Gynaecology in Birmingham

There are a number of medical problems that can affect the reproductive system, and it is important to consult a specialist if you have symptoms that might suggest a gynaecological problem.

At the Gynaecology Clinic at The Priory Hospital, you will find an expert team of gynaecologists who are specialists in treating a wide range of gynaecological problems and conditions. Below you'll find links to the profiles of our experienced team, which will tell you what areas they specialise in and help you choose the right consultant for you. Of course, you can always call us directly and we'll help you find the right specialist.

You will meet your doctor in one of our modern consulting rooms, where you will be able to discuss your needs in privacy.

If you need further investigation, then our state-of-the-art diagnostic suite will ensure that you are seen quickly and efficiently. If you need treatment, then you will be supported by our caring, dedicated team throughout the process.

We can help people who suffer from a wide variety of gynaecology problems, such as:

• Ovarian cysts
• Pre-menstrual bleeding
• Postmenopausal bleeding
• Endometriosis
• Gynaecology cancers: uterine cancer, ovarian cancer, cervical cancer
• Fertility-sparing cancer surgery
• Incontinence
• Prolapse
• Fibroids
• Menopause and HRT
• Cosmetic gynaecology
• Vulval pain
• PCOS

Our consultant gynaecologists at The Priory will ensure you have a thorough, informative consultation and a quick diagnosis.

Due to the different organs involved, gynaecological conditions can cause a range of different symptoms.

Many of these can be caused by more than one condition, and so your consultant will make sure to take a full history and carry out investigations to find out the cause.

Abnormal vaginal bleeding

Abnormal vaginal bleeding can appear in several different ways and due to a number of potential causes.

• Menorrhagia: this is heavy or prolonged bleeding that is part of your normal cycle. Bleeding is said to last too long if it exceeds seven days. Heavy bleeding is when you need to change a pad or tampon after less than two hours, or are passing large clots
• Intermenstrual bleeding: this is when you experience blood loss that is not part of your normal cycle. It is also sometimes called irregular bleeding
• Post-coital bleeding: this is vaginal bleeding that occurs within 24 hours after sex
• Postmenopausal bleeding: this is that bleeding that occurs more than a year after your periods have stopped

While there are different types of abnormal vaginal bleeding and different causes, it is always important to see a specialist in order to determine if further investigation or treatment is required. In addition to getting a diagnosis, a visit to one of our gynaecological consultants can help put your mind at ease.

Pelvic pain

Pelvic pain is felt in the lower part of the abdomen. It can come on very suddenly, or gradually over time.

The pain can manifest in different ways, including sharp and stabbing, a dull ache, or cramping.

Urinary symptoms

Urinary symptoms can vary widely. They can include pain and burning on passing urine, a frequent need to pass urine, needing to pass urine urgently, difficulty urinating, or problems with urinary continence.

Menopause

The most common symptoms of menopause and perimenopause include changes to your periods, changes to your mood or mental health, hot flushes, headaches, joint pain, and vaginal dryness. The menopause affects everyone differently, and for many women it has significant mental and physical effects that can really impact their quality of life. If you think you are showing signs of menopause or perimenopause, no matter your age, speak to your doctor for advice.

Pelvic organ prolapse

Pelvic organ prolapse, often just referred to as prolapse, is when one or more organs from inside your pelvis move down from their usual position and into your vagina, whether partially or wholly. Symptoms include discomfort or a feeling of heaviness in your lower tummy and vagina, feeling or seeing a lump in your vagina, and often you will experience changes to your peeing habits - needing to pee more frequently or feeling like you can't empty your bladder, for example. 

In order to correctly diagnose your condition, your gynaecologist will ask a number of questions about the problem, your general health, and any medications you might be taking.

What they might want to know could include when the problem started, if it has been getting worse, if it is associated with any other symptoms and the effect that this has been having on you.

After you have talked with your specialist, they may want to examine you, particularly your abdomen.

They may also want to perform an internal examination. As part of this, they may also do a speculum examination, where a thin instrument is passed into the vagina to allow the specialist to look at the cervix and vaginal walls.

An internal examination is usually done with a chaperone present, however if you prefer not to have a chaperone you can sign to confirm your preference on the chaperone log.

There are a number of investigations that your specialist could request, both to help make the diagnosis and to decide on the appropriate management plan.

Blood tests

Your doctor may decide to perform blood tests to check for anaemia, look for infection, or check the function of other organs.

Cervical screening (smear test)

Cells from your cervix are removed and examined to look for any changes, such as those that might increase your risk of cancer.

Ultrasound scan

An ultrasound machine uses sound waves to produce images of internal organs and structures. It has the advantage over other types of scan in that it is continuous like a video, rather than a single image, allowing specialists to identify areas of interest and then examine them in more detail.

