Benign Gynaecology Services

Our Benign Gynaecology Services provide comprehensive care for a wide range of non-cancerous gynaecological conditions. From heavy periods and fibroids to cervical screening and preventive care, our experienced team is here to diagnose, treat, and support you through your gynaecological health journey.

Our Benign Gynaecology Services Include

• Heavy menstrual bleeding (menorrhagia)
• Adenomyosis
• Uterine fibroids
• Ovarian cysts
• Cervical smears and screening
• HPV vaccination
• Pelvic pain
• Polycystic ovary syndrome (PCOS)
• Menstrual disorders
• Contraception advice
• Menopause management

Heavy Menstrual Bleeding (Menorrhagia)

What Is Heavy Menstrual Bleeding?

Heavy menstrual bleeding is defined as blood loss that interferes with your physical, social, or emotional quality of life. This may include:

• Bleeding that soaks through a pad or tampon every hour for several hours
• Needing to use double protection (pad and tampon)
• Bleeding for more than 7 days
• Passing blood clots larger than a 10p coin
• Needing to change pads during the night
• Symptoms of anaemia (tiredness, shortness of breath, pallor)

Causes

• Hormonal imbalance
• Uterine fibroids
• Adenomyosis
• Polyps
• Bleeding disorders
• Thyroid problems
• Sometimes no cause is found (dysfunctional uterine bleeding)

Diagnosis

• Medical history and symptom assessment
• Blood tests (full blood count, iron levels, thyroid function)
• Pelvic ultrasound
• Hysteroscopy (camera examination of the uterus)
• Endometrial biopsy if indicated

Treatment Options

Medical treatments:

• Tranexamic acid (reduces bleeding)
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Combined oral contraceptive pill
• Progestogen treatments (tablets, injections, implant)
• Mirena coil (IUS) — highly effective, reduces bleeding by up to 90%

Surgical treatments:

• Hysteroscopic polypectomy (removal of polyps)
• Endometrial ablation (destruction of the uterine lining)
• Myomectomy (removal of fibroids)
• Hysterectomy (removal of the uterus — definitive treatment)

Adenomyosis

What Is Adenomyosis?

Adenomyosis occurs when the tissue that normally lines the uterus (endometrium) grows into the muscular wall of the uterus. This causes the uterus to enlarge and can lead to heavy, painful periods.

Symptoms

• Heavy menstrual bleeding
• Severe menstrual cramps
• Chronic pelvic pain
• Pain during intercourse
• Enlarged, tender uterus
• Bloating before periods

Who Is Affected?

• Most common in women aged 40-50
• Women who have had children
• Women who have had uterine surgery (caesarean section, fibroid removal)
• May coexist with endometriosis or fibroids

Diagnosis

• Pelvic examination (enlarged, tender uterus)
• Transvaginal ultrasound
• MRI scan (most accurate for diagnosis)

Treatment

Medical treatments:

• Pain relief (NSAIDs)
• Hormonal treatments (contraceptive pill, progestogens)
• Mirena coil (IUS)
• GnRH agonists (temporary menopause-like state)

Surgical treatments:

• Hysterectomy (definitive treatment)
• Adenomyomectomy (removal of adenomyosis tissue — in selected cases)
• Uterine artery embolisation (in selected cases)

Uterine Fibroids

What Are Fibroids?

Fibroids (also called myomas or leiomyomas) are non-cancerous growths that develop in or around the uterus. They are extremely common, affecting up to 70% of women by age 50.

Types of Fibroids

Symptoms

Many women have no symptoms. When symptoms occur, they may include:

• Heavy or prolonged periods
• Pelvic pain or pressure
• Frequent urination
• Difficulty emptying the bladder
• Constipation
• Backache or leg pain
• Enlarged abdomen
• Fertility problems (depending on location)

Diagnosis

• Pelvic examination
• Transvaginal ultrasound
• MRI scan (for detailed mapping before surgery)
• Hysteroscopy (for submucosal fibroids)

Treatment

Watchful waiting:

• Small, asymptomatic fibroids may not need treatment
• Regular monitoring with ultrasound

Medical treatments:

• Tranexamic acid and NSAIDs for symptom relief
• Hormonal treatments (contraceptive pill, progestogens)
• Mirena coil (IUS)
• GnRH agonists (to shrink fibroids before surgery)
• Ulipristal acetate (in selected cases)

Surgical treatments:

• Hysteroscopic myomectomy (for submucosal fibroids)
• Laparoscopic or open myomectomy (preserves the uterus)
• Hysterectomy (definitive treatment)

Other treatments:

• Uterine artery embolisation (UAE)
• MRI-guided focused ultrasound

Ovarian Cysts

What Are Ovarian Cysts?

Ovarian cysts are fluid-filled sacs that develop on or within the ovaries. Most are harmless and resolve on their own.

Types of Cysts

Functional cysts (most common):

• Follicular cysts — form when the follicle doesn’t release the egg
• Corpus luteum cysts — form after the egg is released

Other types:

• Dermoid cysts (teratomas)
• Endometriomas (chocolate cysts)
• Cystadenomas

Symptoms

Many cysts cause no symptoms. Symptoms may include:

• Pelvic pain or discomfort
• Bloating or swelling
• Pain during intercourse
• Changes in periods
• Difficulty emptying bladder or bowels

When to Seek Urgent Care

• Sudden, severe pelvic pain
• Pain with fever or vomiting
• Dizziness or fainting
• Rapid breathing

These may indicate a ruptured cyst or ovarian torsion (twisting).

