The menstrual cycle is the time between the first day of your period, through to the first day of your next period. Your period is the specific part of your menstrual cycle where you bleed.

You should speak to your GP in the first instance if you experience painful periods that are not relieved with painkillers or the pain disrupts your ability to work, socialise, study or sleep. Other reasons to seek advice include heavy periods, bleeding between periods and late periods. Causes include fibroids, polyps, adenomyosis, dysfunctional uterine bleeding, pre-cancerous and cancerous change. Treatment options include conservative and surgical means, including ablation and hysterectomy. Bleeding in the post-menopausal period is always abnormal and should be investigated. First line investigation for any abnormal bleeding is hysteroscopy and curettage.

Choosing which contraception is right for you is highly personal, and there are risks and benefits to all options. I can discuss your goals and preferences, including the contraceptive pill (there are many variations of this option, including progesterone-only preparations), vaginal ring (NuvaRing), an intrauterine device (Mirena, Kyleena and copper IUD), contraceptive implant (Implanon), Depo-provera and both male and female sterilisation. The chosen method of contraception can also be used in conjunction with barrier methods, such as condoms, to reduce the risk of sexually transmitted infections.

The Cervical Screening test is a simple (albeit moderately uncomfortable) process that looks for any signs of the human papillomavirus (HPV). HPV is a common infection that causes most forms of cervical cancer. Screening is recommended every 5 years. Your GP may refer you for a colposcopy (examining the cervix under a microscope).

In the very rare event that a concerning strain of the HPV virus is confirmed on biopsy, a short procedure called a LLETZ (large loop excision of the transformation zone) may be offered in order to take a sample of potentially abnormal tissue of the cervix.

Endometriosis is a condition whereby the tissue that grows on the inside of your uterus (endometrial tissue), escapes and grows outside of the uterus.

If this tissue deposits in your ovaries, this can cause cysts (called endometriomas) and other scar tissue to form. Bands of fibrous tissue can form adhesions, which can cause tissues and organs in the pelvis to stick together. The pain can be debilitating and fertility challenges are common.

I offer conservative management, ie medication, and the gold standard treatment for both diagnosing and treating endometriosis, a combination of excision and diathermy.

Urinary incontinence is very common. Symptoms can range from an occasional leak to, distressingly, being completely unable to control your bladder.

There are different types of urinary incontinence, ie stress, overactive bladder, a combination of the two, or neurogenic.

It is important to obtain a thorough history/examination, and investigations may include performing a midstream urine, blood tests, and urodynamics.

For most women urinary incontinence can be managed or cured with physiotherapy, medication, and in some circumstances surgery.

There are a whole host of conditions that may affect this area, some of which are sexually transmitted. Symptoms include itch, discharge, ulceration, lesions etc. These include candidiasis, Behcets disease, lichen sclerosis, lichen planus, psoriasis, HSV, HPV, melanoma, SCC, to name a few. Often swabs, blood tests and even biopsies may be required.