You may have read in the press that The Royal College of Obstetricians and Gynaecologists (RCOG) and British Society for Gynaecological Endoscopy (BSGE) recently published national guidance on the management of endometrial hyperplasia. This is a condition where there is an overgrowth of the cells that line the womb that causes the womb to thicken. This often leads to vaginal bleeding that can be described as ‘abnormal’ because it is heavy and perhaps heavier than normal during menstruation. The bleeding associated with this condition can also occur between periods, at irregular times when a woman is on HRT, and it can also occur after the menopause. There are 2 types of endometrial hyperplasia; hyperplasia without atypia and atypical hyperplasia.
What is the Danger?
The danger of endometrial hyperplasia for some women is that it can develop into one of the most common gynaecological cancers, womb cancer. Figures quoted put the number of women diagnosed with this kind of cancer at 8,500 per year, with the number of women with endometrial hyperplasia thought to be around 25,000. Many women may be suffering from symptoms of endometrial hyperplasia but may not even know that they are and therefore will not have seen a medical professional to be diagnosed and treated. The problem here is that endometrial hyperplasia can be treated if it is caught early, and the risk of the development into womb cancer in many cases could therefore be avoided.
Woman who are likely to be more at risk of suffering from endometrial hyperplasia are those who are older, those who have a higher Body Mass Index (BMI) i.e. more body fat, those who have polycystic ovarian syndrome, or those who are using tamoxifen or are having HRT.
What to do
It is important therefore to look out for symptoms such as abnormal bleeding or discharge, particularly after the menopause. If you have been / are experiencing these kinds of symptoms it is well worth getting them checked out just to make sure.
I offer the full range of office gynaecology including rapid sexual health screening, fertility management, polycystic ovaries and in one visit, I will be able to carry out assessments for pelvic pain and heavy menstrual bleeding. I am trained to carry out and treat major gynaecological conditions including endometriosis, investigation of treatment for polycystic ovaries, HRT, menopause, pelvic pain and pre-menstrual tension.
I also offer the NovaSure therapeutic treatment for heavy menstrual bleeding for women who have not responded to any medical (pill or Mirena coil) treatment. Find out more about it on my website here.
You may already have visited my website via the search engines (this Blog is part of that website although not linked via the menu) because you are searching for information about gynaecological services or obstetrics. You will see that I do list many of the main services on there with some detailed information. There are however many different outpatient services that I offer and I’d just like to give you an outline of some of the main ones here.
The Wellwoman Health Check is something I’ve written about in more detail on this Blog before but it is a very popular service which includes a full history examination, an assessment of an ultrasound scan, and the chance to discuss all of your health concerns. It also includes a Ca 125 test. This is a test to detect a protein called Ca 125 in the blood as the presence of a high level of this protein could be an indication of the presence of ovarian cancer cells. High levels of Ca 125 however can indicate conditions other than ovarian cancer such as endometriosis (where pieces of womb tissue are found outside the womb itself), fibroids (benign tumours in the womb), and of course pregnancy. All things considered the Wellwoman Health Check can be a great way to put your mind at ease about any health worries you may have, identify / detect possible threats to your health, examine and identify any symptoms you may be experiencing, explain smear results that you may have questions about, and get a clear snapshot of your health and wellbeing at this point.
Other outpatient services include Screening for thrombosis risk for contraception and hormone replacement therapy. HRT is something I’ve also written about earlier in this Blog and on my website, and this subject is something that I am asked regularly about. HRT advice is therefore an important outpatient service that I offer.
I also offer assessments for the treatment of premenstrual tension, urinary incontinence, and therapeutic management of polycystic ovarian disease and hirsutism (hairiness). I am also able to offer treatment of genital tract disorders such as bacterial vaginosis. Another outpatient service that I offer is the treatment for vaginal prolapse, both operative and non-surgical treatment treatments. Vaginal prolapse can have some very unpleasant symptoms and I am pleased to be able to offer help, advice and treatment options.
For more information about the different outpatient services visit my website, contact me online, or call 0203 318 0263.
HRT is always a subject that attracts a lot of interest in the press and this is often because of new studies showing the different effects on health. The result of this over time has been that many women have simply avoided the treatment because they fear the side effects more than they fear the immediate symptoms.
For example the UK Women’s Health Initiative studies showed increased breast cancer and heart disease risk and a higher risk of breast cancer diagnosis with combined HRT. On the other hand a recently completed study by New York University, presented to the American Society for Reproductive Medicine in Baltimore showed that women who took HRT for up to 25 years were no more likely to develop breast cancer, heart disease or diabetes than women who were not taking HRT treatment. This study had involved comparing the health of 80 women who had been taking HRT for an average of 14 years to the health of women who had not.
Consider The Benefits
It is worth remembering of course that there are some very good reasons why approximately 1 million UK women are currently taking Hormone Replacement Therapy. The symptoms of menopause can be very unpleasant e.g. hot flushes, night sweats and headaches plus there are the longer term and serious post menopausal risks to think about such as depression, osteoporosis, cardiovascular disease and stroke.
It is worth remembering too when worrying about the risks associated with HRT that Drinking more than 3 units of alcohol a day, and being overweight increase the risk of developing breast cancer and heart disease compared to HRT.
HRT involves replacing the lost oestrogen in the body, thereby relieving the symptoms of menopause and guarding against many other potentially serious longer term conditions.
I believe that HRT has a very valuable role as an effective agent in treating some of the highly unpleasant symptoms of menopause, and premenstrual syndrome, protecting against bone loss, and in treating postnatal depression. Topical oestrogens also have a lower risk of causing thrombosis in the veins and pulmonary embolism. I feel that there are real benefits in using topical oestrogens in combination with a Mirena coil, which minimizes the exposure to progesterone.
Through my private London clinic I offer HRT counselling and advice to women on their breast cancer and heart disease risk. I am also able to carry out specific tests for inherited thrombosis risks which are common in Northern Europeans and Ashkenazi Jews.
If you would like more information about HRT visit my website here, or you would like to make an appointment for a consultation please call 020 7390 8041 or email me here.