Gynaecological history

A reminder of the things that are important differentiators of gynaecological diagnoses.

Remember

Last normal period
Last menstrual period
Menstrual cycle
- How long bleed for
- Normal length cycle
- Regularity
- Number of pads / tampons
- Age started / stopped
Dysmenorrhoea
- Painkillers
- Time off work
- When (normal is 1-2 days before period)
Menorrhagia
Amenorrhoea
- Primary – not started by 16
- Secondary – 6 month gap
- Pregnant?
- Lactation
- Menopause
- Galactorrhoea – (increased prolactin)
- Drugs
Intermenstrual bleeding
Post-coital bleeding
Dyspareunia
- Superficial
- Deep
  - Pelvic inflammatory disease?
Cervical smear
Contraception
Discharge
- Colour
- Smell
- Quantity
Urinary symptoms
- Frequency
- Urgency
- Dysuria
- Haematuria
- Incontinence
  - Stress
  - Urgency
- Prolapse symptoms
- Obstetric history
- Impact on lifestyle
Menopause
- LMP
- Post-menopausal bleeding
- Past surgical history
- Family history of osteoporosis
- Contraindications to hormone replacement therapy
Infertility
- Children before
- Pregnancies / terminations
- Trying for > 1 year
- Adequate intercourse
  - No contraception
- Pelvic inflammatory disease
- Past surgical history
- Endometriosis
- Chlamydia
- Male factors
  - Mumps
  - Smoking
  - Trauma inc. Torsion of the testis
  - Underwear