You can rest assured that you are in safe hands for all your gynaecology care needs. Here at The Fertility and Gynaecology Academy we offer full gynaecological consultations, complemented with ultrasound during the same visit where necessary.

We see many patients who report menstrual disturbance. Below we have outlined some of the most common causes of this to give you a general overview.

Amenorrhea (Period Delay)

Primary amenorrhea could be a result of the obstruction of menstrual flow due to a non-perforated hymen, or ovarian failure. It is important to exclude Turner’s Syndrome and ensure that you have normal pituitary-ovarian axis.

Secondary amenorrhea may be due to pregnancy, eating disorders, ovulation disorders or premature ovarian failure. In most cases the diagnosis can be established by examination, ultrasound, blood tests and, if necessary, chromosome analysis.

Polycystic Ovarian Syndrome

Polycystic ovarian syndrome often leads to irregular periods and excess hair growth; ovulation is usually infrequent or does not take place, leading to infertility. Your consultant will assess you by ultrasound and hormone tests to establish a diagnosis. Treatment varies according to whether fertility is desired or not. Success rate to treatment is good.

Abnormal Vaginal Bleeding

Abnormal bleeding in young women before 40 years is commonly due to ovulation problems and contraceptive pills, but it is important to exclude ectopic pregnancy, uterine polyps and fibroids. Your consultant should be able to find the cause of the bleeding from history, examination, ultrasound and a pregnancy test.

Endometriosis

The inner cavity of the uterus is lined with endometrial cells. Sometimes these cells are implanted outside the uterus i.e in the pelvis, on the ovaries or elsewhere. These abnormal cells will also respond to the oestrogen in your cycle and bleed with each period. The result is blood cyst formation, scarring and immune response, leading to pain with periods, pain during intimacy and infertility.

Diagnosis of this can be difficult and can only be confirmed by laparoscopy. Immune testing often reveals high levels of natural killer cells. Treatment is medical, surgery and immune system modulator to improve fertility.

Fibroids

Fibroids are benign lumps which are common in women over 30, and especially in women who have had no children. Fibroids can lead to subfertility if present in the uterine cavity. Diagnosis is by ultrasound and treatment is usually by surgery – especially if fertility is to be preserved.

Keyhole Surgery (Laparoscopy)

Dr Eskander is very experienced and has been working with keyhole surgery since 1977. Keyhole surgery allows operations to be carried out through a very small incision – usually 3-4 cm – with minimal tissue disturbance. The result is quicker recovery, typically 3-7 days compared with 15-28 days for open surgery.

Keyhole surgery carries approx 1% risk of injury to surrounding structures including blood vessels, bowel, ureter and bladder. Most are correctable once recognised.

We undertake many operations in this way including diagnostic laparoscopy and dye tests, ovarian drilling (in PCO), ovarian cystectomies for ovarian cysts, small fibroids (myomectomy), removal of an ectopic pregnancy and even hysterectomy.