Women's Health
Gynaecology
Know abnormal uterine bleeding (PALM-COEIN), PCOS (Rotterdam criteria), endometriosis, fibroids, contraception (efficacy, contraindications per UKMEC), and menopause (HRT risks and benefits, VMS management).
Screening and infection
Cervical screening (HPV testing/cytology), breast awareness and mammography, STI screening (chlamydia, gonorrhoea, HIV, syphilis), and pelvic inflammatory disease (empiric treatment, partner notification).
Emergency gynaecology
- Ectopic pregnancy: risk factors, β-hCG, transvaginal ultrasound, discriminatory zone, management (methotrexate vs surgery).
- Ovarian torsion: sudden pain, nausea, surgical emergency.
- Postmenopausal bleeding: always investigate (endometrial cancer).
Traps
- Missing ectopic pregnancy in a woman of reproductive age with abdominal pain (always test β-hCG).
- Prescribing combined hormonal contraception in migraine with aura, smoking >35, or hypertension.
- Attributing postmenopausal bleeding to atrophy without excluding malignancy.
- Confusing PCOS with thyroid or prolactin disorders - exclude them.
Worked rule
Any woman of reproductive age with abdominal pain: do a pregnancy test. A positive test with pain = ectopic until proven otherwise.
Bone and pelvic health
Consider osteoporosis screening post-menopause, pelvic floor dysfunction, and urinary incontinence (stress vs urge; conservative management first).