Women's Health

Bacterial vaginosis is a vaginal microbiome syndrome causing thin, grey-white, fishy-smelling discharge with little inflammation; diagnosis is clinical or microscopy-supported, and current UK care prioritises symptomatic treatment, pregnancy assessment, STI exclusion and specialist management of recurrence.

Persistent high-risk HPV infection can cause cervical precancer and invasive cancer; England's screening programme uses primary hrHPV testing with cytology triage, while symptoms or a suspicious cervix require direct clinical assessment and specialist staging.

Endometrial cancer usually presents with abnormal uterine bleeding, especially postmenopausal bleeding; prompt referral, histological diagnosis, MMR and molecular assessment, and risk-adapted gynaecological oncology treatment are the key steps.

Endometriosis is endometrium-like tissue outside the uterine cavity that causes inflammation, pain and fibrosis; suspect it from period-related pelvic, bowel, urinary or sexual symptoms, investigate and treat in parallel, and tailor decisions to pain, fertility and disease location.

Gestational diabetes is pregnancy-related hyperglycaemia diagnosed by risk-factor-based OGTT when maternal insulin secretion cannot compensate for placental insulin resistance; treatment aims to reduce fetal overgrowth and neonatal hypoglycaemia while protecting maternal and fetal safety.

Hyperemesis gravidarum is severe nausea and vomiting of early pregnancy that prevents normal eating and drinking and limits daily function; assess clinically for dehydration, weight loss, electrolyte disturbance and alternative diagnoses, then escalate antiemetics and fluids through community, ambulatory or inpatient care.

A chronic inflammatory dermatosis that usually affects anogenital skin, causing itch, soreness, white fragile plaques and scarring; recognise suspicious change because vulval lichen sclerosus carries a small but important risk of squamous cell carcinoma.

Menopause is the transition caused by declining ovarian follicular activity and fluctuating or low oestrogen; diagnose typical cases clinically, then tailor symptom treatment, HRT risks, contraception, bone health and follow-up to the person's stage and comorbidities.

Miscarriage is the spontaneous loss of a pregnancy before 24 weeks; this chapter focuses on early pregnancy loss, where ultrasound, clinical stability and the amount of tissue passed determine diagnosis, urgency and management.

Ovarian, fallopian-tube and primary peritoneal cancers are closely related diseases that often spread across the peritoneum before causing obvious local symptoms; persistent or frequent bloating, early satiety, pelvic or abdominal pain and urinary symptoms need the current NICE symptom-triggered testing pathway.

An ovarian cyst is a fluid-filled sac in or on the ovary; most in premenopausal women are functional and resolve spontaneously, so the clinical task is to separate these benign cysts from the minority that are complications (torsion, rupture) or malignant, using menopausal status, ultrasound morphology and CA125.

Twisting of the ovary and tube on their vascular pedicle occludes venous outflow first and then arterial inflow, so the ovary congests and infarcts.

Pelvic organ prolapse is descent of the bladder, uterus, rectum or vaginal vault into or through the vagina because the pelvic floor muscles and fascia that support them have weakened; it is common after childbirth and around the menopause, and management runs from pelvic floor training and pessaries to surgery.

Polycystic ovary syndrome is a heterogeneous endocrine, metabolic and reproductive condition characterised by ovulatory dysfunction and hyperandrogenism, with polycystic ovarian morphology in some people; diagnose by the appropriate criteria, exclude mimics and manage reproductive, metabolic, psychological and endometrial risks together.

Postpartum haemorrhage is bleeding after birth that outruns the myometrial contraction meant to close the placental bed, usually from atony, retained tissue, trauma or failed clotting.

Benign uterine smooth-muscle tumours that may be asymptomatic or cause heavy menstrual bleeding, pain, pressure symptoms and fertility problems; management depends on symptoms, fibroid anatomy and reproductive wishes.

Malignancy of the vulva, most often a squamous cell carcinoma arising either from HPV-related intraepithelial neoplasia in younger women or from long-standing lichen sclerosus in older women; it presents with a vulval lump, ulcer, persistent itch or bleeding, and delayed presentation is common because women do not report symptoms.