For Patients Obstetrics and Gynaecology

Ask the expert: Exploring Women’s health

Written by Mr Narendra Pisal for Doctify

Gynaecologists specialise in women’s health of course, but what symptoms do they see every day in their consulting rooms? We asked Mr. Pisal, Consultant Gynaecologist from London Gynaecology, to tell us about the most common women’s health problems.

Heavy periods (Menorrhagia)

“A normal period can be hard to define as every woman is different. But if you have to change sanitary protection frequently, if you have to use double protection (pad and tampon) or if you pass large blood clots, you could call your periods heavy. Heavy periods can make you anaemic and tired. Hormonal changes, fibroids and endometriosis can cause heavy periods. Simple medications such as tranexamic acid or using the contraceptive pill can reduce the bleeding significantly, so it is worth seeing you GP to discuss these options.”

Painful periods (Dysmenorrhoea)

“Some pain during periods is common, but if you take painkillers all the time or have to take time off work, it could indicate a condition called endometriosis which affects up to 10% of women. Going on the pill will often make the periods lighter and less painful. Often, your doctor will be able to suggest simple measures to help your symptoms.”

Pain during sex (Dyspareunia)

“This also could be a symptom of endometriosis if it is persistent and deep; especially if associated with painful periods. Sex can be painful after menopause if you have dryness and using lubrication or oestrogen cream can help.”



Bleeding between periods (Intermenstrual bleeding)

“If you are on the contraceptive pill, this could be a common side effect. It will usually resolve in a few months, but sometimes you may have to try a different pill. It can sometimes be a symptom of benign pathology inside the uterus such as fibroids (non-cancerous lumps in the uterine muscle) or a polyp (grape-like projection of tissue). If persistent, your doctor will recommend a scan to rule out any problems. Occasionally, a hysteroscopy (camera examination of uterus) may be required.”

Bleeding after sex (Postcoital bleeding)

“This symptom could indicate a normal physiological condition called Cervical Ectropion (when the inner delicate lining of the cervix everts out) or infection such as Chlamydia. Do see your doctor if you get more than one episode. Very rarely, it can also be a symptom of cervical cancer. Make sure that you are up to date with your smear test and also have a sexual health screen if you are in a new relationship.”

Abnormal smear

“If you have received a letter telling you that your smear is abnormal, you will understandably be anxious and worried. However, an abnormal smear almost always means that a minor problem (pre-cancerous change) has been detected and not anything serious (such as cervical cancer).

It means that your smear test has done its job and this minor problem can now be dealt with. It is very common to have an abnormal smear (1 in 12 smears), but it is extremely rare for this abnormality to be cancer. You may be referred for a special test called Colposcopy (camera examination of the cervix).”

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Mr. Pisal has practised Gynaecology in London for over 10 years working both as a private and NHS consultant. For further information about any of the symptoms or conditions described above, or just women’s health in general, find his next available appointment on Doctify.


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