General Gynaecology Services at Mediclinic

Menstrual disorders refer to a group of conditions that affect a woman's menstrual cycle, which is the regular pattern of changes in hormones and the uterus that prepare a woman's body for pregnancy each month.

Menstrual disorders can lead to irregular or heavy bleeding, missed periods, and pain, affecting a woman’s quality of life. Common types include:

1. Amenorrhea: The absence of menstrual periods in a woman of reproductive age.
2. Dysmenorrhea: Painful periods that can range from mild to severe.
3. Menorrhagia: Heavy menstrual bleeding that lasts longer than 7 days.
4. Metrorrhagia: Irregular bleeding between periods.
5. Premenstrual Syndrome (PMS): A group of physical and emotional symptoms that occur before a woman's period.
6. Premenstrual Dysphoric Disorder (PMDD): A more severe form of PMS that can cause extreme mood swings and other symptoms.

There are many other types of menstrual disorders as well, and they can be caused by a variety of factors, including hormonal imbalances, uterine fibroids, endometriosis, polycystic ovary syndrome.

If you are experiencing menstrual irregularities or other symptoms, it is important to talk to your healthcare provider to determine the cause and appropriate treatment. 

Polycystic ovary syndrome (PCOS) is a common hormonal disorder impacts reproductive-age women. It is characterised by the presence of numerous small cysts on the ovaries, along with increased levels of androgens (male hormones) and an imbalance of estrogen/progesterone in the body.

The symptoms of PCOS include:

1. Irregular or absent periods
2. Excessive facial, chest, or abdominal hair
3. Acne or oily skin
4. Weight gain or trouble losing weight
5. Infertility or difficulty conceiving
6. Darkened skin in areas like the neck or armpits
7. Skin tags or excess skin in regions like the armpits or neck

The exact cause of PCOS is unknown, but it is believed to be related to a combination of genetic and environmental factors.

PCOS is typically diagnosed through a pelvic exam, ultrasound, hormone tests (DUTCH test/blood test) and some blood tests.

Treatment for PCOS typically focuses on managing symptoms and may include lifestyle changes such as weight loss and exercise, hormonal therapy and some medications to regulate menstrual cycles and lower androgen levels, and fertility treatments if needed.

Women with PCOS are also at increased risk for other health problems such as diabetes, high blood pressure, and heart disease, so it is important to work with a healthcare provider to manage the condition and monitor for these complications.

Endometriosis is a condition in which the tissue that normally lines the inside of the uterus (the endometrium) grows outside of the uterus, on other organs and tissues in the pelvic area, such as the ovaries, fallopian tubes, and the lining of the pelvis. This tissue can cause pain, inflammation, and the formation of scar tissue.

Symptoms of endometriosis can include:

1. Pelvic pain, especially during menstruation
2. Painful periods
3. Pain during or after sexual intercourse
4. Infertility or difficulty getting pregnant
5. Pain with bowel movements or urination during menstrual periods
6. Fatigue
7. Bloating or nausea

The exact cause of endometriosis is unknown, but several theories have been proposed. Some of the risk factors that have been identified include a family history of endometriosis, early onset of menstruation, and long menstrual cycles.

Endometriosis is typically diagnosed through a pelvic exam, ultrasound, or laparoscopy (a surgical procedure in which a thin tube with a camera is inserted into the abdomen

Treatment options for endometriosis can include pain medication, hormonal therapy (such as birth control pills or progestin therapy), and surgery to remove the endometriosis tissue. In cases where fertility is an issue, fertility treatments such as in vitro fertilisation (IVF) may also be recommended.

Managing endometriosis can be challenging, but there are many resources available for women living with this condition. It is important for women to work with their healthcare provider to find a treatment plan that works best for them.

Breast cancer is a type of cancer that forms in the cells of the breast. The cells in the breast can become abnormal and divide uncontrollably, forming a lump or mass of tissue. These abnormal cells can invade nearby tissues or spread to other parts of the body through the lymphatic system or bloodstream.

Breast cancer is most commonly found in women, but it can also occur in men. There are several types of breast cancer, and the most common types are invasive ductal carcinoma and invasive lobular carcinoma.

Breast cancer signs and symptoms may include:

1. An unusual breast bulge or thickening.
2. Breast size, shape, or appearance changes
3. Changes in breast skin, such as dimpling
4. Nipple inversion
5. Skin peeling, scaling, crusting, or flaking around the nipple (areola) or breast skin
6. Redness or pitting of the skin around your breast, similar to the skin of an orange
7. Breast cancer can be detected through routine screening, such as mammography and breast ultrasonography

Treatment options for breast cancer may include surgery, radiation therapy, chemotherapy, targeted therapy, hormone therapy, or a combination of these approaches. The choice of treatment will depend on the type and stage of the cancer, as well as the patient's overall health and preferences.

Osteoporosis is a medical condition characterised by weakened bones that are more prone to fracture or break. It occurs when the body loses too much bone mass, produces too little bone tissue, or both. This can increase the risk of fractures, particularly in the spine, hip, and wrist.

Osteoporosis can affect both men and women, but it is more common in women, especially after menopause.

There are several risk factors for osteoporosis, including age, sex, family history, low body weight, a history of smoking, excessive alcohol consumption, and certain medical conditions such as hyperthyroidism or rheumatoid arthritis. A lack of calcium and vitamin D in the diet can also contribute to the development of osteoporosis.

The symptoms of osteoporosis may not be apparent until a fracture occurs. However, some signs may include back pain, loss of height over time, and a stooped posture.

Osteoporosis typically diagnosed through a DEXA-scan.

Treatment for osteoporosis may include lifestyle changes, such as regular exercise, a healthy diet with adequate calcium and vitamin D, and avoidance of smoking and excessive alcohol consumption. Medications may also be prescribed to slow bone loss and increase bone density.

