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Cambridge University Press 978-1-107-48069-8 - Gynaecology: Evidence-Based Algorithms Jyotsna Pundir and Arri Coomarasamy Index More information

INDEX

abdominal sacrocolpopexy 132, 133, 136 pregnancy and 248 prevalence 214 acne 276 sexual partners 248 recurrent 213, 215 acromegaly 81 anorexia 71 treatment 215 actinomyces-like organisms 168 anovulation management, polycystic ovarian sexual partners 215 acupuncture/acupressure syndrome 83, 84, 85 Baden–Walker System for prolapse dysmenorrhoea 29 anti-D immunoglobulin prophylaxis evaluation 130 hyperemesis gravidarum 26, 24 miscarriage 7, 4 Beçhet’s disease, vulval 156 menopausal symptoms 145 molar pregnancy 16 behavioural interventions adenomyomectomy 52 antimüllerian hormone (AMH) 62 dysmenorrhoea 29 adenomyosis 50 antiandrogens, hirsutism 89 overactive bladder 127 clinical features 50 antibiotics premenstrual syndrome 32 differential diagnosis 29 bacterial vaginosis 215 beta blockers, menopausal symptoms 144 infertility relationship 53 chancroid 236 bilateral salpingo-oophorectomy (BSO) management 53 chlamydia 227 endometrial cancer 177 investigations 50 Donovanosis 238 endometriosis 57 management 51 entry into breast milk 215 heavy menstrual bleeding 41 medical 51 gonorrhoea 225 ovarian cancer and 185, 191, 192 surgical 52 lymphogranuloma venereum 232 premenstrual syndrome 33 prevalence 50 pelvic inflammatory disease 207, 208 biofeedback, urinary incontinence 124 adhesiolysis prophylaxis, pregnancy termination 8 biopsy chronic pelvic pain 202 syphilis 243, 244 ano-genital warts 247 infertility management 103 antidepressants, chronic pelvic pain 202 cervical intra-epithelial neoplasia 166 endometriosis-related 58 antihistamines, hyperemesis gravidarum 25 cone biopsy 15 adhesions 202 antimuscarinic drugs, overactive bladder 127 disorder of sex development 62 investigation 103 antiphospholipid syndrome (APS) 13 endometrial hyperplasia 173 see also adhesiolysis management 14 myometrial 50 adnexal masses, differential diagnosis 183 screening 12 post-menopausal bleeding 180 adnexal torsion 114 antispasmodics, inflammatory bowel vulval 151, 159 alcohol consumption in pregnancy, syndrome 204 black cohosh, menopausal symptoms 145 miscarriage risk 12 anti-thyroid antibodies, miscarriage risk bladder catheterization 123 alpha fetoprotein (AFP), ovarian cancer 13, 15 bladder diaries 121 assessment 189 antiviral therapy bladder scan 121 ambiguous genitalia herpes 229 bladder training 127 differential diagnosis 63 molluscum contagiosum 233 bleeding in early pregnancy investigations 62 aromatase deficiency, placental 66 differential diagnosis 2, 19 see also disorders of sex development aromatase inhibitors investigations 3 ambulatory urodynamics 122 adenomyosis 51 see also miscarriage amenorrhoea fibroid 45 bleeding patterns with hormonal primary 69 polycystic ovarian syndrome 84 contraceptives complications 69 precocious puberty 99 alterations 276 examination 69 ascites, ovarian hyperstimulation expected patterns 272 history 69 syndrome 112, 114 unscheduled bleeding 272 investigations 69 aspiration, ovarian cyst 185, 186 examination 272 secondary 72 aspirin history 272 examination 72 endometrial cancer risk reduction 175 investigations 272 history 72 miscarriage prevention 14, 15 management 273 investigations 62 assisted reproduction 59 bone age, precocious puberty Amsel criteria for bacterial vaginosis 214 long-term safety 105 investigation 97, 98 analgesics premature ovarian failure and 76 bone health 276 chronic pelvic pain 201 virology issues 105 combined hormonal contraceptive endometriosis 55 see also fertility problems; specific effects 278 anastrozole, polycystic ovarian syndrome 84 techniques progestogen-only contraception androgen excess, polycystic ovarian augmentation cystoplasty 128 impact 255, 279 syndrome 80 autoimmune oophoritis 74 women aged over 40 years 278–9 androgen insensitivity 67, 71 azoles, candidiasis 216, 217 Bonney test 122 androgen-secreting tumours 81 botulinum toxin, detrusor overactivity 128 hirsutism and 86 bacterial vaginosis (BV) 212, 214 brachytherapy, endometrial cancer 177 precocious puberty and 96 complications 214 breast cancer ano-genital warts 247 diagnosis 210, 211, 214 BRCA1/BCRA2 mutations 198, 254 clinical features 247 history 214 prophylactic surgery 198 differential diagnosis 247 in pregnancy 213, 214, 215 combined hormonal contraception risk 254 management 248 miscarriage risk 13, 14 HRT risk 141 follow-up 248 termination and 215 breastfeeding see lactation 301

© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-48069-8 - Gynaecology: Evidence-Based Algorithms Jyotsna Pundir and Arri Coomarasamy Index More information

