Not sure if your symptoms are ‘normal’? Ask the London Gynaecology specialists - £200 voucher to be won!

[CeriMumsnet]

Whether it’s telling yourself that heavy periods are “just one of those things”, dealing with pelvic pain that you’ve learnt to push through or experiencing symptoms that don’t quite feel right, for so many women, gynaecological health comes with unanswered questions. And too often, those questions are minimised, delayed or quietly worried about alone.

That’s why three specialist consultants from London Gynaecology are here to help.

From contraception and fertility, to fibroids, endometriosis, PCOS, painful periods and early pregnancy concerns, London Gynaecology experts Mez, Ora and Baljinder will be answering your questions openly and honestly, offering clarity, reassurance and practical next steps.

Share your question by 4 March for expert gynaecologist advice and a chance to win a £200 voucher (T&Cs). The London Gynaecology specialists will be online in from the end of Feb to answer your questions.

About the Experts
Mehrnoosh Aref-Adib (Mez), MRCOG
Consultant Obstetrician and Gynaecologist
Mez supports women with both common and complex gynaecological concerns, from fibroids, endometriosis and PCOS to ovarian cysts, heavy or painful periods, early pregnancy concerns and abnormal smear results. With particular expertise in ultrasound scanning, colposcopy and minimally invasive (keyhole) surgery, she focuses on using the least invasive approach appropriate, helping women feel informed and in control of their treatment decisions. Recently referenced on the Blended podcast hosted by Kate Ferdinand, Mez is known for her calm, clear and reassuring approach.

Ora Jesner, MBBS FRCOG
Consultant Obstetrician and Gynaecologist
Ora specialises in urgent and early pregnancy gynaecological care. Women often see her for early pregnancy pain or bleeding, concerns about miscarriage or ectopic pregnancy, as well as fibroids, endometriosis, adenomyosis and vulval symptoms. She leads the Emergency Gynaecology Unit at Whipps Cross Hospital and offers outpatient hysteroscopy, minimally invasive surgery and contraception procedures, including coil insertion and removal. As a mother of four, Ora understands first-hand the emotional and practical realities of navigating health concerns while caring for a family.

Baljinder Kaur Chohan (Bajinder), MBBS BSc BA MRCOG DFSRH
Consultant Obstetrician and Gynaecologist
Baljinder supports women with a wide range of gynaecological and early pregnancy concerns, including menstrual problems, pelvic pain, PCOS, fibroids, contraception advice and early pregnancy assessment with ultrasound. With over eight years’ experience as a consultant at Royal Berkshire Hospital, where she also holds a joint Clinical Lead role, Baljinder combines clinical expertise with deep empathy. As a mother of two, she appreciates the challenge of managing your own health while juggling work, children and everything else life throws at you.

Thank you, I will try the period knickers - do you recommend any particular brand please ?

Hi, I have endometrosis, adenomyosis, fibroids (some of which can't be removed due to position), two blocked tubs (failed hysterscopy), one badly damaged ovary and a small, concave uterus. I also have a very high AMH level (but don't have PCOS).

Anyway, my question is have you any predictions on what my menopause will be like? I'm early 40s and everyone my age seems to be menopausal or peri.

I still have heavy, monthly periods and ovulate monthly but zero signs of menopause.

Not sure it's relevant but I had a chemical menopause in the past and other than the hot flushes, it wasn't too bad.

Can any of this predicate what kind of menopause I'll have?

In a case you can't tell, I really would love an easy, zero impact menopause 😀

I have pcos with weight gain, hair loss, hair gain infertility, no periods and everything else that comes along. I went to see a gynecologist who prescribed a 40+ obese woman the pill and other hormone. I got a pulmonary embolism in both lungs 3 weeks later. Now been told there is nothing they can do for me- is this true?

What could be the cause of reoccurring UTIs? And what is the best way to prevent them?
Thank you.

