Gynae History

Question 1

When will you carry out a gynaecological history?

Answer 1

When a woman has a problem that may involve their reproductive tract.

Question 2

What gynaecological symptoms may they have(5)

Answer 2

Abdominal or pelvic pain
Post coital vaginal bleeding
Intermenstrual vaginal bleeding
Post- menopausal bleeding
Abnormal vaginal discharge
Dyspareunia (pain during sex)
Vulval skin changes and itching

Question 3

What does vaginal bleeding indicate:

After sex? (3)

Intermesntrual? (5)

After menopause? (3)

Answer 3

After sex- infection, vaginitis, malignancy

Intermenstrual bleeding- STI’s, malignancy, fibroids, endometriosis, pregnancy, hormonal contraception

after menopause- malignancy, HRT and vaginal atrophy

Question 4

What can vaginal discharge indicate?

Answer 4

All woman have some degree of normal discharge. To determine if ti is abnormal, ask these questions:

Volume
Colour- green, yellow or blood stained
Consistency- thickened or watery
Smell - trout= bacterial vaginosis

Question 5

What is dyspareunia?

What is dyspareunia a sign of?

Answer 5

Pain during sex

May be due to infection, endometriosis, vaginal atrophy, malignancy and bladder inflammation

Clarify Duration, Location (superficial or deep) and nature of pain

Question 6

What does vulval skin changes and itching indicate?

Answer 6

Infections- such as candida (thrush) bacterial vaginosis and STI
Vaginal atrophy- occurs in post menopausal women
Lichen sclerosis- appears as white patches on the vulva and is associated with itching

Question 7

What other non-gynaecological symptoms may indicate a issue (5)

Answer 7

Urinary symptoms- frequency, urgency and dysuria can be relevant- vaginal prolapse pelvic pain

Bowel symptoms- endometriosis

Fever- Pelvic inflammatory disease or infections

malsie- non specific symptom but may indicate
malignancy or anaemia

Abdominal distension- may be benign or may be related to underlying pathology

Question 8

What details should you find out about the menstrual cycle

Answer 8

Duration -av. 5 days
Frequency
Blood flow- av. 40ml, excessive 80ml
Menstrual pain
Last menstrual period

Question 9

What else should be asked about the persons future gynaecological history?

Answer 9

Contraception

Reproductive plans