A colposcopy is a detailed examination of the cervix (entrance to the uterus) with a specially lit microscope (colposcope). An instrument called a speculum is inserted into the vagina, and then the colposcope is used to view the cervix under magnification. Solutions are used to show up any changes that may represent abnormal cells. A specialist will perform a colposcopy if your cervical smear has shown abnormal or cancerous cells on the cervix. During the colposcopy further samples of tissue (biopsies) are usually removed and examined in the laboratory so the doctor can get a clearer idea of the extent of the abnormal cells.

Lletz (Large Loop Excision of the Transformation Zone) A thin wire loop that has an electrical current running through it is used to scrape abnormal cells from the cervix. Cone Biopsy of the Cervix A cone of tissue is surgically removed from the cervix for examination in the laboratory.

A long, thin tube with a tiny camera attached (cytoscope) is inserted into the urinary opening and through your urethra (the tube that carries urine from your bladder to the outside of your body) to your bladder. This allows the doctor to view any abnormalities in your lower urinary tract and, if necessary, take a small tissue sample to look at under the microscope (biopsy).

The endometrium is the lining of your uterus (womb). Endometrial ablation is the surgical removal or destruction of this lining. There are different methods of destroying the endometrium including electricity, laser therapy or freezing. A specialist performs the operation and it is done through the vagina, so there is no need for the abdomen to be cut open. The endometrium will heal leaving scarring, which usually reduces or stops menstrual periods. In women who have very heavy periods (menorrhagia), an endometrial ablation can be done instead of a hysterectomy as it is an easier procedure than a hysterectomy and is quicker to recover from. Endometrial ablation is only performed in women who no longer wish to have children.

The endometrium is the name of the tissue that lines your uterus (womb). Endometriosis is a condition where tissue, similar to the endometrium, grows in other parts of the body. Usually these growths occur in places such as the ovaries, bowel, or the lining of the pelvis called the peritoneum. Each month, as the endometrial lining of the uterus builds up with blood that will be lost during your period, these other growths of endometrial-like tissue can cause inflammation and adhesions (internal scaring). Some women with this condition do not have many symptoms, whereas others suffer with bleeding issues, pain and problems such as infertility as well as tiredness and bowel symptoms. Treatment includes medication that will help control the pain and inflammation, and some women may need surgery to remove the tissue growths. Endometriosis surgical treatment Laparoscopic: an incision (cut) is made in your navel (tummy button) and a thin tube with a small camera attached (laparoscope) is inserted, allowing the surgeon a view of the internal organs. If endometriosis is being treated, small instruments are introduced through several other small cuts in the lower abdomen and endometriosis and scarring is destroyed or excised (removed). Abdominal (laparotomy): if endometriosis is very widespread, an incision is made in the abdomen, opening up the abdominal cavity so that the endometriosis tissue can be removed.

Fibroids are noncancerous growths or tumours on the muscular part of the uterus (womb); sometimes they are also called myomas. Fibroids may be very small (about 5mm) or can grow to be quite large (over 100mm). Many women with fibroids do not notice any symptoms and will not need treatment, whereas others may experience problems such as painful and heavy periods. Treatment includes medication to manage bleeding or, shrink the fibroids and, in some women, surgical removal.

A hysterectomy is an operation to remove your uterus (womb). Sometimes it is combined with the removal of other organs as well (such as cervix, tubes, ovaries), and this will depend on the reason for the operation. A hysterectomy is a treatment for many different conditions and it can be done through the vagina, via key-hole (laparoscopically) or through a larger cut (incision) in the tummy (laparotomy).

A long, thin tube with a tiny camera attached (hysteroscope) is placed into the vagina and moved through the cervix into the uterus. This allows the surgeon to see inside the uterus and may, in some cases, show the reason for bleeding, infertility or pelvic pain. A hysteroscope may also be used to take a biopsy (small sample of tissue) or to remove polyps or fibroids and these are sent for examination in the laboratory.

