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The shamefulness associated with the examination of female genitalia has long inhibited the science of gynaecology. This 1822 drawing by Jacques-Pierre Maygnier shows a "compromise" procedure, in which the physician is kneeling before the woman but cannot see her genitalia. Modern gynaecology has overcome these inhibitions.Gynaecology (British) or gynecology (North American) literally means 'the science of women', but in medicine this is the specialty of diseases of the female reproductive system ( uterus, vagina and ovaries). Almost all modern gynaecologists are also obstetricians; see Obstetrics and gynaecology.
1 Examination
Gynaecology is a consultant specialty. In most countries, women must see a general practitioner first. If their condition requires knowledge or equipment unavailable to the GP, they are referred to a gynaecologist.
As in all of medicine, the main tools of diagnosis are clinical history and examination. Gynaecological examination is special in that it is quite intimate, and that it involves special equipment -- the speculum. The speculum consists of two hinged blades of flat metal, which are used to open the vagina, to permit examination of the cervix uteri. Gynaecologists may also do a bimanual examination (one hand on the abdomen, two fingers in the vagina), to palpate the uterus and ovaries. They may occasionally do a rectal exam. Male gynaecologists often have a female chaperone (nurse or medical student) for their examination. Virgins are not usually examined vaginally. An abdominal ultrasound is used normally to confirm the bimanual examination.
2 Investigations
Some of the investigations used in gynaecology are:
- abdominal ultrasound, to give a low-power view of the pelvic organs.
- vaginal ultrasound. A probe is passed into the vagina, which allows a detailed view of the uterus and its contents. Good in early pregnancy.
- blood tests. Levels of hormones such as estradiol, luteinizing hormoneLuteinizing hormone LH is a hormone released by gonadotropes in the anterior lobe of the pituitary gland. It is one of the gonadotrophins, the other being follicle stimulating hormone (FSH). In both males and females, LH stimulates the production of sex s, follicle stimulating hormoneFollicle stimulating hormone FSH is a hormone produced by gonadotropes in the anterior pituitary gland. FSH activates ovulation in women, initiating the approximately-monthly menstrual cycle. The release of FSH causes the immature follicles to grow in the and progesteroneProgesterone is a steroid hormone involved in the female menstrual cycle, pregnancy (supports gestation and embryogenesis of humans and other species. Progesterone levels vary during the menstrual cycle and it is an ingredient of most birth control pills are measured, as well as prolactinProlactin is a hormone secreted by lactotropes in the adenohypophysis (anterior pituitary gland), which is made up of 199 amino acids with a molecular weight of about 23,000 daltons. Prolactin has many effects, the most profound of which are to stimulate.
- hysteroscopy -- a fine tube is passed into the uterus via the cervix under a general anaestheticA general anaesthetic drug is an anaesthetic (or anesthetic AE) drug that brings about a reversible loss of consciousness. These drugs are generally administered by an anaesthetist ( BE) (or anesthesiologist AE) in order to induce or maintain general anae.
- laparoscopy -- tubes are passed into the peritoneal cavity, which is then insufflated with carbon dioxide. This is commonly used to diagnose endometriosisEndometriosis is a medical condition where the tissue lining the uterus (the endometrium, from endo "inside", and metrium "mother") migrates to other parts of the body. The condition can lead to serious health complications including: chronic pain a taut,.
MRI and CT scans are rarely used, apart from tumor staging in gynecological cancer. Pelvic X-ray is rare. It can be used to delineate the uterine cavity with an injected dye (hysterosalpingogram) and to measure the pelvic girdle.
