Gynaecology

Heading our Gynaecology Practice is Mr Nicholas Morris
MBBS MEWI FRCOG

Leading London Gynaecologist

Consultant Gynaecologist Mr Nicholas Morris visits the clinic from Harley Street and has a wealth of experience treating many conditions including  Heavy Periods, Pelvic Pain, Vaginal Atrophy, Endometriosis. He also treats polycystic ovarian disease. He has pioneered  CO2 laser treatment for Lichen Sclerosus, Vaginal Atrophy and Vestibulitus. He will establish local treatments for Pelvic Pain and Endometriosis.

Surgical referral will be  to London Harley Street although pre and post operative care is offered at the clinic locally to save valuable time and expense travelling in and out of London.

A keen advocate of research and its importance, Mr Morris combines his patient-centred approach with an appreciation of the most up-to-date medical advances, to ensure that his patients are well cared for. 

We are using that latest techniques for treating Vaginal Atrophy, Lichen Sclerosus, Vestibulitus and Vulvodynia. Our intimate laser The Mona Lisa Touch Therapy is a painless route to treat symptoms that can debilitate women of all ages.

What is Gynaecology?

Gynaecology is the medical practice which deals with functions and diseases specific to the health of the female reproductive system, usually treating women who aren’t pregnant.

Obstetrics usually treat pregnant women and their unborn children, but scenarios can dictate crossover between the two. For example, women may be referred to consultant gynaecologists in the earlier stages of pregnancy, and obstetricians later in their term.

Gynaecological treatments

vaginal atrophy. mona lisa touch laser therapy. fibroids. endometriosis. menorrhagia (heavy periods). dysmenorrhoea (painful periods). pcos. polyps. prolapse. lichen sclerosus. vestibulitus. post menopausal bleeding. ovarian cancer screening. labiaplasty.

Medical Gynae Procedures

gynae surgical procedures. pelvic reconstruction. labiaplasty & cosmetic gynaecology.

Common Gynaecological Conditions

Heavy periods

Women who experience abnormally heavy menstrual bleeding may have a condition called menorrhagia. This condition causes flows so heavy you need to change your tampon or pad every hour.

This condition can cause anemia and severe cramps. A blockage in the uterus can also cause a heavier flow, which results in more blood pooling. Blockages may occur as a result of growths in the uterus. These include uterine polyps and fibroids, which are not cancerous but can cause other health issues without proper management.


Bleeding between periods

Abnormal vaginal bleeding between periods is also called intermenstrual bleeding, spotting, and metrorrhagia. When bleeding occurs between normal periods, there are many possible causes.

While some causes may be easy to treat, others can indicate a serious underlying condition. Whether you notice spotting or heavier bleeding between periods, it’s important to see your doctor for testing, diagnosis, and treatment options. Potential causes of bleeding between periods include:

  • a growth in your uterus or cervix
  • stress
  • a change in medication
  • a miscarriage
  • vaginal dryness
  • a hormone imbalance
  • cancer

Intermittent or irregular periods

Most women have menstrual periods that last four to seven days. A woman’s period usually occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days.

Examples of menstrual problems include:

  • Periods that occur less than 21 days or more than 35 days apart
  • Missing three or more periods in a row
  • Menstrual flow that is much heavier or lighter than usual
  • Periods that last longer than seven days
  • Periods that are accompanied by pain, cramping, nausea, or vomiting
  • Bleeding or spotting that happens between periods, after menopause, or following sex

Lichen Sclerosus

Lichen sclerosus is a skin condition that causes itchy white patches on the genitals or other parts of the body. There’s no cure, but treatment can help relieve the symptoms.

Lichen sclerosus affects people of all ages, including children. But it’s much more common in women over 50.

It causes patches on the skin that are usually:

  • itchy
  • white
  • smooth or crinkled
  • easily damaged – they may bleed or hurt if rubbed or scratched

The patches can appear anywhere, but most often are on the:

  • area around the opening of the vagina (vulva) and anus – in girls and women
  • foreskin and end of the penis – in boys and men

Endometriosis

Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes.

Endometriosis can affect women of any age, but it’s most common in women in their 30s and 40s.

It’s a long-term condition that can have a significant impact on your life, but there are treatments that can help.