Im 45 and my period lasts most of the month now. My GP didn’t seem interested but the pain, bleeding for weeks at a time then it’s a few days off and more bleeding, is not conducive to much fun. Most of the time I just want to hide with pain killers and a hot water bottle

What should I do?

i had a biopsy and it was confirmed that i have lichen sclerosis on the entrance to my vagina.

for ten years it’s been painful to have sex. i have split up with three partners during this time due to this.

i’ve been told there isn’t anything anyone can do. if it’s removed it will come back. putting a stitch in to protect the fragile skin from ripping isn’t the done thing.

i’ve been written off as though my sex life is worth nothing. nobody cares.

is there really nothing to be done andi just need to accept i will effectively never have a partner again?

thanks for reading.

I'm 44 and have two kids and two questions:

I have a big prolapse (rectocele) with less major prolapse of bladder and womb. I've had it looked at and it's really not bothering me. The only downside is side is I can't use tampons as the bulge won't let one in. Everything works. Sex is fine. I had it looked at and no surgery was recommended. I have seen a physio. All ok. I want to know if this will last or whether it inevitably will lead to issues? If so should I get it fixed before it's an issue?
i have little scraggly bits on my vukva where my episiotomy and stitches were. I'm worried they ar some sort of growth. I had another on on my labia that fell off. Described it to doctor and he think it was a skin tag. Are they normal?

In he past couple of years I’ve started to have an issue with pain when I’m aroused.

its right at the entrance of my vagina and feels almost like a shard of glass. It starts as soon as a feeling of arousal starts and just gets worse and worse. The only things that helps is if I squeeze the muscles of my vagina and squeeze my legs together, this helps the pain ease slowly but I have to continue to do that until the pain is gone, and that’s it, I’m fine. If I don’t squeeze until it’s gone completely, it comes back just the same.

Its starting to make me dread sex because I know it’s going to be a very painful barrier to get past.

What does it mean when you get ovulation and period pain that only ever happens on the same side? For at least the last year, probably longer I have noticed that all my menstrual related pain such as ovulation and period cramps happens on the right side/ovary. I have also noticed that I’m getting a dull ache/pressure feeling in that area when not ovulating or menstruating. My menstrual cycle has also become less regular, often as short as 18 days but sometimes as long as 30-50 days. I’m 35, is this concerning?

I am 47 and for the last 6 years I am spotting with blood for 5 - 7 days before my period. No pain just blood. At first i put it down to the covid jab as people at the time had said it can mess up your cycle for a bit but clearly it is not true. My periods are every 4 weeks, just as heavy and just as painful but with this spotting. Dr is not interested. It is just frustrating bleeding for that long. Sometimes it might be more blood and i think my period has actually started but then there is no blood for 5 days until my period really starts. It is not consistent the amount of pre period bleeding.

Reason for very bad period pain with bowel involvement, but only every 3 cycles?

Would MRI be helpful for diagnosis and what are potential non invasive and non hormonal treatments, beyond non steroidals and paracetamol?

I’m 45 and on HRT for past year. I’m having constant hip and lower back pain which radiates down right leg. Paid for own mri of pelvis last year nothing untoward found. Physio slightly helped but has come back worse. I’m awake now as I can’t sleep again and I can’t find any comfortable position. My husband has naproxen but they don’t do anything for my hip pain. I’ve read about benefits of collagen could this be of any benefit. Even just walking is causing pain . I’m doing stretches and some Pilates.

Can an ovarian cyst disappear without any pain or discomfort? I had an ultrasound about 6 months ago where they found a 2cm cyst. This week have returned for another scan and they couldn’t find it.
I’ve had no pain in the meantime.

Re above post - should have said I am 56 and post menopausal. The cyst was found because I had post menopausal bleeding.

I'm 48 and in peri. I'm on HRT and the mini pill. If I stop taking the pill I bleed all of the time. I have no bleeding whilst on it. I've had several scans and the results said my womb lining was above threshold and referred me to gyny. On the old measurements I'd be ok but the new ones I wasn't. I kept getting messages via NHS app saying we're really busy are you sure you need this appointment so I cancelled it. I get sharp pains now quite low down. Should I been concerned or is this all part of menopause? My HRT isn't really helping either, should I just stop it? I've tried all sorts. Thanks

Is it possible to get pregnant when you have a coil fitted? Can the coil fail?

