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Gynaecological history


  • Wash hands
  • Introduce self
  • Ask Patient’s name, DOB and what they like to be called
  • Explain and obtain consent

Presenting complaint

  • Determine symptoms which brought patient in

History of presenting complaint

  • Exploreevery symptom
  • Relevant systems reviews (see systems review)
    • General
    • Gynaecological (The 4 P’s)
    • Gastrointestinal (βˆ†βˆ† IBS, malignancy, appendicitis, diverticulitis etc.)
    • Urological (βˆ†βˆ† UTI, incontinence etc.)

The 4 P’s

PV bleeding: menorrhagia, intermenstrual, post-coital, post-menopausal

PV discharge

Pain: pelvic, dysmenorrhoea, dyspareunia

Pregnancy (chance of pregnancy)

Menstrual history

  • 1st day of last menstrual period
  • Menarche (usually 12-13 years) Β± menopause (usually 48-55 years)
  • Regularity and cycle length (range from 21-35 days)
  • Duration of periods (range from 3-7 days)
  • Character of periods (heaviness, number of pads per day, flooding, pain)

Obstetric history – GMC

  • Gravida and para
    • Gravida/gravidity = pregnancies
    • Para/parity = birth of fetuses over 24 weeks, regardless if born alive or not
  • Miscarriages, ectopic pregnancies and terminations
    • Stage
    • Treatment
    • Complications
  • Children (living)
    • Number
    • Ages
    • Birthweights
    • Type of deliveries
    • Previous problems during pregnancy/delivery

Sexual history

  • Partners
    • Current partner (male/female, relationship duration)
    • Previous partners (last three or all in last 6 months), high-risk encounters
  • Intercourse: type, pain/discomfort, contraception used
  • Subfertility

Contraception and cervical smear history

  • Contraception: current use, previous methods
  • Cervical smears: date of last smear, results

Rest of history as normal

  • PMHx: including previous abdominal surgery
  • DHx: including HRT/hormones, over-the-counter remedies, allergies
  • FHx: breast/bowel/ovarian cancer
  • SHx

Test your knowledge with a few questions!

A 45 year old female presents pelvic pain. What is in your gynaecological differential diagnosis and which clinical features would help differentiate these causes?

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How would you classify PV bleeding? List three causes of each.

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Time to try some OSCE stations…

  1. Pelvic pain I
  2. Pelvic pain II
  3. Abdominal pain during pregnancy
  4. Vaginal discharge
  5. Find lots more here

One Comment

  1. Thank you for sharing your expertise so generously. Your insights on this topic have expanded my understanding in ways I couldn’t have imagined.

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