Information for Women

2/5/2019 PMS (Premenstrual Syndrome)

What is PMS?

PMS is the name given to the physical and emotional symptoms affecting your daily life in the 2 weeks before you have your period. These symptoms usually get better once your period starts and often disappear by the end of your period.

Nearly all women have some premenstrual symptoms. Each woman’s symptoms are different, but the most common include:

• mood swings

• feeling depressed, irritable or bad-tempered • feeling upset, anxious or emotional

• tiredness or having trouble sleeping

• headaches

• changes in appetite and food cravings

• feeling clumsy

• fluid retention and feeling bloated

• changes to skin or hair

• sore or tender breasts.

Symptoms can vary from month to month, although they tend to form a pattern over time.

Between 2 and 4 in 100 women get PMS that is severe enough to prevent them from getting on with their daily lives.

Once a diagnosis has been made, women should be offered CBT routinely as a first line treatment option to PMS. Vitamin B6 and exercise have also been shown to ease symptoms.

Continuous use of the contraceptive pill (one of the more recently developed combined pills) or an SSRI should be offered as first line pharmaceutical treatment. Other treatment options include estrogen patches or an implant, selective serotonin reuptake inhibitors (SSRIs) and GnRH analogues. Surgery should normally be a last resort and both the ovaries and womb should be removed to ensure that symptoms are permanently removed. Whilst this is an invasive procedure, it is the only permanent cure for PMS.

PMS can be a serious condition which can dramatically impact on the quality of a woman’s life affecting her personal and professional life, therefore it is essential that an integrated holistic approach to treatment is adopted. Whilst many women can be treated by their GP by adopting lifestyle changes, taking the contraceptive pill, SSRIs or vitamin B6, some women will need more complex care provided by a team of GPs, gynaecologists, psychiatrists and dieticians. In the most extreme cases, PMS can lead to self-harm and suicide.

It is important to raise awareness of the seriousness of the condition and available treatment options, not only in women but also among healthcare professionals.

26/11/2018 Ovarian Cysts

A cyst is a fluid filled sac. It is normal to find cysts on the ovaries and most are as a result of the normal ovarian functioning (functional cysts). Occasionally these cysts will grow too big and may cause symptoms. If they are small, they usually disappear without treatment but if they are big or symptoms become severe, the cyst(s) may need to be removed.

Other types of cysts may develop on the ovary which are not part of the normal functioning of the ovary. Such benign cysts include endometriomas, cystadenomas and dermoid cysts. Rarely ovarian cysts can be cancerous. 

Symptoms:

• Symptoms may be:
• Pelvic/abdominal pain
• Pain during intercourse
• Sense of fullness in the abdomen
• Difficulty passing urine
• Irregular bleeding

Treatment:

A cyst may be detected on internal examination but will usually require a pelvic ultrasound scan to make a diagnosis. When a cyst does need to be removed this can usually be done using keyhole surgery (laparoscopy) which enables a much quicker recovery, has less impact on future fertility and helps to preserve normal ovarian tissue. Occasionally more major surgery may be required.

14/01/2018 Pregnancy and Flu Jab

During pregnancy, a woman’s immune system naturally weakens to ensure that the pregnancy is successful and leaves her less able to fight off infections. That means if a woman catches the flu while pregnant she has a higher chance of getting bronchitis or pneumonia. Pregnant women with flu are also at a greater risk of having a miscarriage, giving birth early or having a baby with a low birthweight. We are very concerned that only four in 10 pregnant women have taken up the offer of a flu jab so far this winter. Flu can be a very serious illness in pregnant women and the best way to avoid getting this is by having the vaccination. We often hear from women who are concerned the vaccine will harm their baby, but current evidence shows it is safe during pregnancy.

23/08/2017  Putting on too much weight in pregnancy

Eating too much during pregnancy and putting on too much weight can be detrimental to both mother and baby. Women who are overweight during pregnancy are at an increased risk of having a miscarriage and developing conditions such as gestational diabetes, high blood pressure and pre-eclampsia. They are also more likely to have a premature baby, require a Caesarean section, experience a haemorrhage after birth or develop a clot which can be life-threatening. In addition, overweight women have bigger babies who are themselves more likely to become obese and have significant health problems as a result.

