Gynaecology

What is gynaecology? 

Gynaecology is the branch of medicine concerned with the treatment of disorders of the female reproductive system. Gynaecology deals with hormonal imbalances, menstrual disorders, birth control, menopause, breast disorders, vaginal disorders, uterine disorders and genital cancer screening. Gynaecology also helps couples with fertility problems. 
Obstetrics is a sub-specialism within gynaecology involving the care of women during pregnancy, childbirth and following childbirth.

Who can see a gynaecologist?

Gynaecology is concerned with women’s health and well-being. 
It looks after the reproductive health of a woman during all stages of her life, from puberty to menopause and beyond. 

What happens during a gynaecology consultation? 

If the consultation is for specific symptoms or concerns (for example, pelvic pain, vaginal bleeding, or vaginal discharge) the gynaecologist will begin by asking a series of preliminary questions to establish the overall health of the patient. These questions will give them key information (personal and family medical history, lifestyle, sexual habits) before they carry out a clinical examination. This consists of an examination of the external genitalia and the vagina, in order to determine their physiological and pathological condition.

Here is a specific list of some of the most common examinations carried out by gynaecologists during consultations, depending on the identified symptoms and the specific needs of the patient:
•    Screening tests for cervical cancer, particularly smear tests. A smear test is a routine examination that women will undergo throughout most of their lives. It involves taking a sample of the cervical cells which is then analysed to detect possible signs of cervical cancer. The same sample can be tested for the human papillomavirus (HPV).
•    Microbiological testing to analyse samples of specific microorganisms that are linked to sexually transmitted diseases, such as gonorrhoea and chlamydia. These are carried out if the patient presents any symptoms or risk factors. The samples can be taken from the urinary genital organs, such as the endocervix (sample taken through a smear test) or from a patient’s urine.
•    Diagnostic imaging tests, particularly pelvic ultrasounds. This is a simple, painless examination used to effectively determine the health of the uterus and the ovaries. This examination can be used to diagnose potential gynaecological problems, such as cysts or fibroids.
•    Breast examination, which involves analysing the breasts from different points of view and carrying out a palpation in order to detect cysts or nodules. It is a non-instrumental clinical examination based solely on observation and an evaluation of how the mammary glands feel to the touch. A gynaecologist can also explain the benefits of self-examination to the patient. Self-examination is the first line of defence used to prevent breast cancer, as it enables any abnormal changes in the size or shape of the breasts to be detected at an early stage.

What symptoms does a gynaecologist treat? 

Gynaecological conditions affect different parts of the female reproductive system. 

Gynaecologists treat the following symptoms: 
-    lower abdomen pain 
-    menstrual disorders and irregular or absent periods
-    lower genital tract infections involving the vagina and vulva
-    pelvic organ prolapse which can affect the uterus, bladder or rectum
-    uterine fibroids (non-cancerous growths)
-    endometriosis, a chronic inflammatory disease
-    sexually transmitted infections
-    human papillomavirus (HPV) infection, which causes cervical cancer.

Endometriosis 

Endometriosis is a common condition where small pieces of the womb lining are found outside the womb. It can affect the cervix, fallopian tubes, ligaments that support the uterus, ovaries, peritoneum, vagina and vulva. The main symptoms of endometriosis are painful periods as well as debilitating urinary and digestive problems. 

Breast cancer 

Breast cancer refers to a malignant tumour that has developed from cells in the breast. Cancer cells can invade and destroy surrounding healthy tissue. They can also spread to other parts of the body (metastases).

Cervical cancer 

Cervical cancer starts in the epithelial cells lining the cervix. Nearly all cervical cancers are caused by the human papillomavirus (HPV) infection, which is a sexually transmitted infection. 
Cervical cancer grows slowly; it normally takes 10 to 15 years to develop after infection. 
Cervical cancer is detected during cervical screening (a smear test).

Urogynaecology 

Urogynaecology treats a number of issues in women, including bladder problems, pelvic organ prolapse and urinary incontinence.

Conditions include:
-    urinary and bowel incontinence 
-    after effects of giving birth (perineal pain, urinary problems)
-    pelvic organ prolapse (particularly the uterus, bladder and rectum)
-    weakened perineal muscles.

A urogynaecological consultation is where a specialist performs a full assessment using urodynamic tests to help establish a suitable treatment plan.

What are the potential treatment options in gynaecology?

Gynaecology offers treatment for the following medical and surgical conditions:
-    vulval disorders, vaginal disorders and uterine disorders
-    ovarian tumours and cysts 
-    urinary incontinence 
-    pelvic organ prolapse
-    uterine cancer, ovarian cancer and breast cancer.