Urinary tract infections (UTIs) are infections that occur in any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. UTIs are more common in women than men and can range from a mild infection of the bladder (cystitis) to a more severe infection of the kidneys (pyelonephritis).

The most common cause of UTIs is bacteria, such as Escherichia coli (E. coli), which normally live in the colon but can spread to the urinary tract. UTIs can also be caused by viruses, fungi, or parasites.

Symptoms of a UTI may include a frequent urge to urinate, pain or burning during urination, cloudy or strong-smelling urine, pain or pressure in the lower abdomen or back, and fever or chills. In older adults, symptoms may be less specific, such as confusion or delirium.

UTIs can be diagnosed by a healthcare provider based on a physical exam, medical history, and a urinalysis or urine culture.

Treatment for UTIs typically involves antibiotics to kill the bacteria causing the infection. Drinking plenty of fluids and urinating frequently can also help flush out the bacteria from the urinary system.

Untreated UTIs can lead to more serious health problems, such as kidney damage or sepsis. Therefore, it is important to seek medical attention if you suspect you have a UTI.

Depression and anxiety are common mental health conditions that can affect women. Depression is a mood disorder characterised by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in activities that were once enjoyable. Anxiety is a condition characterised by excessive and persistent worry or fear that interferes with daily activities.

Depression and anxiety can affect women differently than men, and women are more likely to experience these conditions due to a combination of genetic, hormonal, and environmental factors. For example, women may be more likely to experience depression during hormonal changes such as pregnancy, postpartum, and menopause.

Symptoms of depression and anxiety in women may include feelings of sadness or despair, loss of interest in activities, changes in appetite or weight, sleep disturbances, fatigue or low energy, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of self-harm or suicide.

Treatment for depression and anxiety in women may involve a combination of medications, psychotherapy, lifestyle changes such as exercise, healthy eating, and stress management techniques. Hormonal therapy may also be used to treat depression and anxiety in women during certain stages of life.

It is important for women who are experiencing symptoms of depression or anxiety to seek help from a healthcare provider. With proper treatment, most women can manage their symptoms and improve their quality of life.

STIs, or sexually transmitted infections, are infections that are spread through sexual contact, including vaginal, anal, and oral sex. STIs can be caused by bacteria, viruses, or parasites and can affect both men and women.

Some of the most common STIs include chlamydia, gonorrhea, syphilis, herpes, human papillomavirus (HPV), and human immunodeficiency virus (HIV).

STIs can be transmitted through unprotected sexual contact with an infected partner, sharing of needles or injection equipment, or from mother to baby during pregnancy or childbirth. Some STIs, such as HPV, can also be transmitted through skin-to-skin contact.

Symptoms of STIs can vary depending on the infection and may include discharge or pain during urination, sores or blisters in the genital area, abdominal pain, fever, and fatigue. However, some STIs may not cause any symptoms, making it important for sexually active individuals to get regular screenings and check-ups with a healthcare provider.

Treatment for STIs may include antibiotics, antiviral medications, or antiparasitic medications, depending on the infection. Some STIs, such as HIV, do not have a cure, but there are medications available to manage symptoms and reduce the risk of transmission.

Prevention of STIs includes practicing safe sex by using condoms, getting regular STI screenings, and limiting the number of sexual partners.

Vaginitis is an inflammation of the vagina that can cause discharge, itching, and pain. The cause is frequently a vaginal bacteria imbalance or infection. Vaginitis can also result from menopause-induced estrogen deficiency and skin diseases.

The most prevalent kinds of vaginitis are:

Bacterial vaginosis: Overgrowth of vaginal bacteria destroys the normal balance. Grayish-white, foul-smelling discharge may occur

Yeast infections: Candida albicans is typically responsible. Cottage cheese-like discharge may occur.

Trichomoniasis: This is caused by a parasite and is often sexually transmitted. a greenish-yellow, sometimes foamy discharge may occur

Symptoms of vaginitis can vary depending on the infection and may include:

1. Changes in vaginal colour, odour, or discharge
2. Vaginal itching
3. Painful urination
4. Spotty vaginal bleeding

Treatment for vaginal infections may include antibiotics, or antiparasitic medications depending on the infection type. For hormonal changes estrogen might be prescribed to ease symptoms.

All women will go through the menopause at some time in their lives and spend one third of their lives post menopause.

Menopause commonly happens around the age of 50, but can occur prematurely before 45 years old. Menopause can also be brought on by surgery or by treatments for other conditions, such as cancer. This can be a difficult time for most women.

Menopause can pose some health risks to women, as well as produce symptoms which can affect their daily lives such as;

1. Vaginal Dryness and Painful Sexual Intercourse
2. Low Sexual Desire
3. Low Mood, Anxiety
4. Sleeping Problems
5. Hot Flashes
6. Brain Fog-Concentration Problems

At Mediclinic Middle East, help comes in the form of our Menopause Clinic, made up of a multi-skilled team of experts.  Amongst many things, we can support with:

• Diet and lifestyle advice
• Pelvic floor advice
• Psychological support for symptom management

We believe in evidence-based guidance advices, and we have a pharmacy stocked non-hormonal and hormonal options including ‘body-identical’ HRT if this is the chosen treatment path. 

The selection of hormone replacement therapy (HRT) is based on the specific circumstances of the individual. For individuals having a uterus, the recommended hormone replacement therapy (HRT) would consist of a combination of 17 beta estradiol and micronized progesterone, commonly referred to as combined HRT. Women who have undergone a hysterectomy are typically prescribed hormone replacement therapy (HRT) consisting only of 17 beta estradiol.

Postmenopausal women who is experiencing a decrease in libido may be presented with the option of receiving testosterone supplementation.