I’m a consultant gynaecologist - AMA

[quince2figs]

I have worked in a variety of settings - hospital obstetrics and gynaecology incl labour ward, PMS and menopause, currently community contraception and unplanned pregnancy services, NHS and non. Ask away!

reeldoop - you can have whichever HRT you wish. Occasionally a Mirena is tricky to fit, but if so, you could be referred to the local contraceptive consultant. I would t anticipate this just because of your age, and lack of previous hormones not relevant.

What do you think of doulas? Are they used much in the UK? Why or why not? What do you think when women choose to go without pain medication?

What happens to your womb lining if you don't have periods? I started taking Provera a few years ago. I was meant to take it between certain days of my cycle but that was all over the place along with horrifically heavy bleeds. I found if I just took it every day I didn't bleed at all, even on the rare occasions I took a week off. I'm having a total hysterectomy soon anyway but in my head my uterus is full of unshed period stuff!

This thread has been fascinating.

I’m pregnant with 3rd baby and the hair on my chin has gone crazy. Heaps and heaps of whiskers. Is this just because of pregnancy hormones and will settle down after birth or given I’m 38 is more likely to be aging?

Thank you, I may ask to be referred again!

Purely bookmarking to read later, this looks like a great thread, thank you OP

MrsB -so sorry to hear about your daughter’s health problems. Any chronic condition, especially one with chronic and severe pain, can affect your whole wellbeing -I am only surprised this does not happen more often, especially as the response is to prescribe painkillers, without acknowledging how this may be affecting a person’s life.
Hopefully she has been commnced on some other attempt at treatment in the meantime (COC, Mirena, Zoladex?), and I wish her well. It may be that counselling will be helpful when she has some kingpd of resolution.

Shutup - Congratulations. yes, really important to do pelvic floor exercises. Most of us are really bad at doing them at all, and if we do, they are usually ineffective. May be worth asking for referral to a bladder physio, where they can all all sorts of gizmos that measure how hard you are squeezing etc.
Don’t forget contraception - needed from 5 days after childbirth if you are sexually active. Sex will also feel different for a while, tissues take time to heal, esp episiotomy, and you may have altered sensation there. Look after yourself, and your mental health too - babies thrive in most cases, and many women forget themselves.

Stimmy - there are all sorts of treatments for this kind of prolapse, which is actually the front wall of the vagina bulging out (and bladder behind it). Several different operations may be applicable, so can’t really comment as I don’t know which you are having - sorry.

Twinkie - I would suggest contacting the unit where you had your tape fitted to enquire what kind it is. Personally, I have not seen any women who have a tape in other than delighted with the results, ie: not weeing yourself constantly!
The RCOG has some info on their website, and as I noted in another post, the jury is out whilst evidence of safety is gathered.

www - I am not a fan of fertility awareness methods, as the failure rate is so high. All these methods rely on:
Having a regular cycle with no deviation in cycle length
Ovulating on the same day each month
The first is not the case for all women, and we can’t know the second without blood tests and scans, which clearly aren’t feasible.

Some women have always used this, by checking temperature, mucus, charting their cycle etc, and very very well motivated to do so, mainly for spacing babies, where pregnancy would jot be a disaster.

The popularity amongst young women currently panders to the “I don’t want to put hormones in my body” message. This is increasingly common, and of course ignorant of the fact that there are huge amounts of hormone whizzing round your body anyway. It implies that hormones are dangerous - yes there are some health risks with contraception (mostly oestrogen-containing methods), but these are remarkably few. Most of the other problems are side-effects, which can be managed, or changed to another method that suits better.

Most of these younger women don’t do anything to be aware of their own fertility, apart from not use any contraception or just withdrawal. I see lots of them, multiple times, in the termination clinic and with STIs, as condom use is not what it should be,
Sorry for the rant - but we are extremely lucky to have access to free contraception, and a degree of pragmatism is needed is finding the best method for you at that time, and sticking with it, in order to avoid multiple unplanned pregnancies.

quince2figs - thanks for taking the time to reply when you have so many questions to get through! Dd has had a mirena coil fitted (about 10 weeks ago) and her bleeding has stopped but the pain and the fatigue and other symptoms have not yet. I know it can take a while for the coil to have its full effect but it is very difficult when we are up against a time line of wanting her well enough to resume her final year at university in October