It is absolutely possible to have PCOS even if you are slim. While weight gain or difficulty losing weight is common, it is not a requirement for the diagnosis. PCOS is primarily a hormonal and metabolic condition, and some women have normal insulin sensitivity (meaning their body responds to insulin normally) and therefore maintain a normal weight.

We diagnose PCOS using the Rotterdam criteria, which require any two of the following: irregular periods; clinical signs or blood test evidence of raised androgen levels (male hormones, which women also naturally produce); or polycystic ovaries seen on ultrasound.

Around 10% of women have PCOS, and many experience very few problems. Others may notice irregular periods, skin changes such as acne or excess hair growth, or difficulties conceiving. What matters most is identifying whether it is causing any symptoms for you and addressing those specifically.

If you are worried, I would encourage you to speak with your doctor. They can arrange some straightforward blood tests and an ultrasound to clarify things and, if needed, guide you on the next steps.

Thank you for your questions — although I’m not entirely sure which specific symptoms you’re referring to.

Most girls begin to show early hormonal changes between about six and twelve years of age, but each stage starts in its own time. Adrenarche is the early “warm-up” phase and usually begins around six to eight years. This can lead to mild body odour, a small amount of underarm or pubic hair, or subtle skin changes. It’s important to note that this is not considered true puberty.

True puberty typically starts between eight and thirteen years, beginning with breast development. The first period usually follows around two to three years later.

Puberty progresses through five Tanner stages. Stage 1 is when there are no visible changes. Stage 2 marks the appearance of breast buds and the beginning of pubic hair. In Stage 3, girls may experience a growth spurt, increased hair growth, and sometimes acne. Stage 4 is when the first period often begins and the body continues to mature. Stage 5 represents full adult development.

Some children move through these stages earlier or later than others and are still entirely normal. What matters most is that development follows a steady, progressive pattern. However, if noticeable changes begin before the age of six or seven, it would be sensible to seek a medical review.

It’s very normal for women to have completely different experiences around ovulation, as it depends on how sensitive their nerve pathways are and how their bodies respond to the hormonal changes that occur when an egg is released.

When the ovary releases an egg, the follicle stretches and then ruptures. A small amount of fluid or blood can be released into the pelvis, which may irritate the surrounding tissue. In some women, this also triggers the release of inflammatory mediators, which heighten pain signals and make the sensation feel sharper or more intense. Others release these mediators in much smaller amounts, or simply have less reactive nerve endings, so they barely notice anything at all.

Certain conditions, such as endometriosis, can amplify this further. In endometriosis, tissue similar to the lining of the womb sits outside the uterus and becomes inflamed, which can make both ovulation and periods significantly more painful.

Much of the difference between individuals comes down to these factors. However, if the pain is severe, persistent, or worsening over time, it would be sensible to have it assessed.

At 47, shorter and more frequent cycles are very typical of perimenopause. During this time, fluctuating hormone levels can cause periods to come closer together before they eventually become more irregular and stop altogether — often over the course of a few years.

Period-delaying medication such as norethisterone is generally safe for many women your age, provided there are no medical reasons why it wouldn’t be suitable. It can be particularly helpful for holidays or important events.

Another option well worth considering is the Mirena coil. It works by keeping the lining of the womb thin, and many women find their periods become much lighter; a significant number stop bleeding altogether, which can be a huge relief during perimenopause. It also provides reliable contraception and can be especially useful later if you need hormone replacement therapy, as it supplies the progesterone component for you.

I have one myself and genuinely wouldn’t be without it. Your GP can review your medical history and help you decide which option suits you best. We also fit coils at London Gynaecology — one patient once called me the “coil whisperer” 🤣.

At 57, any ongoing bleeding does need proper assessment, even if you are on HRT. While women reach menopause at different ages and hormone therapy can sometimes trigger or prolong bleeding, we still need to be certain that everything inside the uterus is healthy.

The first step is usually a pelvic ultrasound to assess the lining of the womb and the ovaries. Depending on how the lining looks, a hysteroscopy may be recommended. This is a straightforward procedure in which a thin camera is passed through the cervix to look directly inside the womb, and a small sample can be taken if needed. It allows us to rule out polyps, a thickened lining, or other causes of persistent bleeding.