This is an operation where a hysteroscope (small lighted mini telescope) is inserted into the uterus through the vagina and cervix so the specialist can see the inside of the uterus. If no cancer or abnormality is seen, a small spoon-like instrument with a long handle, called a curette, is inserted and the lining of the uterus is scraped off and sent to the laboratory for examination. This procedure can be done under a general (you are asleep) or local (you are awake but the area being investigated is numb) anaesthetic.

Menopausal hormone therapy (MHT) is when hormones (oestrogen, progesterone and sometimes testosterone) are given to a woman during or after menopause when the production by the ovaries declines or after medical treatment that causes early menopause (such as removal of ovaries). MHT can provide relief for women from symptoms caused by having less hormones in their bodies, such as hot flushes night sweats, mood swings, sleeping problems, memory problems, depression, vaginal dryness and loss of bone density. Different types of MHT have different risks and they’re not the same for everyone. The risks and benefits of MHT should be thoroughly discussed with a doctor before treatment begins.

Menopause is also called the “change of life” and is the time after when your periods have stopped. This is a natural process in all women and for most it will occur between the ages of 45 and 55 years. Perimenopause is the time before this and periods can be irregular and symptoms can emerge due to fluctuating hormone levels. Menopause is brought on by decreasing levels of the hormone oestrogen and this can cause a variety of symptoms, including hot flushes, night sweats, mood swings, sleeping problems, memory problems, depression and vaginal dryness. Some women do not notice any symptoms or they are very mild, whereas others experience more severe problems and should go to their doctor for advice. There are many treatments available to reduce the symptoms associated with menopause and lifestyle changes can also help.

Menstruation is the medical name for your monthly period. This is when blood and tissue from the lining of the uterus (womb) is shed through the vagina and out of the body. Menstruation starts at puberty and it is stimulated by hormones that make a girl’s body able to become pregnant. This usually happens anytime between the ages of 9 and 16 years. Menstruation will recur about once a month (the menstrual cycle), unless interrupted by pregnancy, and will stop at menopause, which occurs between 45 and 55 years of age. There are a number of problems that can occur with menstruation ranging from mild to severe. More than half of all women will have cramps (dysmenorrhoea) during the first day or two of their period. Other problems include very heavy or long periods (menorrhagia) or no periods (amenorrhoea).

Hysteroscopic: a long, thin tube with a small camera attached (hysteroscope) is placed into the vagina and moved through cervix into the uterus. This allows the surgeon to see inside the uterus and remove the fibroids with instruments or a special device that pass down the hysteroscope. Laparoscopic: an incision (cut) is made in your navel (tummy button) and several small cuts in the abdomen (tummy). A thin telescopic instrument (laparoscope) and several small instruments are inserted allowing the surgeon to view the uterus and fibroids. Fibroids can then be removed by cutting into the uterus and shelling them out. The fibroids are removed through the ports or by extending a cut to make a larger incision in the tummy, or possibly in the vagina, to pass them through. For very large fibroids, myomectomy may need an incision to be made in your abdomen (laparotomy) to access the fibroids to be cut out of the uterus.

An oophorectomy is an operation to remove one or both ovaries. It is done for many reasons including ovarian cancer, ovarian cysts and as a risk reducing procedure for hormone driven cancers (such as when a BRCA gene mutation has been identified). If both ovaries are removed, you will undergo surgical menopause - your periods will stop and you will not be able to have children without fertility treatment. Sometimes an oophorectomy is done together with a hysterectomy.

This is most often performed laparoscopically (key-hole) where several small incisions (cuts) are made in your abdomen (tummy) and a thin tube with a small camera attached (laparoscope) is inserted, allowing the surgeon a view of your ovaries. Small instruments are inserted through the cuts to remove the cysts.

An ovarian cyst is a fluid-filled sac or pouch in the ovary. In most cases, the cyst grows as a result of ovulation (when the egg is released from the ovary), and it will usually shrink over time. Sometimes, the ovarian cyst may cause pain. The best way to check for an ovarian cyst is by ultrasound examination, and the treatment will depend on how troublesome the symptoms are. Sometimes it is best to leave the cyst alone and check it regularly with ultrasound. In other cases it may need to be removed by surgery, usually laparoscopically (key-hole).