The symptoms of endometriosis can vary. Some women are badly affected, while others might not have any noticeable symptoms.

The main symptoms of endometriosis are:

  • pain in your lower tummy or back (pelvic pain) – usually worse during your period
  • period pain that stops you doing your normal activities
  • pain during or after sex
  • pain when peeing or pooing during your period
  • feeling sick, constipation, diarrhoea, or blood in your pee during your period
  • difficulty getting pregnant

You may also have heavy periods – you might use lots of pads or tampons, or you may bleed through your clothes.

For some women, endometriosis can have a big impact on their life and may sometimes lead to feelings of depression.

See your Gynaecologist if you have symptoms of endometriosis, especially if they’re having a big impact on your life.

It may help to write down your symptoms before seeing your doctor. Endometriosis UK has a pain and symptoms diary (PDF, 238kb) you can use.

It can be difficult to diagnose endometriosis because the symptoms can vary considerably, and many other conditions can cause similar symptoms.

Your Gynaecologist will ask about your symptoms, and may ask to examine your tummy and vagina.

They may recommend treatments if they think you have endometriosis.

Vulvodynia (vulval pain) & Vestibulitus

Vulvodynia is persistent, unexplained pain in the vulva (the skin surrounding the entrance to the vagina).

Localised provoked vestibulodynia is a very common type of vulvodynia.  The term is used to describe pain or irritation that occurs in the vestibule, or the area of the female vulva that surrounds the opening of the vagina. LPV can occur in women of all ages, and whether or not they have ever been sexually active. LPV used to be called vulvar vestibulitis.

Patients who have LPV experience pain with any kind of pressure or touch at the vestibule. Intercourse, tampon use, tight clothes, bicycle-riding, and sometimes just sitting or standing for long periods, can be painful. Often, there is redness on the skin where the pain is located.

It can affect women of all ages, and often occurs in women who are otherwise healthy.

Vulvodynia can be a long-term (chronic) problem that’s very distressing to live with, but much can be done to help relieve the pain.

The main symptom of vulvodynia is persistent pain in and around the vulva. The vulva usually looks normal.

The pain may be:

  • a burning, stinging or sore sensation
  • triggered by touch, such as during sex or when inserting a tampon
  • constantly in the background and can be worse when sitting
  • limited to part of the vulva, such as the opening of the vagina
  • more widespread – sometimes it can spread to the buttocks and inner thighs

Having chronic pain can also affect relationships, reduce sex drive, and cause low mood and depression. Pain in the genital area is often difficult to talk about with friends and it’s not uncommon to feel isolated.

See your Gynaecologist or visit if you have persistent vulval pain. Vulvodynia is unlikely to get better on its own and some of the treatments are only available on prescription. There are also a number of other causes of vulval pain that need to be ruled out.

Your doctor will ask about your symptoms and may touch your vulva lightly with the tip of a cotton bud to see if this causes pain. A swab may also be taken to check for conditions such as infections.

Many people with vulval pain can have the condition for many years before a diagnosis is made and proper management started.


Abdominal or pelvic pain

Pelvic pain affects the lowest part of the abdomen, between the belly button and groin. In women, pelvic pain may be a sign of menstrual cramps, ovulation, or a gastrointestinal issue such as a food intolerance. It can also develop due to a more serious problem.

Sometimes, pelvic pain is an indicator of an infection or issue with the reproductive system or other organs in the area. When this is the case, a woman may need to see a doctor.


Vaginal Atrophy

Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls due to your body having less estrogen. Vaginal atrophy occurs most often after menopause.

For many women, vaginal atrophy not only makes intercourse painful, but also leads to distressing urinary symptoms. Because of the interconnected nature of the vaginal and urinary symptoms of this condition, experts agree that a more accurate term for vaginal atrophy and its accompanying symptoms is “genitourinary syndrome of menopause (GSM).”

Simple, effective treatments for genitourinary syndrome of menopause — vaginal atrophy and its urinary symptoms — are available. Reduced estrogen levels result in changes to your body, but it doesn’t mean you have to live with the discomfort of GSM.

Along with various hormone supplementation options we also offer The Mona Lisa Laser Therapy for the treatment of Vaginal Atrophy. A pain free, hormone free option with very little down time.

