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!

Thanks so much for answering this. I have always wanted to know if it was a myth or not.
How interesting that you say it’s safer for the baby to have a planned c/s. I thought that the nhs Pushed vaginal deliveries in many cases saying things like baby more likely to struggle to breathe after elective c/s as vaginal birth helps prepare airways etc. And babies less likely to have allergies/be overweight in later life after c/s conpared to babies birthed vaginally.
If you were to be honest, you think there’s slighlty skewed/misleading information provided by the nhs to try and push women into the cheaper option of vaginal birth?

Also what is it that makes vaginal birth more risky than a planned c/s for baby? Is it incase baby gets stuck/shoulder dystocia/distressed?

MeganChips - with greatest of respect, that is total rubbish.
So sorry you have been misadvised. A Mirena can help with heavy painful periods superbly when they are due to no known cause.
Endometriosis and sometimes adenomyosis can be helped if your periods stop with one. Mirena will not shrink fibroids or help bleeding related to them, and in fact should NOT be used when fibroids are large (>3cm), multiple, or impacting on the uterine cavity.

Options would be medication to shrink fibroids (but this has temporarily been withdrawn), surgical fibroid or uterine lining removal, or last resort hysterectomy. Most of these impact on fertility, though, so depends if your family complete.
You need a second opinion!

after an EMCS, how do you know that all is well inside? I had one 7 months ago and I have never been seen for a follow up and I ache after walking-is it just a slow process? Hard to know whats right or wrong!

Deux - I no longer do hysterectomies, but not really a strong indication for this major op.....I would suggest have a Mirena IUS fitted, which thins the uterine lining over a few months, resulting in no periods for majority of women. You can then use oestrogen-only HRT and have no bleeds.

Hi. My question is - why do you think endometriosis is so often misdiagnosed at a GP level?

You could certainly argue a case for hysterectomy if, say, difficult to fit an IUS or it was expelled (rare), or you declined this option...

Perfect timing. My sis has been told
She has bicornuate uterus after her third second trimester miscarriage.
Docs here in Ireland are saying they don't do the op to remove the septum.. why would that be when it's appears to be routinely done elsewhere?

Have you really 'seen it all'? This line is used to reassure us but doesn't feel so reassuring

How many birth related injuries do you see? Do you think pregnant women are given enough information about the risk of injury and what is/isn't normal after birth?

This might sound a bit silly but is getting repeated bouts of thrush a gynae issue (currently on bout 4 of this year I think) or is it another issue?

are there any alternatives to the transvaginal mesh implants used for stress incontinence?

There is no getting away from the simple fact that vaginal delivery is significantly more risky for the baby than a planned C/S

We've all been lied to, then! Why don't you tell pregnant women this in real life?

I take bit b6 and magnesium for terrible pms.
Is this a waste of time? I think it has improved things for me but of course it could be placebo. Any other suggestions that means I don’t have to take time off work?!?

LeeMiller - don’t forget those who work on labour ward can have a different view on risks of delivery. I spent both of my pregnancies very worried (and I was quite low risk) as you will see women with pregnancy losses and still births every single shift.
I would say keeping weight down pre and during pregnancy important for many things. Perineal massage - very little evidence is useful. Pelvic floor exercises - yes, do them, but many women still have some pelvic floor tone loss and bladder function affected after a baby. Some is just luck of the draw and what type of connective tissue you were born with.
Risk of perineal trauma/episiotomy depends on so many other factors.
The hardest thing most women and their partners find to accept, is that ultimately we have very little control over childbirth - we just manage it as best we can. We seem to have lost the trust that, in most cases, women’s bodies will manage it well and there will be a good outcome for mum and baby.

Thank you quince! I have another appointment tomorrow so I won’t let them fob me off this time. Largest fibroid in the cavity is 6x5cm but there are plenty of others too.

Is it normal to have excruciating pain during my period? 32, had two children, periods don't last as long as they used to but are terrifyingly painful: cramps so painful I sometimes think I will have to call an ambulance, codeine doesn't touch it. And my bowel movements during my period cause pain akin to active labour. I am crying out and having to breathe through them.