bromocriptine 92 cetirizine, candidiasis 217 expected bleeding patterns 272 hyperprolactinaemia 92 chancre 242 non-contraceptive benefits 253 safety in pregnancy 94 see also syphilis postnatal contraception 283, 298 buboes chancroid 223, 235 risks and side effects 254 chancroid 235 clinical features 235 unscheduled bleeding management 273 lymphogranuloma venereum 232 differential diagnosis 235 women aged over 40 years 278 management 232, 236 investigations 235 combined oral contraceptives (COCs) 37 management 236 adenomyosis management 51 CA125 levels 150, 184 follow-up 236 chronic pelvic pain management 201 endometriosis investigation 55 chemotherapy commencement 253 ovarian cancer 188, 189 cervical cancer 171 continuous and extended use treatment response evaluation 194 endometrial cancer 177, 178 (CECOC) 293 cabergoline 92 ovarian cancer 191, 192 dysmenorrhoea management 30 hyperprolactinaemia 92 first line 193 endometrial cancer risk reduction 175 safety in pregnancy 94 germ cell tumors 197 endometriosis management 56 caffeine reduction, overactive bladder 123 second line 194 fibroid management 45 calcitonin, endometriosis 56 sex cord stromal tumors 197 heavy menstrual bleeding management 36 cancer vulval cancer 162 hirsutism management 88 epidemiology 148 chlamydia 222, 226 interstitial cystitis management 203 gynaecological cancers 149 clinical features 226 missed pill 274, 286 fertility sparing treatments 115 complications 226 ovarian cyst and 186 mortality causes 148 investigations 226 pelvic inflammatory disease and 208 referral recommendations 150 management 227 premature menopause management 76 risk with polycystic ovarian syndrome 82 in pregnancy and lactation 227 premenstrual syndrome management 32 see also specific types of cancer sexual partners 227 venous thromboembolism risk 276, 297 candidiasis see vulvo-vaginal candidiasis pelvic inflammatory disease 207 see also combined hormonal contraception cardiolipin tests, syphilis 243 prevalence 226 combined vaginal ring (CVR) 253, 297 cardiovascular risk sample sites 226 complementary therapies HRT effects 140 screening 103 dysmenorrhoea 29 polycystic ovarian syndrome see also lymphogranuloma venereum endometriosis 57 relationship 82 chromosomal anomalies menopausal symptoms 145 progestogen-only contraception 255 male infertility 108 premenstrual syndrome 33 women aged over 40 years 278 recurrent miscarriage risk 13 urinary incontinence 123 cervical cancer 169 chronic pelvic pain 200 complete androgen insensitivity (CAIS) 67 examination 169 definition 200 computed tomography (CT) management 171 differential diagnosis 200 ovarian cyst 184 fertility sparing treatments 15, 116 examination 200 pituitary imaging 91 follow-up 172 history 200 condoms 251 in pregnancy 172 interstitial cystitis 203 counselling regarding correct use 251 prevalence 169 investigations 201 female 248, 252 referral to colposcopy 169 irritable bowel syndrome 204 postnatal contraception 283 risk factors 169 management 201, 202 STI prevention 248, 251 combined hormonal contraception 254 evidence round-up 205 ano-genital warts 248 progestogen-only contraception 255 service provision 200 condylomata acuminata see ano-genital warts staging 169, 170 what not to do 205 cone biopsy 15 cervical cap 252 ‘red flag’ symptoms 201 congenital adrenal hyperplasia (CAH) 60 correct use 252 referral 201 hirsutism 86 postnatal contraception 283 cidofovir, vulval intra-epithelial neoplasia 152 late-onset 81 cervical cerclage 14 clindamycin management 66, 99 cervical intra-epithelial neoplasia (CIN) 164 bacterial vaginosis 13, 215 see also disorders of sex development ablative techniques 166 entry into breast milk 215 congenital bilateral absence of the vas deferens biopsy 166 clobetasol propionate, lichen sclerosus 154 (CBAVD) 108 colposcopy referral 165 clomiphene citrate 84 congenital syphilis 242 cytological findings 165 polycystic ovarian syndrome 84 management 245 examination 165 clonidine, menopausal symptoms 144 screening 245 follow-up 167 codeine, dysmenorrhoea 30 consent issues histology findings 167 cognitive behavioural therapy (CBT), laparoscopy 205 hysterectomy and 168 premenstrual syndrome 32 sterilization 294 pathogenesis 164 cognitive benefits of HRT 140 surgical management of miscarriage 7 repeat excision 167 colorectal cancer risk utero-vaginal prolapse surgery 134 screening 164 combined oral contraception benefits 253 constipation 204 cervical mucus, post-coital testing 103 HRT benefits 140 constitutional delay 71 cervical screening 164, 168 colpocleisis 132, 137 contraception age of referral 164 colporrhaphy drug interactions 268 cervical stenosis anterior 132 ectopic pregnancy and 23 cervical screening and 168 posterior 132 failure rates 261 differential diagnosis 29 colposcopy 165 female barrier methods 252 cervical weakness, recurrent miscarriage referral 165, 169 fibroids and 48 risk 12, 13, 15 colposuspension 125 gestational trophoblastic disease and 17 management 14 combined hormonal contraception (CHC) 253 long-acting reversible contraception 290 cervicitis 211 drug interactions 253 methods 250, 260 302

