Gynaecology
Diseases of the female reproductive tract, menstrual and hormonal disorders, contraception and fertility.
Introduction
Gynaecology is the care of the female reproductive tract across life: puberty and the menstrual cycle, fertility and contraception, infection, pain and benign disease, cancer, the menopause and the breast.
This section starts with normal development and the cycle, then hormones, fertility and contraception, infection and benign disease, the gynaecological cancers, the breast, and finally emergencies, children's gynaecology and sexual violence.
Every topic uses the same layout: a short summary, what you should be able to do afterwards, the mechanism, the clinical picture, tests, treatment and the traps. Doses, thresholds and cut-offs are checked against named guidelines and shown with their source, because guidelines and countries sometimes differ.
How to study gynaecology
Learn gynaecology by the question you ask first: is she pregnant, is she bleeding, is she in pain, or is there a mass? A pregnancy test and a clear description of the bleeding or pain separate most presentations in the first minute.
Learn the numbers that change what you do: the endometrial thickness that triggers sampling, the cervical screening results and what follows each, the CA-125 and adnexal mass features, and the contraception eligibility categories. The check-yourself questions at the end of each topic test them a few days later.
Link gynaecology to obstetrics and endocrinology: amenorrhoea, polycystic ovary syndrome and the menopause are hormone problems, and many pelvic emergencies must be distinguished from pregnancy complications.
Contents by part
The topics below are in teaching order. Each part builds on the one before it.
- Puberty, cycles and the menopause. Normal development, menstrual disorders, amenorrhoea, bleeding problems and the menopause.
- Menarche, puberty and normal female development
- Primary amenorrhoea
- Secondary amenorrhoea
- Dysmenorrhoea and premenstrual disorders
- Abnormal uterine bleeding
- Postmenopausal bleeding and endometrial assessment
- Menopause and hormone replacement therapy
- Turner syndrome and gonadal dysgenesis
- Congenital adrenal hyperplasia in females
- Hormones, fertility and contraception. Polycystic ovary syndrome, androgen excess, infertility, assisted reproduction, contraception and termination of pregnancy.
- Infection, pain and benign disease. Vaginal and pelvic infection, vulval disease, endometriosis, fibroids, cysts and chronic pain.
- Vaginitis and vaginal discharge
- Cervicitis and pelvic inflammatory disease
- Toxic shock syndrome
- Vulval disorders: lichen sclerosus and vulvodynia
- Endometriosis and adenomyosis
- Uterine leiomyoma (fibroids)
- Ovarian cysts, torsion and benign ovarian tumours
- Chronic pelvic pain
- Sexual dysfunction and sexual health in women
- Pelvic organ prolapse and urinary incontinence
- Gynaecological cancer and examination. Cervical, endometrial, ovarian and vulvar cancer, and the examination and colposcopy used to find them.
- The breast. Benign breast lesions, breast cancer screening and treatment.
- Emergencies, children and violence. Acute pelvic pain, children's gynaecology, sexual assault, and female genital mutilation.
Topics
- Normal female puberty from breast budding to the first periods: Tanner stages, menarche timing, hormones of the menstrual cycle, and what counts as normal.Checked against sourcesVerified 1 November 2026
Primary amenorrhoea
No period by 15 with normal puberty (or by 13 without it): how to find out why menstruation has not started, and what to do.Checked against sourcesVerified 1 November 2026Secondary amenorrhoea
Why periods stop after they have started: pregnancy, hypothalamic, pituitary, ovarian and uterine causes, how to work them up in order, and treatment.Checked against sourcesVerified 1 November 2026Dysmenorrhoea and premenstrual disorders
Primary and secondary dysmenorrhoea, plus premenstrual syndrome and PMDD: causes, diagnosis and treatment.Checked against sourcesVerified 1 November 2026Abnormal uterine bleeding
Abnormal uterine bleeding in reproductive-aged women: the PALM-COEIN causes, focused history and examination, investigations including endometrial sampling.Checked against sourcesVerified 1 November 2026Postmenopausal bleeding and endometrial assessment
Postmenopausal bleeding: causes and the endometrial assessment pathway—TVUS thickness thresholds, endometrial sampling and hysteroscopy.Checked against sourcesVerified 31 October 2026
Menopause and hormone replacement therapy
Menopause, its symptoms and long-term risks, premature ovarian insufficiency, and the evidence-based use of hormone replacement therapy.Checked against sourcesVerified 1 November 2026Turner syndrome and gonadal dysgenesis
Turner syndrome (45,X and mosaics): features, cardiac and renal associations, growth hormone, oestrogen, fertility; plus non-Turner gonadal dysgenesis.Checked against sourcesVerified 31 October 2026Congenital adrenal hyperplasia in females
21-hydroxylase deficiency in 46,XX: virilisation, salt wasting, diagnosis, glucocorticoid therapy.Checked against sourcesVerified 1 November 2026Polycystic ovary syndrome
What polycystic ovary syndrome is, how it is diagnosed with the 2003 Rotterdam criteria as refined in 2023, and its evidence-based management from lifestyle.Checked against sourcesVerified 1 November 2026Hirsutism and androgen excess approach
