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Mr Alan Gillespie, Consultant Gynaecologist
Claremont Clinics: Thursday evenings/Friday & Saturday mornings
Mr Gillespie specialises in the management of most gynaecological problems including the diagnosis and treatment of gynaecological pre-cancer and cancer.
My periods are a real problem. What can be done about this?
Heavy periods or menstrual bleeding has many causes – most are innocent and can be treated very simply after appropriate investigation. Heavy bleeding can be very debilitating and therefore should be promptly investigated and treated.
Can I be helped?
Bleeding problems require investigation to try to identify any specific underlying issue. If such a problem is found and the appropriate treatment given, the symptoms will usually resolve. If no specific issue is identified, there are several different treatments medically and surgically which can help.
I’m worried that my symptoms could be due to cancer…
This is unlikely. Most bleeding problems are due to other causes and not cancer. The investigation of heavy bleeding will hopefully exclude cancer and provide reassurance.
What investigations are usually undertaken?
Investigations typically include an ultrasound scan, endometrial biopsy (a sample taken from the lining of the womb) and/or a hysteroscopy. Depending on the situation, swabs (to exclude an infection) and a cervical smear may be required.
How will the ultrasound scan be performed?
This scan typically is performed by placing a probe on the abdomen and another into the vagina. For the abdominal scan the bladder must be full and the internal scan is usually well tolerated with minimal discomfort.
What is an Endometrial Biopsy?
This a sample taken from the lining of the womb. It is obtained by passing a small plastic tube into the womb via the cervix (neck of the womb). This procedure is typically straightforward and conducted in the outpatient consultation room. Local anaesthetic can be used to minimise patient discomfort.
What is a Hysteroscopy?
A hysteroscope is a small telescope that is introduced into the cavity of the womb in the same way as an endometrial biopsy so the doctor can identify any areas of concern. Usually, the procedure can be performed in the outpatient consultation room under local anaesthetic and is well tolerated. Occasionally a general anaesthetic is required if the results of other tests indicate this is appropriate. Some patients prefer to have the procedure performed under general anaesthetic.
How quickly can I be seen and reassured?
I aim to see patients concerned about their symptoms as soon as possible and offer prompt reassurance.
What will happen if I attend for an endometrial biopsy or hysteroscopy?
After meeting the reception staff, you will see the consultant who will explain the procedure and address any concerns you may have. You will then be taken to a separate private room by the nurse to get ready for the procedure. After the procedure has been performed, you will have a further discussion with the consultant and a follow up plan confirmed.
What happens then?
This depends on the results of the investigations which are usually available within a few days. Most patients will be reassured that there is no serious cause for their symptoms. After this, the range of treatment options available will be discussed. Typically, this may involve taking some sort of medication or having an operation but you can decide with your consultant on the right treatment choice for you.