pelvic inflammatory disease and 208 depression, hormonal contraception and 276 investigations 20 pregnancy diagnosed after starting dermatitis, vulval 156 management 22 contraception 271 desmopressin, overactive bladder 127 evidence round-up 23 premature menopause and 76 desogestrel-only pill 256 follow-up 23 quick starting contraception 269 detrusor myectomy 128 persistent trophoblast 23 assessment 270 detrusor overactivity 120 service provision 20 follow-up 271 see also overactive bladder prevalence 19 potential benefits 269 dexamethasone, polycystic ovarian syndrome 84 prognosis 19 potential risks 269 diabetes mellitus referral pathway 20 requirements when starting 271 polycystic ovarian syndrome association 82 risk factors 19 UKMEC categories 252, 256, 262 gestational DM 82 eflornithine, hirsutism 89 women aged over 40 years 277 recurrent miscarriage relationship 13, 15 ejaculatory dysfunction 108 follow-up 281 vulvo-vaginal candidiasis association 218 management 109 health risks and benefits 278 diaphragm 252 electrical stimulation, urinary HRT and 281 correct use 252 incontinence 124 stopping contraception 280 postnatal contraception 283 embryo cryopreservation 118 young people 275 diarrhoea 204 embryo transfer 104 compliance improvement 275 dietary supplements emergency contraception 250, 284 health concerns and risks 276 dysmenorrhoea 29 advance provision 252 medical eligibility 275 menopausal symptoms 144 guideline comparator 289 STI issues 275 dilatation and curettage, post-menopausal indications 285 see also combined hormonal contraception; bleeding 181 investigations 284 emergency contraception; postnatal dilatation and evacuation 9 medical eligibility 284 contraception; progestogen-only disorders of sex development (DSD) 60 methods 284, 286 contraceptives; specific methods clinical features 60 postnatal 282 corticosteroid therapy congenital adrenal hyperplasia (CAH) 65, 66 what not to do 289 hyperemesis gravidarum 26 differential diagnosis 63 young people 275 lichen sclerosus 154 examination 60 endometrial ablation counselling fertility 64 evidence round-up 39 condom use 251 gender assignment 64 heavy menstrual bleeding 38 female barrier contraception 252 history 60 procedures 39 heavy menstrual bleeding 36 investigations 62 endometrial cancer 175 herpes infection 229 management 64 combined hormonal contraception postnatal contraception 282 masculinization in XX females 66 benefit 253, 278 premature menopause 76 nomenclature 60 histological types 176 crab louse see Phthirus pubis prevalence 60 history 175 Crohn’s disease, vulval 157 undervirilization in XY females 67 HRT risks 141, 146 cryotherapy, molluscum contagiosum 233 dong quai, menopausal symptoms 145 investigations 175 Cu-IUD see intrauterine contraception donor insemination 109, 110 management 177 Cushing’s syndrome 81 Donovan bodies 237 adjuvant treatment 177 hirsutism 86 donovanosis 223, 237 fertility sparing treatments 116 cyproterone acetate (CPA) 88 clinical features 237 follow-up 178 hirsutism 88 complications 237 prevalence 175 precocious puberty 99 investigations 237 recurrence 178 venous thromboembolism risk 297 management 238 risk factors 175 cystectomy see ovarian cystectomy follow-up 238 staging 116, 176 cystitis, interstitial 203 dopaminergic agonists endometrial hyperplasia 173 cystocele 130 hyperprolactinaemia 92 investigations 173 surgical management 132 safety in pregnancy and lactation 94 management 174 cystometry 122 drospirenone 139 pathogenesis 173 cystoscopy 121 duloxetine, urinary incontinence 124 risk factors 173 interstitial cystitis 203 dyskaryosis 165, 166 endometrial polyps, differential diagnosis 29 cystotomy 186 dysmenorrhoea 28 endometrial thickness (ET) 180 cytoreduction differential diagnosis 29 post-menopausal thickening 182 endometrial cancer 177 examination 28 endometrioma 55 ovarian cancer 192, 193 history 28 surgical management 58, 59 investigations 28 endometriosis 54 danazol management 29, 255 complications 54 adenomyosis 51, 53 medical 30 differential diagnosis 29, 54 chronic pelvic pain 201 surgical 30 examination 54 endometriosis 56 prevalence 28 history 54 debulking surgery, ovarian cancer 192 primary 29 infertility and 58 germ cell tumors 197 risk factors 28 management 58, 103 sex cord stromal tumors 197 secondary 29 investigations 55, 103 dehydroepiandrosterone, menopausal women aged over 40 years 278 management 55 symptoms 144 analgesics 55 depot medroxyprogesterone acetate ectopic pregnancy 19 complementary medicine 57 (DMPA) 37, 257, 290 complications 19 hormonal drugs 55, 56, 58 dysmenorrhoea 30 differential diagnosis 19 relapse 58 heavy menstrual bleeding 36 examination 19 surgical 57, 58 risks and side effects 290 history 19 prevalence 54 303

enterocele 130 fish oil supplements, dysmenorrhoea 29 symptoms and signs 224 epididymal obstruction 108 fluid management, ovarian hyperstimulation granuloma inguinale see donovanosis erectile dysfunction 108 syndrome 113 granulosa-cell tumour, precocious puberty management 109 fluid-bridge test 122 and 96 evening primrose oil, menopausal flutamide 89 groin node dissection 161 symptoms 145 focused ultrasound see ultrasound therapy growth hormone exercise follicle stimulating hormone (FSH) polycystic ovarian syndrome 84 dysmenorrhoea management 29 amenorrhoea investigation 73 precocious puberty 99 menopausal symptom management 144 infertility investigation 102 gynaecological cancers see cancer; specific polycystic ovarian syndrome male infertility 108 cancers management 83 menopause assessment 139, 281 secondary sexual characteristics and 70 Haemophilus ducreyi see chancroid Fallopian tube fragile X syndrome (FXS) 74, 77, 78 Hay/Ison criteria for bacterial vaginosis catheterization/cannulation 103 preimplantation genetic diagnosis 78 214 occlusion (sterilization) 294, 295 prenatal diagnosis 78 heat therapy, dysmenorrhoea 29 hysteroscopic 296 prevalence 77 heavy menstrual bleeding 35 patency assessment 103 screening 78 causes 35 rupture 19 fragile X tremor ataxia syndrome (FXTAS) 77 complications 35 tubal infertility 101, 103 examination 35 management 103 gabapentin, menopausal symptoms 144 history 35 female condoms 248, 252 galactosaemia 74 management 36 feminizing genital surgery 64 gamete intrafallopian transfer 105 advice and counselling 36 Ferriman–Gallwey scoring system for genital herpes see herpes evidence round-up 42 hirsutism 87 genital ulcers 221, 223 medical 36 fertility preservation 118 see also chancroid; donovanosis; service provision 35 premature ovarian failure and 76 lymphogranuloma venereum surgical 38 fertility problems 100, 102 genital warts see ano-genital warts prevalence 35 adenomyosis association 53 germ cell ovarian tumors 196 heparin, miscarriage prevention 14, 15 aetiology 101 management 117, 197 hepatitis, assisted reproduction and 105 disorders of sex development and 64 gestational trophoblastic disease (GTD) 16 herbal medicines endometriosis related 58 investigations 16 dysmenorrhoea 29 management 58 management 16 menopausal symptoms 145 examination 102 follow-up 17 see also complementary therapies fibroids and 48 recurrence risk 17 hereditary non-polyposis colorectal cancer history 102 twin pregnancies 17 (HNPCC) 199 hyperprolactinaemia and 94 gestational trophoblastic neoplasia (GTN) 16 diagnosis 199 initial assessment 100 persistent 18 endometrial cancer association 175, investigations 102, 103 gestrinone, endometriosis 56 179, 199 lifestyle factors 100 ginger, hyperemesis gravidarum 26, 24 management 199 male see male subfertility gonadal dysgenesis 67 ovarian cancer association 199 management 102, 103 gonadal investigation, disorders of sex herpes 222, 228 what not to do 106 development 62 asymptomatic viral shedding 229 see also assisted reproduction; specific gonadotrophin-releasing hormone (GnRH), clinical features 228 techniques ovulation induction 102 investigations 228 ovulatory disorders 101, 102 gonadotrophin-releasing hormone analogues management 229 premature ovarian failure and 76 (GnRHa) 37 partner notification 229 fertility preservation 76 adenomyosis 51, 53 recurrent disease 229 prevalence 100 chronic pelvic pain 201 natural history 228 psychological effects 100 endometriosis 56 high-intensity focused ultrasound see referral 100 with ‘add-back’ 56 ultrasound therapy tubal disorders 101, 103 fibroids 45, 46 hirsutism 86 unexplained 103 hirsutism 89 aetiology 86 fibroids (leiomyomas) 44 interstitial cystitis 203 definition 86 differential diagnosis 29, 44 irritable bowel syndrome 204 hyperandrogenic 86 examination 44 polycystic ovarian syndrome 85 idiopathic 86 history 44 precocious puberty 99 investigations 87 investigations 45 premenstrual syndrome 33 management 87 issues 44 gonadotrophin-releasing hormone antagonists, evidence round-up 89 contraception 48 fibroids 46 referral 86 fertility 48 gonadotrophins, polycystic ovarian severity assessment 87 HRT 48 syndrome 85 HIV infection leiomyosarcoma risk 48 gonorrhoea 222 assisted reproduction and 105 management 38, 45 complications 224 chancroid coinfection 236 adjuvant therapy 46 investigations 225 pelvic inflammatory disease and 209 medical 45 management 225 vulvo-vaginal candidiasis association 218 minimally invasive procedures 47 follow-up 225 homeopathy, menopausal symptoms 144 surgical 45, 46 partner notification 225 hook effect 91 see also myomectomy pelvic inflammatory disease 207 hormone replacement therapy (HRT) prevalence 44 prevalence 224 after cancer 146 finasteride 89 specimen site 224 alternatives to 144

