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The shamefulness associated with the examination of female genitalia has long inhibited the science of gynaecology. This 1822 drawing by Jacques-Pierre Maygnier shows a "compromise" procedure, in which the physician is kneeling before the woman but cannot see her genitalia. Modern gynaecology has shed these inhibitions.

Gynaecology or gynecology (see spelling differences) literally means "the science of women", but in medicine this is the specialty of diseases of the female reproductive system (uterus, vagina, and ovaries). Almost all modern gynaecologists are also obstetricians; see Obstetrics and gynaecology. Image File history File links Wiki_letter_w. ... Image File history File links Gynaecology-1822. ... Image File history File links Gynaecology-1822. ... A sex organ, or primary sexual characteristic, narrowly defined, is any of those parts of the body (which are not always bodily organs according to the strict definition) which are involved in sexual reproduction and constitute the reproductive system in an complex organism; namely: Male: penis (notably the glans penis... The Doctor by Samuel Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ... American and British English spelling differences are one aspect of American and British English differences. ... A sex organ, or primary sexual characteristic, narrowly defined, is any of those anatomical parts of the body (which are not always bodily organs according to the strict definition) which are involved in sexual reproduction and constitute the reproductive system in a complex organism; namely: Male: penis (notably the glans... The uterus or womb is the major female reproductive organ of most mammals, including humans. ... The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ... Human female internal reproductive anatomy Ovaries are a part of a female organism that produces eggs. ... This does not cite its references or sources. ... Obstetrics and Gynecology (often abbreviated to OB/GYN or O&G) form a single medical speciality and have a combined postgraduate training program. ...

History

In the United States, J. Marion Sims is considered the father of American gynaecology. Practitioners included Dr. Benjamin B. Weinstein (1913-1974) of Tulane University in New Orleans, who specialized in fertility studies. J. Marion Sims, born James Marion Sims on January 25, 1813 in Hanging Rock, South Carolina is a surgical pioneer and considered the father of American gynecology. ... Benjamin Bernard Weinstein (August 25, 1913 - May 10, 1974) was a New Orleans physician who specialized in gynecology and fertility research. ... Year 1913 (MCMXIII) was a common year starting on Wednesday (link will display the full calendar). ... 1974 (MCMLXXIV) was a common year starting on Tuesday. ... Tulane University is a private, nonsectarian, coeducational research university located in New Orleans, Louisiana. ... New Orleans is the largest city in the state of Louisiana, United States of America. ... Fertility is a measure of reproduction: the number of children born per couple, person or population. ...

Examination

It is typically a consultant specialty. In most countries women must see a general practitioner (GP; also known as a family practitioner (FP)) first. If their condition requires knowledge or equipment unavailable to the GP they are referred to a gynaecologist. However in the United States law and many health insurance plans allow gynaecologists to provide primary care and some women select that option. This article or section does not cite its references or sources. ... Health insurance is a type of insurance whereby the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. ... Primary care may be provided in community health centres. ...

As in all of medicine the main tools of diagnosis are clinical history and examination. Gynaecological examination is special in that it is quite intimate, and it involves special equipment, the speculum. The speculum consists of two hinged blades of concave metal or plastic which are used to retract the tissues of the vagina and permit examination of the cervix the lower part of the uterus located within the upper portion of the vagina. Gynaecologists typically do a bimanual examination (one hand on the abdomen two fingers in the vagina) to palpate the cervix, uterus, ovaries and bony pelvis. It is not uncommon to do a rectovaginal exam for complete evaluation of the pelvis particularly if any suspicious masses are appreciated. Male gynaecologists often have a female chaperone (nurse or medical student) for their examination. An abdominal and/or vaginal ultrasound can be used to confirm any abnormalities appreciated with the bimanual examination or when indicated by the patient's history. A vaginal speculum, such as this Ricord-type speculum, is used to hold the vagina open for visual examinations, taking of samples, or surgery. ... Schematic frontal view of female anatomy The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ... The pelvis (pl. ... A chaperon (or chaperone) is an adult who accompanies or supervises one or more young, unmarried men or women during social occasions usually with the specific intent of preventing inappropriate social or sexual interactions. ... This article focuses on the education and regulation of nurses. ... Obstetric sonogram of a fetus at 16 weeks. ...

Diseases

The main conditions dealt with by a gynaecologist are:

1. Cancer of the reproductive organs including ovaries, fallopian tubes, uterus, vagina, and vulva
2. Incontinence of urine.
3. Amenorrhoea (absent menstrual periods)
4. Dysmenorrhoea (painful menstrual periods)
5. Infertility
6. Menorrhagia (heavy menstrual periods). This is a common indication for hysterectomy.
7. Prolapse of pelvic organs

Obviously there is some crossover in these areas. For example a woman with incontinence may be referred to a urologist. Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges (singular salpinx), are two very fine tubes leading from the ovaries of female mammals into the uterus. ... This article or section is not written in the formal tone expected of an encyclopedia article. ... Amenorrhoea (BE) or amenorrhea (AmE) is the absence of a menstrual period in a woman of reproductive age. ... Menstrual cycle The menstrual cycle is a recurring cycle of physiological changes in the females of some animal species that is associated with reproductive fertility. ... Dysmenorrhea (or dysmenorrhoea), cramps or painful menstruation, involves menstrual periods that are accompanied by either sharp, intermittent pain or dull, aching pain, usually in the pelvis or lower abdomen. ... Infertility is the inability to naturally conceive a child or to carry a pregnancy to full term. ... Menorrhagia is an abnormally heavy and prolonged menstrual period. ... This article or section is in need of attention from an expert on the subject. ... Prolapse literally means To fall out of place. ... This article or section is in need of attention from an expert on the subject. ...