With moderate to severe genitourinary syndrome of menopause (GSM), you may experience the following vaginal and urinary signs and symptoms:

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with urination
  • Urgency with urination
  • More urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop in or on your ovaries. They’re quite common and girls and women of any age can get them. Most ovarian cysts don’t cause any symptoms and they’re usually benign (non-cancerous).

Most ovarian cysts are small and don’t cause symptoms. If a cyst does cause symptoms, you may have pressure, bloating, swelling, or pain in the lower abdomen on the side of the cyst. This pain may be sharp or dull and may come and go. If a cyst ruptures, it can cause sudden, severe pain.

In most cases, ovarian cysts disappear in a few months without the need for treatment.

Whether treatment is needed will depend on:

  • its size and appearance
  • whether you have any symptoms
  • whether you’ve had the menopause. Post-menopausal women have a slightly higher risk of ovarian cancer

In most cases, a policy of “watchful waiting” is recommended.

This means you won’t receive immediate treatment, but you may have an ultrasound scan a few weeks or months later to check if the cyst has gone.

Women who have been through the menopause may be advised to have ultrasound scans and blood tests every four months for a year, as they have a slightly higher risk of ovarian cancer.

If the scans show that the cyst has disappeared, further tests and treatment aren’t usually necessary. Surgery may be recommended if the cyst is still there.

Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed. Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous

There are two types of surgery used to remove ovarian cysts:


Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman’s ovaries work.

The 3 main features of PCOS are:

  • irregular periods – which means your ovaries do not regularly release eggs (ovulation)
  • excess androgen – high levels of “male hormones” in your body, which may cause physical signs such as excess facial or body hair
  • polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)

If you have at least 2 of these features, you may be diagnosed with PCOS.

Polycystic ovaries contain a large number of harmless follicles that are up to 8mm (approximately 0.3in) in size. 

The follicles are underdeveloped sacs in which eggs develop. In PCOS, these sacs are often unable to release an egg, which means ovulation does not take place.

It’s difficult to know exactly how many women have PCOS, but it’s thought to be very common, affecting about 1 in every 5 women in the UK.

More than half of these women do not have any symptoms.

If you have signs and symptoms of PCOS, they’ll usually become apparent during your late teens or early 20s.

PCOS is also associated with an increased risk of developing health problems in later life, such as type 2 diabetes and high cholesterollevels.

What causes PCOS?

The exact cause of PCOS is unknown, but it often runs in families.

It’s related to abnormal hormone levels in the body, including high levels of insulin. Insulin is a hormone that controls sugar levels in the body. Many women with PCOS are resistant to the action of insulin in their body and produce higher levels of insulin to overcome this. This contributes to the increased production and activity of hormones like testosterone.

Being overweight or obese also increases the amount of insulin your body produces.

Find out more about the causes of PCOS

Treating PCOS

There’s no cure for PCOS, but the symptoms can be treated.

If you have PCOS and you’re overweight, losing weight and eating a healthy, balanced diet can make some symptoms better.

Medications are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems.

If fertility medications are ineffective, a simple surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended. This involves using heat or a laser to destroy the tissue in the ovaries that’s producing androgens, such as testosterone.

With treatment, most women with PCOS are able to get pregnant.


Infertility

Infertility is when a couple can’t get pregnant (conceive) despite having regular unprotected sex.

Around 1 in 7 couples may have difficulty conceiving. This is approximately 3.5 million people in the UK.

About 84% of couples will conceive naturally within a year if they have regular unprotected sex (every 2 or 3 days).

For couples who’ve been trying to conceive for more than 3 years without success, the likelihood of getting pregnant naturally within the next year is 25% or less.

Getting help

Some women get pregnant quickly, but for others it can take longer. It’s a good idea to see your Gynaecologist if you haven’t conceived after a year of trying.

Women aged 36 and over, and anyone who’s already aware they may have fertility problems, should see their Gynaecologist sooner.

They can check for common causes of fertility problems and suggest treatments that could help.

Infertility is only usually diagnosed when a couple haven’t managed to conceive after a year of trying.

There are 2 types of infertility:

  • primary infertility – where someone who’s never conceived a child in the past has difficulty conceiving
  • secondary infertility – where someone has had 1 or more pregnancies in the past, but is having difficulty conceiving again

Read more about how infertility is diagnosed.