304

contraception and 281 endometrial cancer 177 postnatal contraception 283 contraindications 138 endometrial hyperplasia 174 quick starting contraception 270 endometrial cancer risk 175, 179 endometriosis 57 risks and side effects 259, 292 endometriosis management 57 fibroids 46 pain 29 fibroids and 48 vs uterine artery ablation 49 STI risks 259 immediate benefits 140 heavy menstrual bleeding 38, 41 women aged over 40 years 279 long-term effects 140 menopausal symptoms 143 stopping contraception 280 post-menopausal bleeding and 179 ovarian cancer and 185, 191, 192 see also levonorgestrel intrauterine system premature ovarian failure 76 premenstrual syndrome 33 intrauterine insemination (IUI) 103, 105, 110 premenstrual syndrome 33 risks 42 intravesical potassium chloride sensitivity progestonic side effects 139 utero-vaginal prolapse 132 test 203 risks of 141, 146 vault prolapse prevention 135 isoflavones, menopausal symptoms 145 routes and regimens 139 hysteropexy 132, 133 isolated precocious menarche 96 utero-vaginal prolapse and 131 hysterosalpingo-contrast ultrasonography isolated precocious pubarche 96 hot flushes 138 (HYCOSY) 103 isolated precocious thelarche 96 HRT benefits 140 hysterosalpingography (HSG) lifestyle measures 144 adenomyosis investigation 50 Kallman’s syndrome 71 see also menopausal symptoms tubal patency assessment 103 karyotype investigation human chorionic gonadotropin (hCG) uterine abnormalities 103 disorders of sexual development 62 ectopic pregnancy and 20, 21, 22 hysteroscopy male infertility 108 hCG stimulation test 62 dysmenorrhoea investigation 28 ketoconazole, precocious puberty 99 miscarriage prevention 14 endometrial hyperplasia 173 Klebsiella granulomatis see donovanosis ovarian cancer assessment 189 myomectomy 46 polycystic ovarian syndrome myometrial ablation and excision 52 lactation management 85 post-menopausal bleeding 180, 181 antibiotic safety 215, 227, 236, 238 human leucocyte antigen (HLA), miscarriage sterilization 297 dopamine agonist safety 94 risk relationship 13, 15 uterine abnormalities 103 molluscum contagiosum treatment 233 human papillomavirus (HPV) postnatal fertility and 282 ano-genital warts 247 iliococcygeus fixation 137 laparoscopic helium plasma coagulation 57 cervical cancer 169 imiquimod laparoscopic ovarian drilling (LOD), testing 164 ano-genital warts 248 polycystic ovarian syndrome 85 vulval cancer 158 vulval intra-epithelial neoplasia 152 laparoscopic uterine artery ligation 52 hydrosalpinges surgery 103 immunotherapy, miscarriage prevention 14 laparoscopic uterine nerve ablation hydrothorax 114 imperforate hymen 70 chronic pelvic pain 202 11β-hydroxylase deficiency 66 Implanon 291 endometriosis 57 21-hydroxylase deficiency 66 see also progestogen-only contraceptives laparoscopy hyperemesis gravidarum 24 in vitro fertilization (IVF) 104 chronic pelvic pain 201 complications 24 endometriosis and 58, 59 consent issues 205 differential diagnosis 24 factors affecting outcome 104 disorders of sexual development 62 investigations 25 hormonal treatment before 59 dysmenorrhoea 28, 30 management 24, 25 long-term safety 105 ectopic pregnancy 22, 23 evidence round-up 26 polycystic ovarian syndrome and 85 endometriosis 55, 57 refractory/severe HG 26 referral 104 infertility 58 rehydration 25 screening 104 infertility investigation 103 service provision 24 incontinence see urinary incontinence myolysis 47 prevalence 24 inflammatory bowel syndrome (IBS) 204 myomectomy 46 hyperprolactinaemia 90 infracoccygeal sacropexy with mesh 137 myometrial electrocoagulation 52 complications 90 inhibin B 62 ovarian cancer 195 diagnosis 91 insulin, polycystic ovarian syndrome ovarian cyst 185, 187, 195 pitfalls 91 pathophysiology 80 cystectomy 59 fertility relationship 94 insulin-sensitizing agents pelvic inflammatory disease 207, 208 history 90 hirsutism 89 pelvic lymph node dissection 15 investigations 91 polycystic ovarian syndrome 83 sterilization 296 management 92 International Ovarian Tumor Analysis tubal patency assessment 103 follow-up 93 (IOTA) Group, malignancy risk tubal surgery 103 pathogenesis 90 estimation 184 vaginal vault prolapse 136 pregnancy and 94 intersex see disorders of sex development laparotomy see also prolactinoma interstitial cystitis 203 ectopic pregnancy 22, 23 hypertension, combined hormonal interval debulking surgery, ovarian cancer 192 ovarian cyst 185, 187 contraception and 254 intracervical insemination 110 laser therapy women aged over 40 years 278 intracytoplasmic sperm injection fibroids 47 hypertrichosis 86 (ICSI) 105, 109 lichen sclerosus 155 hypogonadism, sex-steroid replacement 64 intrauterine contraception (IUC) 259, 292 vulval intra-epithelial neoplasia 152 hypothalamic amenorrhoea 73 as emergency contraception 284, 286 leiomyomas see fibroids hypothyroidism, precocious puberty and 96 efficacy 292 leiomyosarcoma risk 48 hysterectomy 41 emergency contraception indications 286 letrozole, polycystic ovarian syndrome 84 cervical cancer 115, 171 follow-up 259, 292 levator myorraphy 132, 136 cervical intra-epithelial neoplasia 168 insertion 259, 292 levonorgestrel intrauterine system chronic pelvic pain 202 pelvic inflammatory disease and 208 (LNG-IUS) 37, 259 dysmenorrhoea 30 management 209 adenomyosis 51, 53