CT scan

A CT scan uses x-rays to produce a series of images of the inside of the body. It can show particular parts of the abdomen from all angles, and can even be reconstructed to give a 3-dimensional image of any organ.

MRI scan

Unlike a CT, MRI uses magnetism rather than x-rays to produce images. It is particularly good at examining the soft tissues of the body to look for evidence of the cause of your symptoms.

Gynaecological problems can have an array of symptoms, some of which might not be obviously related to the reproductive organs. This is why it is important to consult a specialist who will really listen to what you have to say, both to understand your problem fully and to come to the correct diagnosis. Once a diagnosis has been made, then the specialist can discuss with you if any further investigation or treatment is required.

Below are just a few of the causes of gynaecological symptoms which your consultant could diagnose.

Causes of abnormal bleeding

There are a number of causes of abnormal bleeding. These can be broadly grouped into:

Uterine-related problems:

• Growths of the uterus that are not cancer, including uterine fibroids or polyps
• Problems related to pregnancy, such as miscarriage
• Thickening of the lining of the womb (endometrial hyperplasia)
• Cancer of the uterus

Cervical and vaginal problems:

• Infection, which can include sexually transmitted infections (STIs)
• Dryness of the vaginal tissue
• Thinning and inflammation of the vaginal tissue (atrophic vaginitis)
• Harmless changes to the cell types of the cervix, such as cervical ectropion
• Cancer of the cervix or vagina

Hormone-related problems:

• Bleeding due to hormonal contraception or intrauterine device (IUD)

Other illnesses:

• Conditions that increase your bleeding risk, such as von Willebrand disease
• Other conditions such as liver, kidney or thyroid disease

As you can see from the above list, the causes of abnormal bleeding can vary from the benign to the serious.

This is why it is so important to see a specialist who can investigate the full extent of your bleeding, find if there are any other symptoms that are related, and determine if any further investigation is needed.

Even if you think that you might know the cause it is best to be certain, and that can only be achieved by expert investigation, diagnosis and treatment if required.

Causes of pelvic pain

There are lots of causes of pelvic pain, which can be due to problems with any of the organs in the pelvis. Common causes include pain from the urinary tract (such as in urinary tract infections) and the bowel (constipation).

In women, pelvic pain can be due to:

• Ectopic pregnancy – the fertilised egg implants outside the womb, often in the fallopian tube, which can lead to pain and bleeding
• Miscarriage
• Pelvic organ prolapse
• Pelvic inflammatory disease – inflammation inside the abdomen, which may be due to infection
• Pain related to ovulation
• Menstrual cramps
• Ovarian disorders, commonly due to ovarian cysts
• Fibroids
• Endometriosis – where the tissue that normally grows inside the womb, the endometrium, is found elsewhere
• Cancer – including of the cervix, uterus and ovaries

There is a multitude of other potential diagnoses for gynaecological symptoms, and this list should not be taken as a substitute for expert medical investigation and care.

Visit our gynaecology specialists at the Priory Hospital and you will have access to a full multidisciplinary team, including gynaecologists, radiologists, nurses and more. All of these healthcare professionals work together to ensure that you receive a swift and accurate diagnosis, whilst making sure that you feel safe and cared for.

Urinary symptoms

Urinary symptoms are extremely common, and the subspeciality of urogynaecology exists to diagnose and treat these in women.

In women, urinary symptoms, particularly related to continence, can come about due to physical and hormonal changes that occur during ageing.

These conditions can include childbirth-related pelvic floor issues, menopause or perimenopause, and prolapse of the uterus or vagina. 

The management of your condition will depend on your diagnosis. Once the cause of your symptoms has been determined, your specialist will discuss a possible course of treatment with you. Together, you will come up with a plan that will improve your symptoms and treat your underlying condition.

Some gynaecological problems can be treated by using medication such as:

• Pain relief – this can include paracetamol, ibuprofen, or stronger painkillers. This does not treat the underlying cause of your pain
• Hormonal contraceptives/IUDs – these can be used to treat heavy periods or problems such as endometriosis
• Hormone replacement therapy (HRT) – this can be used to treat some of the symptoms of the menopause
• Hormonal implants for menopause– this is a form of HRT that can offer relief from menopause symptoms for 6-8 months, or even longer in some cases
• Antibiotics – to treat infection

Other conditions may require procedures or operations as part of the treatment.

There are a number of procedures that can be performed in gynaecology.

Colposcopy

A colposcopy is a simple procedure that allows a gynaecologist to see the cervix, vagina and vulva using an instrument called a colposcope. A colposcopy can be used if some cells from a cervical screening sample were abnormal, or to find out the cause of abnormal vaginal bleeding.

