The combined oral contraceptive pill has been used by an estimated 300 million women worldwide since it was first developed. In recent years it has been linked…

Breast pain

Breast pain is common and usually caused by hormonal changes during the menstrual cycle. Taking the contraceptive pill or hormone replacement therapy can also cause breast pain.

Some women experience breast pain…

Transvaginal ultrasonography, needle biopsy, and MRI often can’t distinguish adenomyosis from fibroids. Classical signs like uterine enlargment, pelvic pain, and abnormal menstrual bleeding are not pathognomic.

With no clear-cut set of…

Injuries to the perineum and vaginal opening affect 35-75% of women during vaginal birth.  Even after careful repair, permanent weakening may create vaginal ‘looseness’.  Some…

Premenstrual dysphoric disorder (PMDD)a is identified by a variety of physical and emotional symptoms that occur during the last week of the luteal phase of the menstrual cycle and that remit within a few…

Introduction
In the United States, sterilization is the most popular method of birth control for couples who want no more children. Although sterilization is reversible in some instances, reversal surgery in both men and women…

Introduction

Introduction

Essentials of Diagnosis

 
• Vaginal irritation, pruritus, pain, or unusual discharge.

Introduction

 
• Women neither secretly want to be raped nor do they expect, encourage, or enjoy rape.  
• Rape is always a terrifying experience in which most victims fear for their lives.  
• The rapist…

Introduction

Essentials of Diagnosis

 
• Cessation of menses due to aging or to bilateral oophorectomy.  
• Elevation of FSH and LH levels.  
• Hot flushes and night sweats (in 80% of women).  …

Introduction

Voluntary control of childbearing benefits women, men, and the children born to them. Contraception should be available to all women and men of reproductive ages. Education about contraception and access to contraceptive pills or devices…

Introduction

A couple is said to be infertile if pregnancy does not result after 1 year of normal sexual activity without contraceptives. About 25% of couples experience infertility at some point in their reproductive lives; the…

Introduction

Questions related to sexual functioning should be asked as part of the reproductive history. Two helpful questions are, “Are you sexually active?” and “Are you having any sexual difficulties at this time?”

Introduction

Essentials of Diagnosis

 
• Chronic anovulation.  
• Infertility.  
• Elevated plasma testosterone.  
• Insulin resistance.  
• Evidence of hyperandrogenism including hirsutism, acne, and alopecia.

Introduction

Essentials of Diagnosis

 
• Vague gastrointestinal discomfort.  
• Pelvic pressure and pain.  
• Many cases of early-stage cancer are asymptomatic.  
• Pelvic examination, CA 125, and ultrasound are mainstays of diagnosis.

Introduction

Uterine prolapse most commonly occurs as a delayed result of childbirth injury to the pelvic floor (particularly the transverse cervical and uterosacral ligaments). Unrepaired obstetric lacerations of the levator musculature and perineal body augment…

Cystocele, rectocele, and enterocele are vaginal hernias commonly seen in multiparous women. Cystocele is a hernia of the bladder wall into the vagina, causing a soft anterior fullness. Cystocele may be accompanied…

Introduction

Essentials of Diagnosis

 
• Pelvic pain related to menstrual cycle.  
• Dysmenorrhea.  
• Dyspareunia.  
• Increased frequency among infertile women.

Introduction

Essentials of Diagnosis

 
• History of genital warts.  
• History of prolonged vulvar irritation, with pruritus, local discomfort, or slight bloody discharge.  
• Early lesions may suggest or include nonneoplastic epithelial…

Introduction

Essentials of Diagnosis

 
• Abnormal bleeding is the presenting sign in 80% of cases.  
• Pap smear frequently negative.  
• After a negative pregnancy test, endometrial tissue is required to…

Introduction

Essentials of Diagnosis

 
• Irregular enlargement of the uterus (may be asymptomatic).  
• Heavy or irregular vaginal bleeding, dysmenorrhea.  
• Acute and recurrent pelvic pain if the tumor…

Introduction

Essentials of Diagnosis

 
• Abnormal uterine bleeding and vaginal discharge.  
• Cervical lesion may be visible on inspection as a tumor or ulceration.  
• Vaginal cytology usually positive; must be confirmed…

Introduction

Essentials of Diagnosis

 
• The presumptive diagnosis is made by an abnormal Pap smear of an asymptomatic woman with no grossly visible cervical changes.  
• Diagnose by…

Trauma or infection may involve Bartholin’s duct, causing obstruction of the gland. Drainage of secretions is prevented, leading to pain, swelling, and abscess formation. The infection usually resolves and pain disappears,…