305

levonorgestrel intrauterine system magnetic therapies, menopausal recurrent 12 (LNG-IUS) (cont.) symptoms 145 history 12 dysmenorrhoea 30 malathion investigations 12, 15 emergency contraception indications 285 Phthirus pubis 239 male factor 13 endometrial cancer 116 scabies 241 management 14, 15 endometriosis 56, 57 male subfertility 101, 107 risk factors 12, 13 fibroids 45 disorders of sexual development and 62 unexplained 14 heavy menstrual bleeding 36 examination 107 see also bleeding in early pregnancy postnatal contraception 283 history 107 misoprostol 11 quick starting contraception 270 investigations 108 miscarriage 6 side effects 259 lifestyle factors 100, 107 pregnancy termination 9 women aged over 40 years 279 management 108 missed pill 274, 285 stopping contraception 252 guideline comparator 110 molar pregnancy see gestational trophoblastic lichen planus 156 what not to do 110 disease lichen sclerosus 154 see also fertility problems molluscum contagiosum 233 examination 154 Marshall test 122 mood changes with hormonal follow-up 155 masculinizing genital surgery 64 contraception 276 medical management 154, 155 maternal age, miscarriage risk relationship 12 Müllerian inhibition, isolated deficiency of 67 surgical management 155 Mayer–Rokitansky–Kuster–Hauser myocardial infarction risk, combined symptoms 154 syndrome 71 hormonal contraception and 254 lichen simplex 156 mefenamic acid women aged over 40 years 278 life style factors adenomyosis 51 myolysis 47 irritable bowel syndrome 204 dysmenorrhoea 31 myomas see fibroids menopausal symptoms 144 megestrol acetate, menopausal symptoms 144 myomectomy 40, 46 subfertility 100, 107 menopausal symptoms 138, 279 abdominal 46 urinary incontinence 123 assessment 138 heavy menstrual bleeding 38, 40 lignans, menopausal symptoms 145 complications 138 labour following, uterine rupture risk 48 liver enzyme-inducing drugs, emergency history 138 laparoscopic 46 contraception indication 285, 286 investigations 139 vs uterine artery ablation 49 long-acting reversible contraception (LARC) 290 management 140, 143, 144, 255 myometrial ablation and excision 52 continuous and extended hormonal complementary therapies 145 myometrial biopsy 50 contraception 293 lifestyle measures 44 myometrial electrocoagulation 52 history and assessment 290 urogenital symptoms 140 intrauterine devices 292 vasomotor symptoms 140 natural killer cells, miscarriage risk progestogen-only implants 290 see also hormone replacement therapy relationship 13, 15 progestogen-only injectable prevalence 138 nausea and vomiting in pregnancy 24 contraceptives 290 see also premature ovarian failure see also hyperemesis gravidarum women aged over 40 years 279 menorrhagia see heavy menstrual bleeding Neisseria gonorrhoeae see gonorrhoea young women 275 metformin 84 non-steroidal anti-inflammatory drugs see also contraception miscarriage prevention 14 (NSAIDs) 31 luteinizing hormone (LH) polycystic ovarian syndrome 83, 84 dysmenorrhoea 30 amenorrhoea investigation 73 methotrexate 23 endometriosis 55 infertility investigation 102 adenomyosis 52 fibroid 45 miscarriage prevention 14 ectopic pregnancy 22, 23 heavy menstrual bleeding 36 polycystic ovarian syndrome metoclopramide, hyperemesis gravidarum 25 norethisterone 37 pathophysiology 80 metronidazole heavy menstrual bleeding 36 precocious puberty investigation 97, 98 bacterial vaginosis 215 nucleic acid amplification tests (NAATs) secondary sexual characteristics and 70 entry into breast milk 215 chlamydia 226 lymphogranuloma venereum (LGV) 223, 231 prophylaxis, pregnancy termination 8 gonorrhoea 225 clinical features 231 Trichomonas vaginalis 220 lymphogranuloma venereum 232 complications 231 microprolactinoma 92 Nugent score, bacterial vaginosis 214 differential diagnosis 231 pregnancy and 94 nystatin, candidiasis 216 investigations 232 mifepristone 11 management 232 adenomyosis 51 obesity, thromboembolism risk follow-up 232 fibroids 45 relationship 298 sexual partners 232 pregnancy termination 9 see also weight loss sample sites 231 migraine obstructive sleep apnoea, polycystic ovarian combined hormonal contraception syndrome and 82 McCune–Albright syndrome 96 and 254, 280 oestradiol management 99 progestogen-only contraception and 256, 258 precocious puberty investigation 97 macroprolactin 91 miscarriage 2 premenstrual syndrome 33 macroprolactinoma 92 clinical features 2 oestrogen pregnancy and 94 follow-up 7 deficiency symptoms 76 magnetic resonance imaging (MRI) management 4, 14 endometriosis management 56 adenomyosis 50 expectant 5 menopausal symptom management 140 chronic pelvic pain 201 medical 6 premature menopause 76 endometriosis 55 service provision 4 overactive bladder management 127 fibroids 47 surgical 6, 7 see also combined hormonal contraception; MRI-guided focused ultrasound energy 47 what not to do 15 hormone replacement therapy ovarian cyst 184, 186 prevalence 2, 12 older women see women aged over 40 years pituitary imaging 91 psychological complications 2 omeprazole, hyperemesis gravidarum 25 306