Therapies

As with all surgical specialties, gynaecologists may employ medical or surgical therapies (or many times, both), depending on the exact nature of the problem that they are treating. Pre- and post-operative medical management will often employ many "standard" drug therapies, such as antibiotics, diuretics, antihypertensives, and antiemetics. Additionally, gynaecologists make frequent use of "specialized" hormone-modulating therapies (such as Clomifene citrate and oral contraceptive pills) to treat disorders of the female genital tract that are responsive to pituitary and/or gonadal signals. An antibiotic is a drug that kills or slows the growth of bacteria. ... A diuretic is any drug that tends to increase the flow of urine from the body (diuresis). ... In medicine and pharmacology, antihypertensives are a class of drugs that are used in the treatment of arterial hypertension. ... Wikipedia does not yet have an article with this exact name. ... Norepinephrine A hormone (from Greek όρμή - to set in motion) is a chemical messenger from one cell (or group of cells) to another. ... Clomifene (INN) or clomiphene (USAN and former BAN) is a selective estrogen receptor modulator (SERM), used mainly in female infertility due to anovulation (e. ... Oral contraceptives are contraceptives which are taken orally and inhibit the bodys fertility by chemical means. ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ... The gonad is the organ that makes gametes. ...

Surgery, however, is the mainstay of gynaecological therapy. For historical reasons gynaecologists are not usually considered "surgeons," although this point has always been the source of some controversy. Modern advancements in both fields, however, have blurred many of the once rigid lines of distinction. The rise of sub-specialties within gynaecology which are primarily surgical in nature (for example urogynaecology and gynaecological oncology) have strengthened the reputations of gynaecologists as surgical practitioners, and many surgeons and surgical societies have come to view gynaecologists as comrades of sorts. As proof of this changing attitude, gynaecologists are now eligible for fellowship in both the American and Royal Colleges of Surgeons, and many newer surgical textbooks include chapters on (at least basic) gynaecological surgery. The Royal College of Surgeons of England is an independent professional body committed to promoting and advancing the highest standards of surgical care for patients. ...

Some of the more common operations that gynaecologists perform include:

1. Dilation and curettage (removal of the uterine contents for various reasons, including partial miscarriage and dysfunctional uterine bleeding refractive to medical therapy)
2. Hysterectomy (removal of the uterus)
3. Oophorectomy (removal of the ovaries)
4. Tubal ligation
5. Hysteroscopy
6. Diagnostic laparoscopy - used to diagnose and treat sources of pelvic and abdominal pain; perhaps most frequently used to provide definitve diagnosis of endometriosis
7. Exploratory laparotomy - may be used to investigate the level of progression of benign or malignant disease, or to assess and repair damage to the pelvic organs
8. Colposuspension - "tightening" of the ligaments around the vagina: a common therapy for incontinence and discomfort in older women
9. Appendectomy - often performed to remove site of painful endometriosis implantation and/or prophylactically (against future acute appendicitis) at the time of hysterectomy or Cesarean section. May also be performed as part of a staging operation for ovarian cancer.
10. Cervical Excision Procedures (including cryosurgery, LLETZ, LEEP) - removal of the surface of the cervix containing pre-cancerous cells which have been previously identified on Pap smear.

Dilation (dilatation) and curettage (D&C) is a gynaecological procedure performed on the female reproductive system, often as a form of abortion. ... This article or section is in need of attention from an expert on the subject. ... Oophorectomy is the surgical removal of the ovaries of a female animal. ... Tubal ligation is a permanent, but sometimes reversible form of female sterilization, in which the fallopian tubes are severed and sealed, in order to prevent fertilization. ... Hysteroscopy is the inspection of the uterine cavity by endoscopy. ... Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... A laparotomy is a surgical maneuver involving an incision through the abdominal wall to gain access into the abdominal cavity. ... An appendicectomy (or appendectomy) is the surgical removal of the vermiform appendix. ... Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix[1]. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. ... This article or section is in need of attention from an expert on the subject. ... A caesarean section (cesarean section AE), is a surgical incision through a mothers abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more fetuses. ... The stage of a cancer is a descriptor (usually numbers I to IV) of how much the cancer has spread. ... Ovarian cancer is a malignant ovarian neoplasm (an abnormal growth located on the ovaries). ... Schematic frontal view of female anatomy The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ... The pap smear as we know it is an invention of Dr. Georgios Papanikolaou (1883-1962), an American of Greek birth, the father of cytopathology. ...

See also

• Andrology, the study of the male reproductive system.
• Cervical cancer
• Dalkon Shield
• HPV vaccine
• Hydatiform mole
• Obstetrics
• Pelvic inflammatory disease (PID)
• Reproduction medicine
• Sexually transmitted disease

Andrology (from the Greek andros, man) is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. ... Cervical cancer is a malignancy of the cervix. ... Dalkon Shield was the name of a contraceptive intrauterine device (IUD) introduced by the Dalkon Corporation. ... Human papillomavirus (HPV) vaccine research focuses on the prevention of diseases, such as cervical cancer and genital warts, caused by sexually transmitted human papillomaviruses. ... Hydatiform mole (or mola hydatiforma) is a disease of trophoblastic proliferation. ... This does not cite its references or sources. ... Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. ... Reproductive endocrinology (RE) is a medical subspecialty that addresses hormonal functioning as it pertains to reproduction. ... Sexually transmitted infections (STIs) — also known as sexually transmissible diseases(STDs), venereal diseases (VD), or infrequently, social disease — are diseases or infections that have a significant probability of transmission between humans by means of sexual contact, vaginal intercourse, oral sex, or anal sex. ...

References

External links

• Ingenious: archive of historical images related to obstetrics, gynaecology, and contraception.
• Articles and News on Obstetrics and Gynecology