Mollywobbles - love your name, I am a Weasley fan too.
I would strongly suggest you consider a Mirena IUS after you have had this baby. It gives more contraceptive protection than being sterilised, but is reversible in case you do want more children. Safe when breastfeeding, but if not fitted within 2 days of a baby (unusual), you would need to wait 4 weeks to have fitted. Usually stops periods within 9-12 months, and lasts 5 years.
Many women find that this can ease PMS symptoms (not sure why as no logical basis for this, but can vouch for it myself!), and there is some crossover with PMS and menopausal symptoms.
If you do start to develop perimenopausal symptoms, with the Mirena you would simply need to start some oestrogen-only HRT to relieve these, preferably by patch or gel as lowest risk. Highly recommend this regime, as no need for periods, and extremely low risk of progestogenic side effects (before or after HRT).

Are there any benefits to keeping your cervix when you have a hysterectomy?

MrsB good to hear the bleeding has topped at least. It. It may take another few months to have maximal effect. She could try something to downregulate the cycle in the meantime, eg: continuous COC or even a Depo Provera injection.
Worth thinking holistically, and making sure she is not anaemic or close to it, is taking some supplements, incl but B complex, high dose vitamin D, probiotics, etc, good diet, ruled out glandular fever, thyroid, diabetes, pernicious anemia etc.

Do you perform terminations? If so do you ever worry about your safety from pro-life activists, or are attacks from them not really an issue in the UK as in the US?

notabee - downside of keeping cervix in is you still need smears, potential for malignancy later, and can get slight bleeding.

Mostly removed routinely now - there was a vogue for keeping it as thought to maintain sexual function, but this was never evidence-based. It would reduce the risk of later vaginal vault prolapse (where your vagina sort of turns itself inside out).

Depends really on the reason for the hysterectomy.

@quince2figs really sorry to be a bother please can you answer my question a few pages back.
I dont know how to copy and paste on phone
Thank you x

Thanks so much for this OP.

to those suffering.

Mine is vvv trivial in comparison - I'm 27 and have had acne for 10 years. I thought I might have PCOS as also v hairy, GP didn't want to refer on (having read the thread I understand why). I don't want/need to go on the pill - is there anything I can do for the acne? Or anything I could do privately if I can't get anything with the GP?

Hii op. Hopefully I can get some adviceplease and thank you

Im 32 weeks preg (no.4) I have history of pph due to uterus not contracting.
Most being 2.5l and least beimg

This monkey is transverse and has been for a while. Hes plotting LGA like his brother (10lb at 38 weeks)

Consultant did mention they might try ECV but im relectuant. Hes in this position for a reason, one we cant see (imo please correct me if im wrong) and with him being bigger would it not be harder?

I did ask them whats the safest way to deliver, they said naturally but this cant happen if hes still in this position.

Is a section really that bad for someone likr me? They were saying increased risk of bleedimg etc
I would have thought being in theatre would be helpful to treat me if that did happen.Would they be able to have the oxytocin drip up after the incision to reduce pph?

Im scared if I try naturally his shoulders getting stuck or needimg a cut etc

Also bigger babies-bigger bleeds? Theymightinduce me at 37-38 weeks if hes gone higher than 90th centile (last baby was 10lb at 38 weeks)

Sorry last question
I have anterior placenta which used to be low. Could this moving up be causing him to be 'stuck' in this position. Big baby+ Big placenta in the way etc (my placenta fill those big dish things they put them in! I always get told that they are huge)

No g.d
'Normal fluid' etc

Thank you

Ps i learnt how to c+p lol

Thanks quince2figs!

@quince2figs thank you.
It's for severely heavy periods where flooding is almost a weekly occurrence (I'm bleeding around half the time), causing anemia (not to mention the regular embarrassment and cost of extra clothes). Tried the mirena already.
Also (sorry), I haemorrhaged after having my DC, are you aware if this increases any likelihood of issues during or after?
Thank you for doing this thread, very helpful to many I think.

What can cause mid-cycle bleeding and is it a cause for concern?
I am 41 years old and have had the copper coil for about 20mins. My periods were a bit irregular just after I got it fitted and I usually had some spotting in the couple of days leading up to my period. It's settled down now into a regular period, just a bit longer and heavier than pre-coil.
I am currently mid-cycle - due next period in about 12 days and I have had some spotting today. Not very much but I have never had it before and it's freaked me out a little bit!
Should I be worried?

@LostMyBaubles I think OP is up to about page 10 ish 😊💐

Why do some women have constant bleeding on LARC such as implants?