Treating infertility

Fertility treatments include:

  • medical treatment – for lack of regular ovulation
  • surgical procedures – such as treatment for endometriosis, repair of the fallopian tubes, or removal of scarring (adhesions) within the womb or abdominal cavity  
  • assisted conception – this may be intrauterine insemination (IUI) or in vitro fertilisation (IVF)

Pelvic Organ Prolapse

Pelvic organ prolapse is when one or more of the organs in the pelvis slip down from their normal position and bulge into the vagina.

It can be the womb (uterus), bowel, bladder or top of the vagina.

A prolapse isn’t life-threatening, but it can cause pain and discomfort. Symptoms can usually be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed.

Symptoms of pelvic organ prolapse:

  • a feeling of heaviness around your lower tummy and genitals (pelvis)
  • a dragging discomfort inside your vagina
  • feeling like there is something coming down into your vagina – it may feel like sitting on a small ball
  • feeling or seeing a bulge or lump in or coming out of your vagina
  • discomfort or numbness during sex
  • problems peeing – such as feeling like your bladder isn’t emptying fully, needing to go to the toilet more often, or leaking a small amount of pee when you cough, sneeze or exercise (stress incontinence)

Sometimes pelvic organ prolapse has no symptoms and is found during an internal examination carried out for another reason, such as cervical screening.

When to see your Gynaecologist

See your Gynaecologist if you have any of the symptoms of a prolapse, or if you notice a lump in or around your vagina.

What happens at your appointment?

Your doctor will ask if they can do an internal pelvic examination.

For this you will need to undress from the waist down and lie back on the examination bed. Your doctor will then feel for any lumps in your pelvic area and inside your vagina. They may gently put an instrument called a speculum into your vagina to hold the walls of it open so they can see if there is a prolapse.

Sometimes they will ask you to lie on your left-hand side and examine you in that position to get a better view of the prolapse.

Some women may put off going to their Gynaecologist if they’re embarrassed or worried about what the doctor may find. However, the examination is important. It only takes a few minutes and is similar to having a smear test.

You can ask for this examination to be done by a female doctor and, if you like, bring someone you trust along with you for support.

Further tests:

  • a urine test to look for an infection
  • inserting a small tube into your bladder to look for any problems

Treatment for pelvic organ prolapse

If you don’t have any symptoms, or the prolapse is mild and not bothering you, you may not need medical treatment. But making some lifestyle changes will probably still help.

If the prolapse is more severe, or your symptoms are negatively affecting your daily life, there are several medical treatment options to consider, including:

The recommended treatment will depend on the type and severity of the prolapse, your symptoms and your overall health. You and your doctor will decide together what is the best option for you.

Read more about treatment for pelvic organ prolapse.

Causes of pelvic organ prolapse

Pelvic organ prolapse happens when the group of muscles and tissues that normally support the pelvic organs, called the pelvic floor, becomes weakened and can’t hold the organs in place firmly.

A number of things can weaken your pelvic floor and increase your chance of developing pelvic organ prolapse, including:

  • pregnancy and childbirth – especially if you had a long, difficult birth, or if you gave birth to a large baby or multiple babies
  • getting older and going through the menopause
  • being overweight or obese
  • having long-term constipation or a long-term condition that causes you to cough and strain
  • having a hysterectomy
  • a job that requires a lot of heavy lifting

Some health conditions can also make a prolapse more likely, including:

Types of prolapse

The 4 main types of prolapse are:

  1. the bladder bulging into the front wall of the vagina (anterior prolapse)
  2. the womb bulging or hanging down into the vagina (uterine prolapse)
  3. the top of the vagina (vault) sagging down (vault prolapse) – this happens to some women after they have had surgery to remove their womb
  4. the bowel bulging forward into the back wall of the vagina (posterior wall prolapse)

It’s possible to have more than one of these at the same time.

Pelvic organ prolapse will usually be classified on a scale of 1 to 4 to show how severe it is, with 4 being a severe prolapse.


The Female Health Clinic provide comprehensive private care for women in Hampshire with a wide range of gynaecology issues.

If you want to learn more about your gynaecology problem the links below have very helpful and detailed information.


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