How to score hirsutism, test for androgen excess, find the cause, and treat safely.Checked against sourcesVerified 31 October 2026Infertility and Bartholin gland disease
Infertility as a couple's condition: causes in both partners, work-up and treatment, plus Bartholin gland cyst and abscess.Checked against sourcesVerified 1 November 2026Assisted reproduction and fertility preservation
Pathways in assisted reproduction: ovulation induction, IUI, IVF and ICSI, donor gametes, and oncofertility with oocyte freezing and consent rules.Checked against sourcesVerified 31 October 2026Contraception
How each contraceptive method works, how well it prevents pregnancy, who can use it safely, and how to choose and monitor it.Checked against sourcesVerified 1 November 2026Termination of pregnancy and early pregnancy care
Medical and surgical abortion by gestation, mifepristone and misoprostol, complications, counselling, legal context, and post-abortion contraception.Checked against sourcesVerified 31 October 2026Vaginitis and vaginal discharge
Causes of vaginal discharge, from BV to atrophic, with focused history and exam, tests, treatment and a stepwise approach.Checked against sourcesVerified 1 November 2026Cervicitis and pelvic inflammatory disease
Cervicitis, endocervical and pelvic infection: causes, diagnosis, outpatient and inpatient treatment, complications, and partner management.Checked against sourcesVerified 1 November 2026Toxic shock syndrome
Staphylococcal toxic shock syndrome: tampon-associated menstrual TSS, CDC criteria, and acute management.Checked against sourcesVerified 1 November 2026Vulval disorders: lichen sclerosus and vulvodynia
Chronic vulval inflammatory disorders: lichen sclerosus, lichen planus, eczema, vulvodynia, Paget disease, diagnosis and steroid treatment.Checked against sourcesVerified 31 October 2026Endometriosis and adenomyosis
Endometriosis and adenomyosis: pain, infertility, diagnosis, medical and surgical treatment, and adenomyosis-specific care.Checked against sourcesVerified 31 October 2026Uterine leiomyoma (fibroids)
Benign uterine smooth-muscle tumours: FIGO types, presentation, diagnosis, imaging and medical, interventional and surgical management.Checked against sourcesVerified 1 November 2026Ovarian cysts, torsion and benign ovarian tumours
Benign ovarian cysts (functional, dermoid, endometrioma, haemorrhagic), adnexal torsion as an emergency, ultrasound with O-RADS, and management.Checked against sourcesVerified 31 October 2026Chronic pelvic pain
Chronic or recurrent pelvic pain in women and men: causes by system, assessment, and multidisciplinary treatment.Checked against sourcesVerified 31 October 2026Sexual dysfunction and sexual health in women
Desire, arousal, orgasm and pain disorders in women: how they present, how to assess them, and evidence-based psychosexual, medical and menopausal treatments.Checked against sourcesVerified 31 October 2026Pelvic organ prolapse and urinary incontinence
Prolapse and urinary incontinence in women: POP-Q grading, incontinence types, DIAPPERS, management, NICE NG123, ACOG, EAU.Checked against sourcesVerified 1 November 2026Gynaecological examination, cervical sampling and colposcopy
Taking a gynaecological history and examining the pelvis safely: consent, chaperones, cervical sampling and what colposcopy involves.Checked against sourcesVerified 31 October 2026Cervical cancer and screening
HPV-driven cervical cancer: epidemiology, screening and management, from pathogenesis to staging and treatment.Checked against sourcesVerified 1 November 2026Endometrial cancer and hyperplasia
Endometrial cancer and hyperplasia: risk factors, postmenopausal bleeding work-up, hyperplasia with and without atypia, FIGO 2023 staging, molecular.Checked against sourcesVerified 1 November 2026Ovarian cancer and adnexal masses
Ovarian, tubal and peritoneal cancers, and how to assess an adnexal mass: types, risk factors, symptoms, staging, surgery, chemotherapy and follow-up.Checked against sourcesVerified 1 November 2026Vulvar and vaginal cancer
Vulvar and vaginal cancer: HPV and lichen sclerosus pathways, VIN, staging, treatment, DES-related clear cell cancer, and follow-up.Checked against sourcesVerified 1 November 2026Benign breast lesions
Benign breast disease: classification, fibrocystic change, fibroadenoma, phyllodes, atypical hyperplasia, cancer risk, and triple assessment.Checked against sourcesVerified 1 November 2026Breast cancer: screening, staging and systemic therapy
Breast cancer: how it is staged and how endocrine, HER2-targeted and chemotherapy treatment are chosen by receptor subtype, plus screening and surveillance.Checked against sourcesVerified 1 November 2026Gynaecological emergencies and acute pelvic pain
Acute pelvic pain in women: pregnancy test first, red flags, differentials, imaging and the surgical decision, from ectopic pregnancy to torsion.Checked against sourcesVerified 31 October 2026Paediatric vaginal discharge and precocious puberty
Causes of vaginal discharge and bleeding in girls, and the work-up and treatment of central versus peripheral precocious puberty.Checked against sourcesVerified 1 November 2026Sexual assault: assessment and care
Trauma-informed assessment and care after sexual assault, from first response to forensic evidence, prophylaxis, follow-up, consent and reporting.Checked against sourcesVerified 1 November 2026Female genital mutilation and gender-based violence
FGM types, complications, deinfibulation, safeguarding and reporting, and intimate partner violence recognition and response.Checked against sourcesVerified 31 October 2026