I am fairly good with pain. So this is another level. Feels like a poker is up my bum. Also can't sit down flat on my bum during my period as it's so painful, have to sit leaning to one side.

Mefanemic (sp?) acid have me terrible side effects so not an option. I tend to use ibuprofen and paracetamol through the first 3 days of a period.

Does this sound normal?

I have anti-c (small c) antibodies in my blood, discovered during my second pregnancy and had lots of blood tests but my level never rose above 0.3 and DS was absolutely fine. However, I worried all through the pregnancy about it. In your experience is this likely to worsen in a subsequent pregnancy?

I've nc for this!
But can i ask if I need to push further or go private?

I have pcos, I've been having periods every two weeks for the last 2/3 years apart from when I was pregnant with ds who is now 6months old. And it's started again.
Gp keeps saying it's because of my pcos gave me the pill which I haven't took yet (dp had the snip so really don't want to have to take it unless necessary. She's told me to take it for 3 months then if it's no better to have the mirena coil. Dp has the snip so I didn't have to continue with taking any contraception.
I also had a colposcopy 3/4 months ago and results come back as CIN1 and the letter said to see gp for unusual bleeding/or after sex. Gp has ignored this and just blames pcos (which it could well be!) but is there anything else I am do apart from taking/having contraception? I'm utterly exhausted from the constant periods. Thankyou in advance!

I have had lots of problems post childbirth 5 years ago. Eventually had laparoscopy 2 years ago which showed one spot of probable (?) endo, plus mild adhesions. Consultant gynae was quite dismissive. Since laparoscopy pains have returned to include mid cycle pain, sciatica plus severe menstrual pains. Basically some type of pain for most of cycle. GP thinks it sounds like endo has either returned or wasn't properly noticed and removed during laparoscopy but I'm reluctant to see same consultant again, who mainly specialises in obstetrics. Any advice?

I wouldn't usually use up someone's time on my own diagnosis but....please can you help?

I have had a strong and unpleasant vaginal odour for a few months. This has now also become accompanied by a strange pressure/burning feeling inside my pelvis.

No other symptoms - no itching, regular periods, no colour to discharge.

I had a previous similar smell and it was BV but I have tested negative for BV, I took antibiotics for it anyway but no change.

I have now had two separate STI tests and both have come back negative.

GP referred me to consultant. Since I have no other symptoms and STI test is negative she's just said it's normal?

I'm finding it hard to believe that such a strong odour (very different to usual) and pelvic pressure/burning is 'normal'.

Help! Any ideas?

Thank you for this thread. I had a copper coil inserted after my last son was born (a few months after) and it fell out. I went back and the doctor said I had very little resistance and inserted another one that is attached to me somehow.
Fast forward 3 years and I have started HRT. I started with Elleste but hated the progesterone part. So now i use estrogel and take progesterone tablets. Which is fine but a faff to remember which day of the cycle it is and I also bleed for about half the month.
Would a Mirena coil be a good idea? I like the idea of not having to remember the tablets. But I'm worried it might fall out. Also that I might not get on with the progesterone part and will have to have it taken out and start all over again....
I've asked my GP and he didn't know
Thank you

I just had a pipelle biopsy - bugger did it hurt

I was told it's like mild period pains by the gynae - I said bloody hell if my periods felt like that I'd kill myself - seriously it was as bad as when my tube burst with an ectopic pregnancy

Why do women perpetuate the myth that women are making a big fuss about nothing?

I had a fibroid for a good five years, last time it was checked it was the size of a tennis ball. It doesn't seem to cause any problems, should I be bothered?

Similar question to kaytee87 . No orgasms from PIV ( although plenty in my sleep...) since my first pregnancy nearly 6 years ago ( 2x emsc since then). What could have gone astray? Not that I'm tempted to try these days, the thought of another emergency slash and grab completely puts me off sex.

Really interesting thread!