10/5/2017 Egg Freezing

Egg Freezing success rate is low (around 15%) therefore it may not be a good idea to delay pregnancy even if you wish to freeze your eggs.   

Technological improvements in oocyte vitrification (egg freezing) offer young healthy women the possibility of preserving oocytes until the less fertile years of life. This science is in its infancy and many practical and ethical issues remain. Chances of healthy pregnancy resulting from a vitrified oocyte are small (10%-15%), so many eggs should be collected and frozen to give a realistic chance of success later on. This exposes the healthy woman to superovulation and oocyte collection with concomitant hazards, albeit small. The best age for oocyte vitrification is probably under 30 years, resulting in medicalisation of relatively young women. Unrealistic reliance on their store of vitrified oocytes may lead women to defer pregnancy for many years only to experience disappointment when the stored oocytes later fail to fertilise or implant. Also, anxieties about the effects of prolonged vitrification on the offspring remain. Nevertheless, oocyte vitrification has attracted considerable interest, although this treatment is currently not widely available in the NHS.

10/5/2017 Reproductive Ageing

Women over 35 years of age are at increased risk of early pregnancy and obstetric and neonatal complications. The older woman is more likely to experience stillbirths, failed pregnancy or ectopic pregnancies. In the general population, the risk of failed pregnancy in a woman 35–39 years of age is 24%, and doubles to 51% at 40–44 years of age if the woman conceives with her own, rather than donor, eggs. Obstetric complications associated with increased maternal age include gestational diabetes, placenta praevia, placenta abruption, hypertension and caesarean section. Older women are also more likely to be nulliparous, require assisted reproductive therapy for conception and have multiple pregnancies naturally and after assisted reproductive therapy, all of which are risk factors for increased obstetric and neonatal morbidity. Advice to women using routes such as schools, media, general practice and family planning should consistently reflect that the optimal age for childbearing is between 20 and 35 years, for obstetric as well as for reproductive health reasons.

01/02/2017  Sexual Health  

The emotional and physical issues that can occur from mistaken and late diagnosis of sexual health concerns can have long-lasting effects. Our sexual health consultations and Well Woman Checks help to protect our patients and provide them with clear and up-to-date guidance. From smears, infection screens and contraceptive information to detailed examinations into recurring conditions such as cystitis, thrush and herpes, we provide expert advice and access to comprehensive treatment. This can also include help for partners to reduce the risk of transmission or re-infection.

29/01/2017 Gynaecology Yearly Check Up

Our yearly check up package provides women a piece of mind. It involves detailed consultation with Consultant Gynaecologist, smear and swab tests and a gynaecological ultrasound to diagnose problems in the uterus, ovaries and the tubes such as fibroids, polyps, ovarian cysts. Our state of art clinics are based at two locations (at Harley Street and at Chelsea) in London.

02/12/2016 Gynaecological Cancers 

Some women may have higher risk of developing ovarian or uterine cancer. The family history, genetic associations and other cancers can increase the risks. There is role of propyhlactic interventions to reduce the risk of cancer such as prophylactic oophorectomy/ salpingectomy in high-risk groups.

Postmenopausal bleeding and irregular periods after the age 45 poses a risk of uterine cancer. Early referral, pelvic ultrasound scan and uterine biopsy is a key to early detection of uterine cancer. Cervical cancer is yet another common female cancer. Regular cervical smear is the best way to prevent it. If cervical smear is abnormal, colposcopy and biopsy are the right steps forward. Click on Smear and Colposcopy tab to find out more. 

General investigations for the diagnosis Gynaecological cancer?

Pelvic Ultrasound scan 

Serum CA125

Cervical Smear

Colposcopy 

Uterine Biopsy

Hysteroscopy

02/10/2016  Cervical Suture (Cervical Cerclage)

Dr Tezcan has extensive experience in the treatment of women who have had miscarriages in the middle part of pregnancy or premature births. If this applies to you, Dr Tezcan will carry out a full analysis to find out whether weakness of the cervix (cervical incompetence) is playing a role. Other causes of mid-trimester pregnancy loss and pre-term birth also have to be considered such as multiple pregnancy, abnormal shape of the womb, bleeding problems, infections, excessive amniotic fluid with fetal abnormality or monochorionic twins and associated complications and a history of cervical cone biopsy, laser treatments (LLETZ).