ondansetron, hyperemesis gravidarum 26 ovarian tissue cryopreservation 118 polycystic ovarian syndrome (PCOS) oocyte cryopreservation 118 ovarian transposition 116 diagnosis 79 oocyte donation 105 overactive bladder 120 differential diagnosis 81 oocyte retrieval 104 management 123, 127 examination 79 cervical cancer and 116 surgical 128 guideline comparator 85 oophorectomy 41 what not to do 129 history 74, 79 ovarian cyst 185, 186 see also urinary incontinence investigations 81 see also bilateral salpingo-oophorectomy; ovulation induction (OI) 104 issues 79, 52 unilateral salpingo-oophorectomy polycystic ovarian syndrome hirsutism 86 oral contraceptive pill see combined oral management 83, 84, 85 management 83, 84, 85 contraceptives pulsatile GnRH 102 pathophysiology 80 osteoporosis safety 105 prevalence 79 HRT benefits 140 ovulatory disorders see fertility problems recurrent miscarriage risk 13, 14 primary amenorrhoea relationship 69 oxybutynin, overactive bladder 127 post-menopausal bleeding (PMB) 179 outflow tract obstruction 71 guideline comparator 181 ovarian cancer 188 pad tests, urinary incontinence 121 histology 181 BRCA1/BCRA2 mutations 198 Paget’s disease, vulval 157 HRT users 179, 180 prophylactic surgery 198 paracentesis, ovarian hyperstimulation incidence 179 combined hormonal contraception syndrome 114 investigations 180 benefits 253, 278 paravaginal repair 132 referral 179 history 188, 196 partial androgen insensitivity (PAIS) 67 risk factors 179 HRT risks 141, 146 pelvic abscess 208 tamoxifen users 179, 180 management 191, 197 pelvic congestion syndrome 202 postnatal contraception 282 advanced disease 192 pelvic floor muscle assessment 121 advice 282 early stage disease 191 pelvic floor muscle training emergency contraception 282 evidence round-up 193 urinary incontinence 124 hormonal methods 283, 298 fertility-sparing treatments 117, 195 utero-vaginal prolapse 131 non-hormonal methods 283 follow-up 194, 197 pelvic inflammatory disease (PID) 29, postnatal fertility 282 recurrent disease 194 206, 211 precocious puberty 95, 96 response evaluation 194, 197 chronic pelvic pain and 202 benign variants 96 what not to do 195 complications 206 classification 95 non-epithelial cancers 196 contraception options 208 CNS lesions and 96, 99 prevalence 188 definition 206 complications 95 referral 150, 189 differential diagnosis 206 definition 95 risk factors 188 examination 206 early sex steroid exposure and 96 screening 188 history 206 examination 97 staging 185, 187, 190, 196 hospital admission 208 gonadotrophin-dependent (GDPP) 96, 99 tissue diagnosis 192 in pregnancy 209 gonadotrophin-independent (GIPP) 96, 99 ovarian cyst 183 investigations 207 history 97 differential diagnosis 183 management 207, 208 idiopathic 96 examination 183 follow-up 208 investigations 97 history 183 HIV-infected women 209 management 99 investigations 184 information provision 208 nonprogressive 95 malignancy risk estimation 184 sexual partners 209 prevalence 95 management 185, 195 surgical 208 progressive central 95, 99 post-menopausal women 185 what not to do 209 pregnancy premenopausal women 186, 187 women with IUD 209 after starting contraception 272 what not to do 187 young women 209 bacterial vaginosis 213, 214 prevalence 183 prevalence 206 cervical cancer and 172 ovarian cystectomy 59, 186 risk factors 206 chancroid treatment 236 bilateral 117 pelvic pain chlamydia treatment 227 ovarian development 61 differential diagnosis 54 donovanosis treatment 238 ovarian diathermy, polycystic ovarian empirical treatment 54 dopamine agonist safety 94 syndrome 83, 85 IUD related 29 genital warts management 248 ovarian hyperstimulation syndrome management 55 hyperprolactinaemia and 94 (OHSS) 111 penicillin, syphilis 243, 244, 245 molluscum contagiosum treatment 233 assessment 113 pentosan polysulphate sodium 203 of unknown location (PUL) 2, 21 examination 111 permethrin management 22 investigations 112, 113 Phthirus pubis 239 pelvic inflammatory disease 209 complications 111 scabies 241 syphilis 244 differential diagnosis 111 pessaries management 244 grading 112 utero-vaginal prolapse 131 termination see termination of pregnancy history 111 vault prolapse 135 trichomoniasis 213 incidence 111 phenothiazines, hyperemesis gravidarum 25 vaginal discharge 213 management 112 Phthirus pubis (crab louse) 239 vulvo-vaginal candidiasis 213, 218 fluid management 113 phytoestrogens, menopausal symptoms women aged over 40 years 277 inpatient care 113 145 see also ectopic pregnancy; gestational surgical 114 pimicrolimus, lichen sclerosus 155 trophoblastic disease thrombosis prevention 114 pituitary imaging 91 preimplantation genetic diagnosis (PGD) risk factors 111 placental aromatase deficiency 66 fragile X syndrome 78 ovarian remnant syndrome 202 placental site trophoblastic tumour 18 recurrent miscarriage and 14 307