In-depth diagnostic tests, such as a colposcopy. A gynaecologist will perform a colposcopy to fully diagnose a patient if their smear test results come back with any abnormalities.
In addition, gynaecology is a surgical specialty; depending on the precise nature of the abnormality or condition, the patient may be prescribed medication, a surgical treatment, or a combination of both. Gynaecologists can perform many different operations: for example, laparoscopic procedures to assess anatomical changes or changes to the surface of internal organs (e.g. endometriosis, phlogosis, adhesions). They can also remove myomas and fibroids and perform tubal ligations, hysterectomy procedures (removal of the uterus), ovariectomy procedures (removal of the ovaries), curettage to remove contents of the uterus (e.g. in the case of an incomplete miscarriage), as well as surgical procedures for urinary incontinence or pelvic organ prolapse.
Gynaecologists often work with other specialists if the conditions affecting the reproductive system are caused by and/or linked to changes or conditions which affect other organs and vice versa. For example, gynaecologists work with oncologists if a patient has a tumour on or around the genital organs or the breasts. Similarly, they work with endocrinologists when treating abnormalities relating to the endocrine glands that can damage how the reproductive organs work, such as thyroid conditions or diabetes.

Care

Gynaecology helps patients with:
-    birth control
-    pregnancy care
-    assisted conception
-    help and support with the menopause
-    side effects of menopause (osteoporosis, angina, high blood pressure, depression)
-    benign (non-cancerous) breast conditions
-    cancer (breast cancer, cervical cancer, endometrial cancer, ovarian cancer)
-    genital infections (vulvovaginitis and salpingitis, HIV)
-    fertility problems
-    surgical procedures involving the vulva, vagina, uterus and uterine appendages (ovaries and fallopian tubes).

Obstetrics involves the care of women during pregnancy, childbirth and the weeks following childbirth. 
Obstetricians work closely with midwives.

Midwives are involved in:
-    preparing mothers-to-be for childbirth 
-    preventing pregnancy-related conditions
-    childbirth.

Postoperative and medical follow-up

Gynaecological follow-up 

Gynaecologists may carry out several examinations depending on the reason for the consultation:
-    cervical screening 
-    vaginal examination 
-    breast examination 
-    ultrasound scan 
-    laboratory and clinical techniques related to assisted conception.
They are also present during childbirth, whether this is a vaginal or a caesarean section delivery.

Postoperative follow-up

Postoperative follow-up is provided by a multidisciplinary medical team who supports you through your recovery. This team includes gynaecologists and obstetricians, midwives, nursing assistants and physiotherapists. 
Outpatient surgical protocol means that you can return home a few hours after the procedure.

Why see a gynaecologist with Swiss Medical Network? 

Swiss Medical Network is the second largest network of private clinics in Switzerland. It has 22 facilities and women’s health clinics.

The highly-skilled gynaecologists and obstetricians have the best medical training while 
the midwives, care assistants and medical assistants support you through your care journey and consider your needs. 

-    The Centre du Sein GSMN is a state-of-the-art medical facility for the diagnosis and treatment of breast cancer.
-    It has cutting-edge technology in gynaecology and obstetrics, including laser vaginal rejuvenation and laser ablation techniques for gynaecological and breast cancers.

FAQs

What is the role of a gynaecologist?

A gynaecologist specialises in the branch of medicine concerned with disorders of the female reproductive system, hormonal imbalances and cancer screening as well as assisted conception, pregnancy care and childbirth.

When should I start seeing a gynaecologist?

Girls should see a gynaecologist if their periods are painful or if they have an itchy or sore vagina. They should also see a gynaecologist when they become sexually active and need birth control. They can ask for cervical screening which involves taking a small sample of cells from the cervix to rule out any infections.

We recommend that you see a gynaecologist after unprotected sex or if the condom breaks as there is a risk of pregnancy as well as getting or passing on sexually transmitted infections.

When should I see a gynaecologist?

We recommend that you see a gynaecologist for regular check-ups.

You can see a gynaecologist for the following:

  • pain during sex
  • pain, bleeding or discharge affecting internal reproductive organs (uterus, vagina, fallopian tubes, ovaries)
  • pain affecting external reproductive organs (vulva, breasts)
  • breast problems (lump, tenderness, discharge)
  • birth control needs
  • before and during pregnancy
  • fertility problems
  • menopause monitoring
  • unprotected sex or if the condom breaks
  • follow-up care for ovarian cancer, cervical cancer, breast cancer or vulval cancer.

How do I prepare for my consultation with the gynaecologist?

You will receive results from previous tests and examinations, including breast screening, cervical screening, ultrasound scans, birth control prescriptions and medications, in your gynaecological follow-up consultation.

The gynaecologist will ask you for information about yourself, including:

  • date of your period
  • start of your pregnancy
  • health problems (infections, intolerances, allergies)
  • family history (cancers, cardiovascular diseases).

What is cervical screening?

Cervical screening or a smear test is a simple, painless and harmless test which can detect abnormal cells in the cervix.

It is used to prevent cervical cancer as it can detect precancerous cervical cell changes.

Routine screening is recommended every three years for women aged 20 to 65. If cervical screening results are abnormal, a visual examination of the cervix (colposcopy) is performed to locate the abnormal cells and take biopsies.

What is the male equivalent of a gynaecologist?

An andrologist is a specialist doctor with postgraduate training in the male reproductive system. We recommend that men should start seeing an andrologist from the age of 40.

The main reasons for a consultation are:

  • male infertility problems
  • erection problems
  • ejaculation problems
  • testicular cancer
  • genital or testicular abnormalities
  • azoospermia (no sperm count)
  • frenulum tear
  • priapism
  • male birth control
  • andropause (decrease in testosterone production).

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