What is Cervical Suture?

Cervical suture – also called cervical cerclage – can help prevent a miscarriage in certain cases where cervical weakness is playing a role. A cervical suture is a mersilene tape placed around the upper part on the cervix (neck of the womb) to strengthen it.  There are three types of cervical suture: McDonald Suture, Shirodkar Suture and Transabdominal Suture.

17/09/2016

Having a check up with your gynaecologist is important, not just for the health benefits, but also you can build a trusting relationship with a professional in case there ever is a medical issue. Reassurance provided by your gynaecologist and the information provided to you will help you further build up your confidence.

We recommend that all women have an annual check-up to prevent them developing illnesses such as cervical cancer, endometrial cancer or ovarian cancer. Usually an annual check-up will include:

A consultation during which you would discuss your medical history and any worries or concerns.

A blood pressure check.

A cervical smear test to check for cervical cancer. We recommend this be done at least once a year.

A transvaginal scan. This scan is painless and is very important as it allows your gynaecologist to see the fallopian tubes, ovaries and uterus. Ms Tezcan will be able to check that everything appears normal and to check for ovarian cysts and ovarian cancer, polyps, endometrial hyperplasia and endometriosis.

It can also include other tests such as swabs, biopsy and blood tests. This could be to check for sexually transmitted diseases, a cancer marker test (CA125), cholesterol, haemoglobin, hormone levels, liver function and thyroid profile, amongst others. These can be done during the consultation if you wish.

03/09/2016

Menopause symptoms occur predominantly as a result of the ovary no longer producing the hormone oestrogen. The severity of the symptoms varies and can have a different impact on women’s lives. We provide personalized care depending on our patients’ symptoms and provide extensive counselling on the benefits and the risks related to hormone replacement therapy (HRT). There are also alternative treatments that we can provide for symptoms such as vaginal dryness, hot flushes and night sweats and osteoporosis. We can also provide information on complimentary therapies. 

Some women may experience menopause early before the age of 45 and even 40. Those women are at much higher risk of developing osteoporosis, cardiovascular disease and dementia. Use of HRT may decrease these risks and is recommended until the average age of menopause, which is around age 52

01/09/2016

Women who give birth at a very advanced maternal age (48 years+) are at higher risk of pregnancy complications, however most can be explained by multiple pregnancy or the use of assisted conception, suggests a new study published today (1 September) in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG)

07/08/2016

Infertility is a common problem and affects one in seven couple. As this is such a common occurrence there are plenty of help available; it is important to take a detailed medical history, and there are various diagnostic tests to understand the reasons behind infertility. I am specialized in ultrasound and ultrasound is one of the most important diagnostic tests to understand the pathologies in the uterus, cervix and ovaries. We also organize hormone tests to check whether you are ovulating. We can either organize an X-ray or laparoscopy (key hole surgery) to test for tubal patency in order to diagnose any blockage in the fallopian tubes.

In those women who do not ovulate regularly, ovulation induction is achieved using a mild fertility drug known as Clomiphene. When Clomiphene is used a scan is performed usually on approximately day 10 of the cycle to ensure that ovulation is going to occur and to exclude ovarian hyperstimulation. 

Intrauterine Insemination is a form of assisted conception used for very mild sperm problems and also in those couples with unexplained infertility. If your investigation results are suggestive of IVF as the best treatment for you, we can organize a referral to one of the best clinics in London with highest success rates.

05/07/2016

Menorrhagia is defined as unusually heavy and/or long lasting menstrual periods. If your bleeding lasts 7 or more days per cycle, or is so heavy that you need to change protection every 1 to 2 hours, then you may have menorrhagia. Menorrhagia is more than just a problem with bleeding. It can have very disruptive effects on your family and social life, regular daily activities and your mood. 

Menorrhagia occurs in 20% of women. Millions of women suffer from heavy periods, yet only 25% of them seek treatment. There are many treatment options (medical & surgical) available to you depending on the reasons for Menorrhagia. 

Please contact us if you are suffering from menorrhagia and seeking for more information.