Urogynaecology is the subspecialty that deals with pelvic floor and bladder dysfunction in women. These problems can be dealt with surgically or conservatively depending on the severity of the problem and the patient's wishes. Recently a simple non-surgical procedure called ThermiVa was added to the list of ways of non-surgical methods to treat mild to moderate prolapse and urinary incontinence.
Menstrual disorders
Are ones of the commonest problems affecting up to 17% of women in the child bearing age. They includ heavy, painful and / or irregular periods. They also include bleeding in between periods and after intercourse together with absence of periods. There are a multitude of possible reasons behind this not least hormonal disturbance, stress and Polycystic Ovarian Syndrome.

Endometriosis is not an uncommon condition affecting women between their first period and the menopause. It presents itself with a one or more of heavy paiful periods, painful intercourse, painful tampoon insertion and sometimes painful defecation during period time. The condition can potentially damage vital organs in the pelvis causing permanent infertility. It is suspected by a combination of symptoms and findings on examination but the suspicion can be confirmed and the condition treated by laparoscopy. Laparoscopy is a day-case procedure done under general anaesthetic when a camera is introduced inside the abdominal cavity through a small (5mm) incision on the lower border of the belly button.
Colposcopy is a simple procedure undertaken with no anaesthetic in an outpatient's setup where one would examine the cervix under magnification staining it with special staines that would immediately highlight abnormal cells. The area worst affected is then biopsied and the biopsy represents the gold standard way of diagnosis before a treatment is contemplated. Colposcopy is needed for women with abnormal smear, women who bleed after intercourse or if they have what is regarded an abnormal looking cervix. An essential part of this investigation is to find out the type of HPV affecting the cervix. HPV is the virus that causes most of cervical cancers. 

The menopause is defined as the final sessation of menstruation and is diagnosed 12 months after the last period. However, this in itself is not the problem. The problem that a lot of women have is what we call the climacteric which is a group of symptoms that can start months if not years before the actual menopause and can last also for months if not years after the menopause. The climacteric is characterised by symptoms that include hot flushes, sweats, forgetfulness, clumsiness, poor sleeping pattern, wooliness, poor ability to make decisions, lethargy, poor libido and sexual dysfunction. To decide on if it is advisable to go on HRT or not needs fine balancing the risks versus the benifits taking into account the patient's wishes. ThermaVi; a new Radio Frequency heat generating procedure has a significant prospect in addressing the sexual dysfunction aspect that accompanies the menopause.