Specialty Area: Gynecology

Description of Specialty: Gynecology is the area of medicine which diagnosis and treats abnormalities and diseases of the female organs.

1. Diagnosis: Vaginal Discomfort/Child Discharge

Questions that should be asked: (by mom for child)

1. Why does she have this discharge/irritation?
2. Is there anything we can do differently to prevent this discharge/irritation?
3. Is it true that bubble baths, perfumed or deodorant soaps can cause irritation?
4. Does it matter if she wipes from front to back or not?
5. Does soaking in plain warm bath water help?
6. Can this be a sign of another problem?

2. Diagnosis: Vaginal Bleeding (child)

Questions that should be asked:

1. What age is too young for vaginal bleeding? (Any age before secondary development.)
2. Can swelling around the urethra cause bleeding? (urethral prolapse)
3. Can a vaginal infection cause bleeding?
4. Can a tumor cause bleeding?
5. Is trauma (either accidental or abuse) the only cause of bleeding?
6. What is precocious puberty?

3. Diagnosis: Irregular Periods/teen Questions that should be asked:

1. At what age should periods become regular?
2. Does my daughter's acne, and excess body hair play a possible role in her menstrual irregularities?
3. When should I worry about her periods?
4. If my daughter is bleeding more than once a month, should other tests be run?

4. Diagnosis: Failure to start to menstruate by age 14-15 years old

1. Questions that should be asked: At what age should my daughter menstruate?
2. If my daughter has normal breast development, at what age should she menstruate?
3. If my daughter has no signs of breast development should I worry?
4. Is pregnancy a possibility?
5. Is her nutrition a possible cause for failure to menstruate?
6. Are her athletics a cause for failure to menstruate?
7. Should her body weight to be taken into consideration?

5. Diagnosis: Wants Birth Control

Questions that should be asked:

1. What guidelines should my sexually active daughter follow to prevent AIDS and STDs?
2. birth control? How can I increase my daughter's chances of using her medication correctly?
3. What should my daughter do if she has unprotected intercourse?
4. What is "emergency contraception"?

6. Diagnosis: Menopause

Questions that should be asked:

1. What is menopause?
2. What are the symptoms of menopause?
3. How can we tell if I have really reached menopause?
4. If my mother had breast cancer, can I use hormones?
5. What do you think about estrogen replacement?
6. What about "natural" hormones?
7. If I had a hysterectomy, how will I know I'm in menopause?
8. Do I need a bone density test?
9. Do I still need pap smears and mammograms?

7. Diagnosis: UTI (urinary tract infections)

Questions that should be asked:

1. Does sexual intercourse play a role in urinary tract infections (UTIs)?
2. Does wiping incorrectly play a role in UTIs?
3. If I take cranberry juice will it help?
4. How many days should I take antibiotics?
5. Do I have to do a culture, or get a "proof of cure after taking antibiotics"?
6. At what point should I see a specialist?
7. Should I empty my bladder after sex or use medications after sex to decrease my risk of UTIs?

8. Diagnosis: Abnormal Pap Smear

Questions that should be asked:

1. What is the most likely cause of an abnormal Pap smear?
2. What is a colposcopy?
3. If a person has an abnormal pap smear, does that mean she will get cancer?
4. What steps should be taken for this condition?
5. Do I need to see a specialist?
6. What is the natural history of ASCUS, LGSIL, and HGSIL?

9. Diagnosis: Dyspareunia

Questions that should be asked:

1. Why am I having painful intercourse?
2. Do I have an infection?
3. Do I have enough estrogen?
4. Are there sexual positions that may be more comfortable?
5. What is vaginismus?
6. Can you have sex when you are pregnant?
7. Post partum?
8. Menopausal?

10. Diagnosis: Enlarged Uterus/Fibroids

Questions that should be asked:

1. How common are fibroids?
2. Will they interfere with pregnancy?
3. Do they cause pain?
4. Do they go away after menopause?
5. Do they require surgery?
6. Can they cause heavy bleeding?
7. Can they press on my bladder and make me feel like I have to go to the bathroom?
8. Are they common among women in a family?

11. Diagnosis: Endometriosis

Questions that should be asked:

1. How do you diagnose endometriosis?
2. Does it cause painful periods?
3. Painful intercourse?
4. Does it seem to run in families (genetic or inheritance)?
5. Can I have endometriosis and not know it?
6. Do I have to have surgery to diagnose endometriosis?
7. What are the pros and cons of the different therapies?
8. Which therapy will increase my chances of being able to become pregnant?

12. Diagnosis: Infertility

Questions that should be asked:

1. How often is infertility diagnosed?
2. Is it ever a male problem?
3. Does my weight matter?
4. If my periods were never regular, does that matter?
5. What can I do short of medication to enhance my chances of becoming pregnant?
6. What are the different tests that should be run?
7. Will my insurance pay for any of these tests?
8. What medications can be used?
9. What are the pros and cons of therapy?
10. Are there any support groups for infertility?

13. Diagnosis: Ectopic Pregnancy

Questions that should be asked:

1. Do you have to operate on me if I have a tubal pregnancy?
2. Are there other treatment options that may preserve my fallopian tube?
3. What will this ectopic pregnancy mean in terms of future pregnancies?
4. Why do you follow blood tests? (BHCG's)

14. Diagnosis: Premenstrual Syndrome (PMS)

Questions that should be asked:

1. What are the symptoms of PMS?
2. Is PMS common?
3. What causes PMS?
4. How do you determine if I have PMS?
5. Are there any treatments for PMS?

15. Diagnosis: Epilepsy & Pregnancy

Questions that should be asked:

1. What are the risks to me if I became pregnant?
2. What are the risks to my baby?
3. What can I do to protect my baby and myself?
4. What can I expect when I am pregnant?

Diane F. Merritt, M.D. Professor of OB/GYN Washington University School of Medicine St. Louis, MO