Gynecological Conditions: An Overview

Menstrual conditions

Structural and benign growths

• Uterine fibroids: non-cancerous muscle growths in the uterus; very common; cause heavy periods, pressure and frequent urination.
• Adenomyosis: uterine lining tissue grows into the muscle wall, causing heavy, painful periods.
• Endometrial and cervical polyps: cause bleeding between periods.
• Ovarian cysts: usually harmless fluid sacs; can cause pain, rupture or torsion.
• Bartholin cyst or abscess: a swelling at the vaginal opening.

Hormonal and chronic pain conditions

• Endometriosis: tissue similar to the uterine lining grows outside the uterus, causing painful periods, pain during sex, chronic pelvic pain and infertility. Diagnosis is often delayed by years.
• Polycystic ovary syndrome: irregular periods, excess hair growth, acne and difficulty conceiving; linked to insulin resistance.
• Chronic pelvic pain: pain lasting 6 months or more from gynecologic, bladder, bowel or musculoskeletal causes.
• Vulvodynia: chronic vulvar burning or pain without a visible cause.
• Primary ovarian insufficiency: the ovaries stop functioning before age 40.

Infections

• Vaginal yeast infection: itching, soreness and thick white discharge.
• Bacterial vaginosis: thin gray discharge with a fishy smell.
• Sexually transmitted infections: chlamydia, gonorrhea, trichomoniasis, herpes, HPV, syphilis.
• Pelvic inflammatory disease: infection of the uterus, tubes and ovaries, often from untreated chlamydia or gonorrhea; can cause infertility and ectopic pregnancy.

Pelvic floor and urogynecologic conditions

• Pelvic organ prolapse: the bladder, uterus or rectum bulges into the vagina, causing pressure or a lump.
• Urinary incontinence: stress and urge leakage.
• Fistulas after childbirth or surgery (rare in high-income countries).

Skin conditions of the vulva

• lichen sclerosus: itchy, white, thin skin; needs treatment and monitoring
• lichen planus, eczema and psoriasis
• contact dermatitis from products

Menopause and aging

• hot flashes, night sweats and sleep problems
• genitourinary syndrome of menopause: vaginal dryness, pain with sex and urinary symptoms
• bone loss

Pregnancy-related conditions

• miscarriage and ectopic pregnancy
• infertility
• conditions after childbirth such as postpartum hemorrhage and pelvic floor injury

Gynecologic cancers

When to see a gynecologist

See a primary care doctor or gynecologist for:

• abnormal, heavy or painful periods
• bleeding between periods, after sex or after menopause
• pelvic pain or pain with sex
• unusual discharge, itching or sores
• pelvic pressure or a bulge
• difficulty conceiving after 12 months (6 months if over 35)
• contraception and preconception advice
• routine cervical screening

What to expect

Your clinician will ask about your periods, pregnancies, sexual health, contraception and symptoms, and may perform an abdominal and pelvic examination. Common tests include urine and pregnancy tests, swabs for infections, cervical screening, blood tests for hormones and anemia, and pelvic ultrasound.

Staying well

• attend cervical screening as recommended (typically every 3 to 5 years from age 21 to 65)
• get the HPV vaccine (recommended at 11 to 12, and catch-up through age 26, sometimes later)
• use condoms with new partners and get STI testing
• maintain a healthy weight and stay active
• know your family history of breast, ovarian, uterine and bowel cancer

Frequently asked questions

What are the most common gynecological conditions?

The most common include period problems such as heavy or painful periods, vaginal infections like yeast and bacterial vaginosis, uterine fibroids, endometriosis, polycystic ovary syndrome, ovarian cysts, pelvic floor problems and menopause symptoms.

What symptoms should I see a gynecologist about?

See a doctor for abnormal or very heavy bleeding, bleeding after sex or after menopause, pelvic pain, pain during sex, unusual discharge, itching or sores, a pelvic bulge, or difficulty getting pregnant.

Are gynecological conditions serious?

Most are not life-threatening and are very treatable, though some, such as endometriosis, can significantly affect quality of life. Gynecologic cancers are less common but serious, so symptoms like postmenopausal bleeding or persistent bloating should be checked promptly.

Can gynecological problems affect fertility?

Yes. Endometriosis, PCOS, fibroids, pelvic inflammatory disease and ovarian insufficiency can all affect fertility. Many of these can be treated, and fertility specialists can help if you have difficulty conceiving.

How can I prevent gynecological cancers?

HPV vaccination and regular cervical screening prevent most cervical cancers. Maintaining a healthy weight lowers endometrial cancer risk. Women with a strong family history of ovarian or breast cancer should discuss genetic testing. Reporting abnormal bleeding early helps catch uterine cancer.