premature ovarian failure (POF) 74, 77, 138 prolapse see utero-vaginal prolapse; vault vault prolapse 137 aetiology 74 prolapse smoking complications 74 prolapse reduction stress test 130, 133 in pregnancy, miscarriage risk 12 examination 75 psoriasis, vulval 156 venous thromboembolism risk history 75 puberty association 298 investigations 75 delayed 71 combined hormonal contraception and management 76 Tanner stages 69 254 fertility 76 pyridoxine, hyperemesis gravidarum 25 women aged over 40 years 278 prevalence 74 sperm banking 118 premenstrual syndrome (PMS) 32 Q-tip test 122 spinal manipulation, dysmenorrhoea 29 management 32 quick-starting contraception see contraception spironolactone 89 complementary therapies 33 stellate ganglion blockade, menopausal medical 32 radiotherapy symptoms 144 surgical 33 cervical cancer 171 sterilization 283, 294 prevalence 32 endometrial cancer 177, 178 consent issues 294 prenatal diagnosis, fragile X syndrome 78 prolactinoma 93 history and assessment 294 presacral neurectomy (PSN) vulval cancer 162 procedures 295, 296 chronic pelvic pain 202 ranitidine, hyperemesis gravidarum 25 what not to do 296 dysmenorrhoea 30 rectocele 130 women aged over 40 years 279 progesterone surgical management 132 stress urinary incontinence see urinary endometrial cancer treatment 116 5α-reductase deficiency 67 incontinence miscarriage prevention 14 reflexology, menopausal symptoms 145 stroke risk see also hormone replacement therapy rehydration therapy, hyperemesis combined hormonal contraception 254 progestogen-only contraceptives (POCs) 255 gravidarum 25 HRT 141 emergency contraception 284, 286 residual ovary syndrome 202 women aged over 40 years 278 expected bleeding patterns 272 retroperitoneal lymph node assessment 191 subfertility see fertility problems; male postnatal contraception 283 retropubic suspension procedures 125 subfertility progestogen-only implant (POIM) 258, Risk of malignancy index (RMI) 184 suction curettage 273, 291 miscarriage 6 efficacy 291 sacral colpoperineopexy 132 molar pregnancy 16 insertion 258 sacral nerve stimulation surgical sperm retrieval (SSR) 109 risks and side effects 291 chronic pelvic pain 202 syphilis 242 progestogen-only injectable contraception overactive bladder 128 clinical features 242 (POIC) 257, 273, 290 sacrocolpopexy 132 congenital 242, 245 efficacy 291 St John’s wort, menopausal symptoms 145 in pregnancy 244 risks and side effects 291 salpingectomy, ectopic pregnancy 22, 23 investigations 243 progestogen-only pills (POPs) 256, 273 salpingo-oophorectomy see bilateral management 243, 244, 245 missed pill 274 salpingo-oophorectomy; unilateral risk groups 242 thromboembolism risk 297 salpingo-oophorectomy screening 242, 243, 245 unscheduled bleeding management 273 salpingotomy, ectopic pregnancy 22, 23 systematic retroperitoneal lymphadenectomy women aged over 40 years 279 salt-wasting 63 (SRL) 191 progestogens 37 scabies 241 systemic lupus erythematosus, venous adenomyosis 51 seborrhoeic dermatitis 157 thromboembolism risk and 299 chronic pelvic pain 201 secondary sexual characteristics 70 dysmenorrhoea 30 selective noradrenaline reuptake tacrolimus, lichen sclerosus 155 endometrial cancer 178 inhibitors (SNRIs), menopausal tamoxifen endometrial hyperplasia 174 symptoms 144 endometrial cancer risk 175, 179 endometriosis 56 selective serotonin reuptake inhibitors endometrial hyperplasia risk 173 menopausal symptoms 144 (SSRIs) 34 post menopausal bleeding and 179 polycystic ovarian syndrome 82 menopausal symptoms 144 Tanner stages of puberty 69 premenstrual syndrome 33 premenstrual syndrome 32, 33 termination of pregnancy 8 side effects 139 semen analysis 107 aftercare 10 see also combined hormonal sex cord stromal tumors 196 bacterial vaginosis and 215 contraception; hormone replacement management 197 complications 8 therapy; progestogen-only sexual differentiation 61 infective complication prevention 8 contraceptives sexual function, HRT benefits 140, 146 frequency 8 prolactin sexually transmitted infections (STIs) 221 information provision 8 amenorrhoea investigation 73 advice for young people 275 investigations 8 measurement 91 condom use in prevention 251 medical management 9 see also hyperprolactinaemia female condoms 252 method based on gestational age 10 prolactinoma 90 intrauterine contraception use and 258 service provision 8 investigations 91 risk assessment 210 surgical management 9 malignant 93 testing and screening guidance 221 testicular development 61 management 92 see also specific infections testicular failure macroprolactinoma 92 sickle-cell disease, venous thromboembolism anatomical 67 microprolactinoma 92 risk and 299 enzymatic 67 radiotherapy 93 sleep disturbance, menopause related 138 testosterone resistant 93 sling procedures amenorrhoea investigation 73 surgical 93 urethral 125 increased level 70 see also hyperprolactinaemia utero-vaginal prolapse 132, 133 male infertility investigation 108

