Gynaecology

The Gynaecology service at The Alexandra Hospital sees women aged 18+ for all gynaecological concerns. People visit us for help with:

• Pelvic pain, either during or between periods
• Heavy periods
• Bleeding between periods or after intercourse
• Absent, intermittent or irregular periods
• Itching or burning
• Bloating
• Pain during intercourse
• Vaginal discharge
• Pelvic prolapse
• Vulval irritation or lesion
• Pain during intercourse
• Urinary incontinence
• Hot flushes and/or night sweats
• Reduced sex drive
• Lower mood
• Abnormal cervical smears
• Vaginal dryness, itching or discomfort
• A scan has shown a possible fibroid or ovarian cyst
• Fertility problems

If you have one or more of these symptoms, it can be sensible to see a gynaecologist for expert help. At a time when waiting times elsewhere are stretching into many weeks and months, we can help you to access the most appropriate support for your specific condition sooner.

• Endometriosis – A long-term condition causing pelvic pain.
• Uterine fibroids - Non-cancerous growths within the uterus.
• Polycystic ovary syndrome (PCOS) – Causes irregular periods and enlarged ovaries.
• Pelvic floor muscle dysfunction – Cause difficulties having a bowel movement.
• Pelvic organ prolapse – Caused by one or more of the organs in the pelvis pushing down on the vagina.
• Menopause – A reduction in oestrogen levels (one of the two female sex hormones) causes the body to stop producing eggs. Common symptoms include hot flushes, vaginal dryness and discomfort, reduced sex drive and lower mood.

If you have any of the symptoms or conditions, our Consultant Gynaecologists would be delighted to meet with you and help get clarity on the best way forward.

If there is a presumptive diagnosis of gynaecological cancer, this can be investigated and treated at The Alexandra Hospital.

In addition, they can investigate any infertility concerns and refer you to the most appropriate person for further help.

• Hormonal or other drug therapies
• Physiotherapy
• Behavioural therapy
• Lifestyle changes
• Surgery

Many problems within the reproductive system can be well managed and treated using non-surgical (conservative) means. Other conditions may require surgery.

Where surgery is required, laparoscopy (keyhole surgery) can often be used. This minimally invasive surgery is an excellent way of looking inside the abdomen to diagnose and treat a number of uterine conditions. Because laparoscopic surgery uses only very small incisions, it causes less pain and bleeding, helps promote a faster recovery and causes less scarring.

Hysteroscopy may be used to examine the uterus (womb). A hysteroscope is passed through the vagina and cervix into the womb, so no incisions are needed.

Open surgery may be required to treat some conditions.

• If conservative treatments aren’t effective at managing the symptoms of endometriosis, endometrial ablation may be done to break down the lining of the womb. If the problem is more widespread, a hysterectomy (surgery to remove the womb in its entirety). This can be carried out vaginally, abdominally or laparoscopically.
• Pelvic floor muscle dysfunction will often be improved by physical therapy, and medication to help keep your stools soft can also help
• Different medicines are available to help reduce heavy periods or to shrink uterine fibroids. If these options are not effective at relieving your symptoms, the fibroids may be removed surgically.
• Symptoms caused by polycystic ovary syndrome will often improve with lifestyle changes like exercise, diet and weight loss. Other treatment options include medication and laparoscopic ovarian drilling (LOD).
• For mild symptoms of pelvic organ prolapse, pelvic floor exercises may be all that is needed. Other treatments include hormone treatment, vaginal pessaries and surgery.
• Menopausal symptoms can be extremely varied, and treatment may involve hormone replacement therapy (HRT), talking therapies, physiotherapy, dietary changes or exercise.
• If you are diagnosed with a gynaecological cancer, treatment will depend on how far it has spread. It may be treated with surgery or chemotherapy. While your initial investigations may be carried out by your Consultant Gynaecologist, you will be referred to the Oncology team for treatment.

Treatment is always most effective when it is carefully planned around the individual. We can provide you with a bespoke treatment plan which may not be available as easily or quickly through other routes.

When you first meet with your consultant, they will talk with you about the symptoms you have and how they are affecting you.

They may need to carry out a physical examination. This will always be explained to you, so that you know what to expect and why it’s being done.

Sometimes, further test may be needed to help with diagnosis. These may include:

• Blood test
• Vaginal swab - to check for infection
• A colposcopy – a special microscope (colposcope) is used to examine the cervix, vagina and vulva.
• Diagnostic scans – most commonly ultrasound, but X-ray, MRI or CT are also sometimes required

Your medical history, the physical examination and any test results will be used to help diagnose the problem and to determine what the next step should be. Some problems may resolve themselves naturally, while others will benefit from medical intervention.

If treatment is needed, your consultant will talk you through suitable options so that you can make an informed choice. If you have any questions or concerns at any time, they will be very happy to discuss these with you.

• Rapid access to an expert - As the largest private hospital in the country outside London, we have a number of extremely experienced Consultant Gynaecologists, able to provide you giving quick, easy access to assessment, diagnosis and treatment.
• Continuity of care - The consultant you see for your initial consultation will be the same one you see for any further visits. Your care will always be consultant-led, you will never be seen by a more junior doctor.
• Peace of mind - In our most recent patient survey, we were delighted that 97.3% of the people we’d treated said they were likely or extremely likely to recommend us to their friends and family.
• Flexible appointments – We offer Gynaecology consultations throughout the week, so it is easy to book a time that is convenient for you. We can also provide remote consultations by telephone or video call if required.
• Multidisciplinary team - Your Consultant Gynaecologist is supported by a number of other healthcare professionals including nurses, physiotherapists and radiographers. Fast, easy access to any member of this multidisciplinary team ensures you will always see the most appropriate specialist for your specific needs.

If you are feeling anxious or concerned about any gynaecological symptoms, it is important to know that good help is available.