Diagnosis

• Pelvic examination
• Ultrasound scan
• Blood tests (including CA-125 if appropriate)
• MRI in selected cases

Treatment

• Watchful waiting — Most functional cysts resolve within 2-3 months
• Pain relief — For symptom management
• Hormonal contraception — May help prevent new cysts
• Surgery — Laparoscopic cystectomy or oophorectomy if needed

Cervical Screening (Smear Tests)

What Is Cervical Screening?

Cervical screening (also called a smear test or Pap test) is a method of detecting abnormal cells on the cervix before they can develop into cervical cancer. It is one of the most effective ways to prevent cervical cancer.

Who Should Have Cervical Screening?

• All women aged 25-65 with a cervix
• Screening intervals depend on local guidelines and previous results
• Women who have had the HPV vaccine should still attend screening

What Happens During a Smear Test?

1. You lie on an examination couch
2. A speculum is gently inserted to visualise the cervix
3. A small brush collects cells from the cervix
4. The sample is sent for laboratory analysis
5. The procedure takes only a few minutes

Understanding Your Results

Normal result:

• No abnormal cells detected
• Routine recall for next screening

Abnormal result:

• Abnormal cells detected — this does not mean cancer
• Further investigation may be recommended (colposcopy)
• Many abnormalities resolve on their own

HPV testing:

• Samples are tested for high-risk HPV
• HPV-positive results require further investigation

Colposcopy

If your smear test shows abnormalities, you may be referred for colposcopy:

• Detailed examination of the cervix using a microscope
• Biopsy may be taken
• Treatment can often be done at the same time (LLETZ procedure)

HPV Vaccination

What Is HPV?

Human papillomavirus (HPV) is a very common virus spread through skin-to-skin contact. Some types of HPV can cause:

• Cervical cancer
• Other genital cancers
• Genital warts
• Throat cancers

HPV Vaccine

The HPV vaccine protects against the types of HPV that cause most cervical cancers and genital warts.

Who should be vaccinated:

• Girls and boys aged 9-14 (most effective before exposure to HPV)
• Catch-up vaccination available for older teenagers and young adults
• Can be given up to age 45 in some cases

Vaccine schedule:

• Two doses, 6-12 months apart (for those under 15)
• Three doses for those 15 and over

Benefits:

• Prevents up to 90% of cervical cancers
• Prevents genital warts
• Protects against other HPV-related cancers

We offer HPV vaccination at our clinic. Contact us for more information.

Pelvic Pain

Causes of Pelvic Pain

Pelvic pain can have many causes, including:

• Endometriosis
• Adenomyosis
• Fibroids
• Ovarian cysts
• Pelvic inflammatory disease (PID)
• Irritable bowel syndrome (IBS)
• Bladder conditions
• Musculoskeletal problems

When to Seek Help

Consult us if you experience:

• Persistent pelvic pain lasting more than 6 months
• Pain affecting daily activities or quality of life
• Pain during intercourse
• Pain with periods that doesn’t respond to painkillers
• Associated symptoms (abnormal bleeding, bowel or bladder problems)

Our Approach

• Detailed history and examination
• Appropriate investigations (ultrasound, blood tests, laparoscopy)
• Multidisciplinary approach when needed
• Individualised treatment plan

Polycystic Ovary Syndrome (PCOS)

What Is PCOS?

PCOS is a common hormonal condition affecting how the ovaries work. It is characterised by:

• Irregular or absent periods
• Excess androgen (male hormones) — causing acne, excess hair growth
• Polycystic ovaries on ultrasound

Symptoms

• Irregular, infrequent, or absent periods
• Difficulty getting pregnant
• Excess facial or body hair (hirsutism)
• Acne
• Weight gain
• Thinning hair or hair loss from the scalp
• Skin darkening (acanthosis nigricans)

Diagnosis

Diagnosis requires two of the following three criteria:

1. Irregular or absent ovulation
2. Clinical or biochemical signs of excess androgens
3. Polycystic ovaries on ultrasound

Treatment

Lifestyle modifications:

• Weight management (even 5-10% weight loss can improve symptoms)
• Regular exercise
• Healthy diet

Medical treatments:

• Combined oral contraceptive pill (regulates periods, improves acne and hirsutism)
• Metformin (improves insulin sensitivity)
• Anti-androgen medications
• Fertility treatments (clomiphene, letrozole, gonadotrophins, IVF)

Menopause Management

What Is Menopause?

Menopause is when periods stop permanently, usually between ages 45-55. Perimenopause is the transition period leading up to menopause when symptoms often begin.

Common Symptoms

• Hot flushes and night sweats
• Sleep disturbance
• Mood changes (anxiety, low mood, irritability)
• Vaginal dryness and discomfort
• Reduced libido
• Joint aches
• Brain fog and memory problems
• Urinary symptoms

Treatment Options

Hormone Replacement Therapy (HRT):

• Most effective treatment for menopausal symptoms
• Available as tablets, patches, gels, or sprays
• Localised oestrogen for vaginal symptoms
• Benefits and risks discussed individually

Non-hormonal options:

• Vaginal moisturisers and lubricants
• Certain antidepressants (for hot flushes)
• Cognitive behavioural therapy (CBT)
• Lifestyle modifications

We provide personalised menopause consultations to discuss your symptoms and treatment options.

Contraception

We offer advice and provision of all contraceptive methods:

• Combined oral contraceptive pill
• Progestogen-only pill
• Contraceptive patch and ring
• Contraceptive injection
• Contraceptive implant
• Intrauterine device (IUD/copper coil)
• Intrauterine system (IUS/Mirena)
• Emergency contraception

We can help you choose the best method based on your health, lifestyle, and preferences.

Book a Consultation

If you’re experiencing any gynaecological symptoms or need routine screening, our team is here to help. Contact us at info@salamivf.com or call +973 1725 5095 to schedule an appointment.