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thrombophilia urinary incontinence investigation 122 referral 211 miscarriage risk relationship 12, 13 ultrasound therapy STI risk assessment 210 management 14 adenomyosis 53 STI testing 221 screening 297 fibroids 47 vaginal dryness management 140, 144 venous thromboembolism risk unilateral salpingo-oophorectomy (USO), vaginal sacrospinous fixation 132, 133, 136 relationship 142 ovarian cancer 117, 191 vaginal uterosacral ligament suspension 136 thrombosis see venous thromboembolism urethral closure augmentation 125 vaginal wall repair 136 thyroid disorders, recurrent miscarriage urethral function tests 122 vasal agenesis 108 relationship 13, 15 urethral sling operations 125 vasal obstruction 108 tibolone, endometriosis 56 urinary diversion 128 vasectomy 283, 294, 295 tinidazole, bacterial vaginosis 215 urinary incontinence 120 see also sterilization TORCH, miscarriage risk 13, 15 assessment 121 vasoepididymostomy 109 total mesh reconstruction 137 complications 120 vasovasostomy 109 total parenteral nutrition, hyperemesis definition 120 vault prolapse 130, 135 gravidarum 26 examination 121 assessment 135 toxic metabolite accumulation 74 history 120 management 135 trachelectomy investigations 122 surgical 136, 137 radical abdominal (RAT) 115 life style factors 123 prevalence 135 radical vaginal (RVT) 15 management 123 prevention at hysterectomy 135 tranexamic acid (TXA) 37 recommendations 124, 126 vault suspension to the anterior abdominal adenomyosis 51 stress urinary incontinence 124 wall 137 heavy menstrual bleeding 36 surgical 125, 126 venous thromboembolism 297 trans-abdominal ultrasound see ultrasound what not to do 126, 129 evidence round-up 299 scan prevalence 120 prevalence 297 trans-vaginal ultrasound see ultrasound scan referral indications 121 prophylaxis, ovarian hyperstimulation transcutaneous electrical nerve stimulation risk factors 120 syndrome 114 (TENS), dysmenorrhoea 29 urinary sphincters, artificial 125 risk assessment 142 transrectal USS (TRUS), male infertility urinary tract infection (UTI) 121 risk factors 142, 298, 299 investigation 108 urine dipstick test 121 genetic factors 298 transurethral resection of the ejaculatory urodynamic assessment 121, 122 hormonal contraception 254, 276, 278, duct 109 uroflowmetry 122 297, 298 transvaginal sonography (TVS) uterine anomalies, recurrent miscarriage HRT 141 adenomyosis investigation 50 relationship 12, 13, 15 immobilization 298 endometriosis investigation 55 management 14 obesity 298 Treponema pallidum see syphilis uterine artery embolization (UAE) 40 sickle-cell disease 299 treponemal tests 243 adenomyosis management 52, 53 smoking 298 Trichomonas vaginalis (TV) 212, 219 complications 47 systemic lupus erythematosus 299 complications 219 contraindications 47 women aged over 40 years 278 history 219 fibroid management 47 what not to do 299 in pregnancy 213 evidence round-up 49 videourodynamics 122 investigations 219 fertility issues 48 virilization 86 management 220 pregnancy outcome 49 vitamin supplements refractory TV 220 vs hysterectomy 49 dysmenorrhoea 29 sexual partners 220 vs myomectomy 49 menopausal symptoms 144 prevalence 219 heavy menstrual bleeding management 38, 40 vulval cancer 158 recurrent 213 uterine rupture, following myomectomy 48 examination 158 trigger point injection, chronic pelvic utero-vaginal prolapse 130 histology 159 pain 202 assessment 130 history 158 tubal disorders see Fallopian tube; fertility history 130 HRT and 146 problems management 131 investigations 159 tumour markers 184 consent issues 134 management 161 Turner’s syndrome 71, 74 evidence round up 131 advanced disease 162 twin pregnancies, gestational trophoblastic mesh repair 133 chemotherapy 162, 163 disease (GTD) 17 risks 134 follow-up 162 surgical 132 radiotherapy 162 UKMEC categories for the use of a prevalence 130 surgical 161, 162 contraceptive method 252, 263 risk factors 130 prevalence 158 progestogen-only pills 256 uterosacral ligament suspension 132, 133 prognostic factors 160 ulipristal acetate (UPA), emergency recurrent disease 163 contraception 284, 286 vacuum aspiration risk factors 158 ultrasound scan (USS) miscarriage management 6 staging 160 adenomyosis 50 pregnancy termination 9 vulval intra-epithelial neoplasia (VIN) 151 chronic pelvic pain 201 vaginal cones, urinary incontinence 124 differential diagnosis 151 disorders of sexual development 62 vaginal discharge 210 examination 151 dysmenorrhoea 28 differential diagnosis 210 history 151 fibroids 45 in pregnancy 213 investigations 151 infertility investigation 103 investigations 211 management 151, 152 ovarian cyst 184 management 211 prevalence 151 postmenopausal bleeding 180 empirical treatment 210, 211 surveillance 153 precocious puberty investigation 97 recurrent 213 types 152

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vulval skin conditions 156 recurrent 213, 217 non-hormonal methods 279 see also lichen sclerosus; vulval intra- severe VVC 218 progestogen-only contraceptive benefits epithelial neoplasia and risks 279 vulvectomy 152, 162 weight gain issues with hormonal stopping contraception 280 vulvo-vaginal candidiasis (VVC) 157, 212, contraception 277 pregnancy 277 216 weight loss sexual and reproductive health 277 clinical features 216 hirsutism management 88 see also hormone replacement therapy; diabetes association 218 polycystic ovarian syndrome menopausal symptoms diagnosis 210, 211, 216 management 83, 84 HIV-infected patients 218 urinary incontinence management 123 Y-chromosome microdeletions 108 in pregnancy 213, 218 women aged over 40 years Yasmin 34 management 216, 217 contraception issues 277 premenstrual syndrome 32 treatment failure 216 combined hormonal contraception what not to do 218 benefits and risks 278 zafirlukast, candidiasis 217 non-albicans species 218 HRT and 281 zygote intrafallopian transfer 105 prevalence 216 long-acting reversible contraception 279

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