Gynaecology

Gynecology is a medical specialty concerned with the identification, investigation, treatment, and care of diseases of the female reproductive organs. In addition to evaluating symptoms, gynecological outpatient care also includes supporting prevention, performing regular screening examinations, and monitoring hormonal and age-related changes.

When should you see a gynecologist?

• Lower abdominal pain
• Pain associated with menstruation
• Irregular bleeding
• Changes in the amount of menstrual bleeding
• Vaginal irritation, itching, or discharge
• Frequent or painful urination
• Bleeding after sexual intercourse (so-called contact bleeding)
• Symptoms related to menopause (e.g., sleep disturbances, mood swings, hot flashes, night sweats, vaginal dryness)
• Questions related to contraception

It is recommended to attend a screening examination once a year, even if you have no symptoms.

What is examined during a gynecological consultation?

• Characteristics and disorders of the menstrual cycle
• Condition of the uterus, ovaries, and vagina
• Suspicion of hormonal abnormalities
• Presence of infections and inflammations
• Screening for benign and malignant changes
• Individual considerations related to contraception

How does a general gynecological examination take place?

Medical history (anamnesis)

• Menstrual data (first menstruation, cycle length, nature of bleeding)
• Pregnancies and obstetric history
• Previous gynecological diseases and surgeries
• Family medical history
• Contraceptive methods
• General illnesses and medications

Physical and instrumental examinations

• Gynecological inspection and bimanual examination
• Colposcopy (vaginal/cervical examination with magnification), extended colposcopy if needed
• Cytological sampling (Pap smear)
• Vaginal ultrasound or abdominal and pelvic ultrasound
• Rectovaginal examination if indicated

Additional diagnostics

• Exfoliative cytology, supplemented with CINtec® Plus (p16, Ki67 immunohistochemistry) if required by pathology
• Ultrasound screening for detecting uterine and ovarian abnormalities

Contraception-related services

• Counseling on hormonal contraception
• Individual risk assessment
• Emergency contraception

Investigation of menstrual disorders

• Painful menstruation (dysmenorrhea)
• Infrequent menstruation (oligomenorrhea/raromenorrhea)
• Absence of menstruation (amenorrhea)
• Abnormal or contact bleeding

Examinations not included in standard specialist care

The following tests are available for an additional fee:

Specialist sample collection

• Vaginal discharge testing and culture
• Screening for sexually transmitted infections, including:
  • HPV
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae
  • Mycoplasma genitalium
  • Ureaplasma urealyticum
  • Gardnerella vaginalis
  • Trichomonas vaginalis
  • Atopobium vaginae
  • Herpes simplex virus
  • Treponema pallidum

Tumor marker tests (blood tests)

• CA 125
• CEA
• HCG
• HE4
• ROMA index

When is a follow-up examination necessary?

• If symptoms persist or worsen
• To discuss cytology or laboratory results
• After initiating or modifying hormonal treatment
• To monitor menopause-related symptoms
• When scheduling screening examinations

Frequently asked questions – Gynecology

How often should you attend a gynecological screening?
It is recommended once a year, even without symptoms.

Is a gynecological examination painful?
The examination is usually not painful, though it may cause mild discomfort.

Is any preparation needed before the examination?
Special preparation is generally not required, but bringing previous medical records and a list of medications is useful. It is also advisable to know the start date of your last menstrual period.

Can the examination be performed during menstruation?
Routine annual screening is not recommended during menstruation, as some tests are not advisable at that time. It is best to consult in advance.

Glossary – Gynecology

CA 125: A blood-measurable tumor marker that may indicate ovarian-related conditions. Elevated levels can also occur in non-cancerous conditions such as menstruation, endometriosis, or inflammation.

Cytology (Pap smear): A screening test that helps detect precancerous conditions and early signs of cervical cancer based on cervical cell samples.

Colposcopy: A magnified examination of the cervix using a special instrument (colposcope).

Extended colposcopy: A more detailed examination using acetic acid and Lugol’s iodine to better identify abnormalities.

HPV (Human papillomavirus): A widespread virus; certain types are associated with cervical cancer and other gynecological or head and neck cancers.

CINtec® Plus test: A specialized immunohistochemical test used to determine whether cytological abnormalities indicate a true pathological process.

HE4: A tumor marker that may more specifically indicate ovarian cancer risk compared to CA 125.

Vaginal ultrasound: An imaging test that provides detailed information about the uterus, ovaries, and pelvic organs.

Dysmenorrhea: Painful menstruation that can significantly affect quality of life.

Amenorrhea: Absence of menstruation, which may have hormonal or other medical causes.

Raromenorrhea: Infrequent menstrual bleeding.

Contact bleeding: Bleeding occurring after gynecological contact (e.g., intercourse), requiring evaluation.

Tumor marker: A substance measured in blood that may suggest or help monitor certain cancers.

ROMA index: A calculated risk score for ovarian cancer based on CA 125, HE4, and menopausal status.

Chlamydia trachomatis: A often asymptomatic bacterial infection that can lead to infertility and pelvic inflammatory disease if untreated.

CEA (Carcinoembryonic antigen): A protein used as a tumor marker, including in certain rare ovarian tumors.

Neisseria gonorrhoeae: A sexually transmitted bacterium causing discharge, pelvic pain, and inflammatory complications.

Mycoplasma genitalium: An increasingly detected sexually transmitted bacterium causing urogenital symptoms and inflammation.

Ureaplasma urealyticum: A bacterium that may be asymptomatic in small amounts but can cause infection if overgrown.

Gardnerella vaginalis: A common cause of bacterial vaginosis, associated with discharge and odor.

Trichomonas vaginalis: A parasitic infection causing abundant, unpleasant-smelling discharge and irritation.

Atopobium vaginae: A bacterium associated with bacterial vaginosis and recurrent vaginal symptoms.

Herpes simplex virus: A viral infection causing painful blisters and sores, which may recur.

Treponema pallidum: The bacterium causing syphilis, a serious sexually transmitted infection affecting multiple organs.
 

This description was reviewed by Dr. László Zoltán Nagy, obstetrician-gynecologist, head physician.