A colposcopy is usually done in the outpatient setting. The procedure occurs with you lying down with your legs in padded supports. A device called a speculum is gently inserted into the vagina and opened. A microscope with a light is then used from a distance to examine the cervix.

During the procedure, liquids may be applied to the cervix to highlight abnormal areas, and a tissue sample (biopsy) may be taken.

If an abnormal area is identified, the surgeon may opt to remove it during the colposcopy using a technique called a loop excision.

Cystoscopy

There are two main types of cystoscopy: a flexible cystoscopy and a rigid cystoscopy.

Both types of procedure involve the use of a thin tube with a light and camera at one end of it called a cystoscope. This is inserted in your urethra (the tube that carries urine out of your body) and up into your bladder to examine it. This cystoscope relays images to a monitor that your consultant can refer to as they perform the procedure. A cystoscopy can help diagnose and treat many conditions that affect your bladder, including bladder stones, recurrent UTIs, and pelvic floor dysfunction.

Hysteroscopy

Hysteroscopy involves passing a thin camera into your womb to view the inside and diagnose any related conditions.

If the aim of the procedure is just to look inside, the procedure can sometimes be performed in the outpatient clinic with some pain relief.

If the intention is to treat a condition, then an operative hysteroscopy is performed. This takes place in an operating theatre, either under general anaesthetic (asleep) or spinal anaesthetic (awake or sedated). A thin telescope is passed into the uterus.

If a condition is identified, it may be possible to treat it then, for instance cutting out fibroids or getting rid of (ablating) excess endometrial tissue. If necessary, samples of tissue (biopsies) can be taken and sent off for analysis.

Recovery from hysteroscopy is usually quick, and you can hopefully go home the same day. You may have some discomfort afterwards, which has been compared to period pains.

Laparoscopic surgery

If your surgeon suspects that the cause of your symptoms may be coming from inside your abdomen, they may suggest performing a laparoscopy. In an operating theatre, with a general anaesthetic (where you are asleep), a thin telescope is passed through a small cut into your abdomen.

Images from the telescope are displayed on a screen for the surgeon and team to see. Here they can examine the inside of the abdomen, as well as look for causes of your symptoms related to the organs.

Many conditions of the uterus, tubes and ovaries can be managed during laparoscopic surgery.

You will be given pain-relieving drugs whilst you are asleep, and advised to continue taking painkillers afterwards.

Transvaginal surgery

Some procedures can be performed via a small incision in the vagina. This is usually less uncomfortable afterwards than a cut on the abdomen.

Operations that can be undertaken this way include those to manage prolapse of the uterus or vaginal prolapse, procedures related to incontinence, or even hysterectomy.

Hysterectomy surgery

Hysterectomy involves removing the uterus. It may be performed to treat heavy periods, long term pelvic pain, non-cancerous growths, or cancer of the uterus, ovaries or cervix.

There are four main types of hysterectomy:

• Total hysterectomy: the uterus and cervix are removed
• Subtotal hysterectomy: the womb is removed, but the cervix is left in place
• Total hysterectomy with bilateral salpingo-oophorectomy: the womb, cervix, tubes and ovaries are removed
• Radical hysterectomy: the womb, tubes, ovaries, cervix, part of the vagina and surrounding tissues such as lymph glands and fat are removed

The hysterectomy is a very common operation. It can be performed via keyhole surgery, via the vagina, or through a cut on the abdomen. 

IVF treatment

In-vitro fertilisation (IVF) is designed to help people that are struggling to conceive naturally. It is a procedure in which an egg is fertilised in the laboratory and the resulting embryos are transferred into the womb a few days later.

Our team of expert gynaecologists provide a range of treatments for common conditions in private, modern surroundings. We offer quick and easy access to state-of-the-art investigations to allow a quick diagnosis.

Once the cause of your problem is known, our specialist will work with you to create a treatment plan that takes into account your needs.

Our supportive, caring team will look after you from your first consultation, through any treatment, and on to your recovery.

If you have symptoms that are worrying you, or are interfering with your daily life, you can make an appointment with one of our gynaecology specialists to begin your journey back to health today.

The Priory Hospital is the largest independent hospital in Birmingham, offering the latest treatments in a caring and friendly setting.

We offer facilities for advanced surgical procedures with the ability to recover afterwards in our luxurious private bedrooms.

Our medical, nursing and physiotherapy teams will ensure that you are well cared for and able to go home as soon as you are ready.

After you have gone home your surgeon will see you again in the clinic to ensure that your treatment has gone well and that your recovery is progressing.

If you have symptoms that are concerning you, get in touch today to book an appointment with one of our experts. 

Content reviewed by Mr Philip Toozs-Hobson in August 2022. Next review due August 2025.