Polycystic ovary syndrome (PCOS) is a complex disorder involving endocrine (hormonal), reproductive (fertility), cardiovascular, metabolic, dermatologic (skin) and psychological features. It can cause you to have a variety of symptoms, commonly including no periods or irregular periods, increased hair growth on the face and body (hirsuitism), acne, anxiety and depression and increased bodyweight. PCOS is also one of the main causes of infertility in women. The ovaries of women with PCOS often contain many small cysts (fluid-filled sacs), but not always and this is not the cause of the condition. For women who have not reached menopause, the most common treatment is is with a hormonal contraceptive pill, which will regulate your periods. There are also other medicines that can help control the symptoms. PCOS is considered a lifelong condition and can impact on health risks such as for heart disease, diabetes and endometrial abnormalities. Regular reviews are recommended throught out different stages of life.

Up to 75% of women experience feelings of tension, anger, fatigue and depression just before and during the first days of their menstrual period. This is called premenstrual syndrome (PMS) and is probably caused by the change in hormone levels. In most women with PMS, symptoms will not be severe enough to require treatment, but some will need to discuss their symptoms with a doctor. Severe symptoms afect up to 8% of women and is known as Premenstrual Dysphoric Disorder (PMDD) and this can have a big impact on quality of life. Management and treatment options include lifestyle measures, supplements, psychological therapy and medications, and hormonal medications.

This is most often performed laparoscopically (key-hole) where several small incisions (cuts) are made in your abdomen (tummy) and a thin tube with a small camera attached (laparoscope) is inserted, allowing the surgeon a view of your pelvic organs. Small instruments are inserted through the cuts to remove part of or the full length of your tubes. Abdominal (laparotomy): an incision is made in your abdomen and part or all of the fallopian tube is removed.

A person with urinary incontinence is unable to control the release of urine from their bladder. This may be an occasional leakage or a complete inability to hold on to their urine. Women experience incontinence more often than men, and this may result from muscle damage during pregnancy and childbirth or the changes associated with menopause. The most common type of urinary incontinence in women is stress incontinence. This is when urine leaks out when movements, such as coughing, laughing or sneezing put pressure on the bladder. The treatment of urinary incontinence will depend on the cause of the problem, but may include exercises, medication, vaginal pessaries or surgery.

Prolapse is caused when the supporting muscles and fascia become weak, allowing a part of the uterus, bladder or rectum to bulge into the vagina. The most common reason that these muscles become weak is childbirth. Symptoms include pain, heaviness or a bulge in the vaginal area, a frequent need to pass urine and difficulty emptying bowels. Conservative measures such as pelvic physiotherapy and exercises and vaginal pessaries can help improve the symptoms, but women with more severe prolapse may need to have surgery.

The most common vaginal infections are yeast infections (also called candidiasis or thrush), trichomoniasis, or bacterial infections (also called bacterial vaginosis). Symptoms of an infection may include irritation, itching, discharge and odour. To make a diagnosis a doctor will usually do a vaginal swab, which involves wiping a type of cotton bud gently across the infected area. The swab is then sent to the laboratory for analysis. There are many medicines that can successfully treat these infections.

A sample of tissue (biopsy) is surgically removed from a lesion (area of damaged tissue) on your vulva. If the lesion is cut out completely, the procedure is called an excision.

Persistent or chronic pelvic pain and vulval pain (vulvodynia) have significant effects on daily life for many women. We'll work with you to get find out what is going on and find a collaborative treatment plan that aims to bring relief. Pelvic physiotherapy plays a key role along with psychosocial strategies, and sometimes surgery, to improve symptoms and quality of life.

We offer friendly, confidential advice on contraception and sexual health — including IUDs, implants, and STI testing.

If you're experiencing discomfort, itching, or changes in your vulval or vaginal area, we provide gentle, expert care to find out what’s going on and how best to treat it. Some of the more common conditions are genitourinary syndrome of menopause (also known as atrophy), contact dermatitis, lichen sclerosus, VIN (a precancerous change), and recurrent infections such as candida and BV.