If the lining appears normal and there is no concerning cause, adjusting your HRT — or switching to a different type — may help, as different doses and combinations suit different women. Another option, if you do not already have one, is a Mirena coil. This keeps the lining very thin and often significantly reduces or even stops bleeding, including in women using HRT.

If bleeding continues despite appropriate investigations and medical management, some women understandably reach a point where they feel completely fed up. In selected cases, a hysterectomy can be considered. It is major surgery and not a first-line option, but for women who have had years of ongoing bleeding and have exhausted other treatments, it can be life-changing.

In your situation, the key message is not to ignore this. Please arrange to see your GP or a gynaecologist for an updated scan so that the next steps can be guided appropriately. Persistent bleeding at 57 is not always serious — and in your case may well be related to HRT — but it does need to be properly checked.

It is also worth noting that some women do go through menopause later than others, but bleeding at this stage should always be evaluated rather than assumed to be hormonal.

The age at which women reach menopause varies quite widely. For most, it reflects a combination of genetics, overall ovarian reserve, and certain health or lifestyle factors rather than being purely random.

One of the strongest influences is family history. If a woman’s mother or sisters experienced menopause early, she is more likely to do the same. This is because we tend to inherit both the number of eggs we are born with and the rate at which we use them over time.

There are also medical factors that can lead to earlier menopause, including autoimmune conditions, thyroid or adrenal disorders, smoking, previous chemotherapy or radiotherapy, or surgery involving the ovaries.

However, in many women no specific cause is identified beyond their natural biology. Reaching menopause at different ages is often simply part of the normal variation in how ovarian function gradually declines over time.

I love this question!

One piece of advice I often give as a gynaecologist and something many women don’t realise can be genuinely helpful — is to consider having a pelvic ultrasound every 18 months to two years, even if everything feels completely normal.

Women’s health is often overlooked, and many gynaecological conditions develop quietly without obvious symptoms in the early stages. A good example is fibroids, which are non-cancerous growths within the muscle of the womb. Up to 80% of women will develop fibroids at some point, yet many are unaware of them because they can grow slowly and silently.

For some women, however, fibroids can cause heavy bleeding, pelvic or back pain, leg discomfort, pressure on the bladder or bowel, bloating, or even fertility difficulties. Many spend years assuming these symptoms are simply “normal” or something they have to put up with.

A straightforward scan can detect issues early, provide reassurance, and allow treatment to begin long before symptoms become disruptive. Regular checks are a small step, but they can make a significant difference to long-term gynaecological health.

At 45, longer or more irregular bleeding can be part of perimenopause due to fluctuating hormone levels. However, continuous bleeding for several months should not be ignored.

If bleeding lasts more than two weeks, is very heavy or frequent, or is associated with pain, it’s important to have it checked. A pelvic ultrasound is a sensible first step to assess the lining of the womb and ovaries, and to look for causes such as polyps or fibroids.

Most causes are straightforward to manage, with options including a coil, hormonal tablets, or non-hormonal treatments. If needed, a hysteroscopy can be performed to look directly inside the womb.

Perimenopause can certainly affect bleeding patterns, but persistent bleeding always deserves proper assessment. We have a Menopause GP, Claire Phipps, that is a source of all menopause related queries, tests and medication plans if you need futher assistance.

At 41, changes like this can absolutely be part of early perimenopause. When hormone levels start to fluctuate, spotting becomes quite common. Light pink spotting for a few days after a period is often due to lower progesterone levels or slightly irregular ovulation.

That said, because this is a new pattern and it’s been happening for several cycles, it’s worth getting it checked. Sometimes there’s a very simple explanation, such as a polyp — a benign (non-cancerous) little growth inside the womb or on the cervix. Polyps can cause light bleeding after a period, between periods, or after sex, and they’re usually quick and straightforward to treat if needed.

Other possibilities include hormonal shifts, temporary changes in the womb lining, or occasionally an infection. A pelvic exam and an ultrasound will usually clarify things. It’s also important to make sure your smear test is up to date, just so nothing obvious is being missed.

So yes, this could well be perimenopause — but because there are common and very fixable causes too, it’s sensible to have a check and a scan. For the reassurance. you can book in a scan with our team and a consultation with a gynaecologist to discuss your concerns.