovascular diseases.
- Irregular periods
- Vaginal dryness
- Hot flashes
- Sleep problems
- Mood changes
- Weight gain and slowed metabolism
- Loss of breast fullness
Treatment methods for menopause are customized for each woman and are directed towards alleviating uncomfortable symptoms. Talk to your doctor if you are having trouble coping with the symptoms.