What I treat

Pregnancy and birth

Care from the first trimester through delivery and the weeks that follow.

Antenatal care

Routine monitoring through the pregnancy, scans, screening, and management of the complications that can arise along the way — raised blood pressure, gestational diabetes, growth concerns.

High-risk pregnancy

Pregnancies that need closer watching: previous caesarean or loss, twins, diabetes or thyroid disease, high blood pressure, a baby measuring small or large, or simply a history that makes you anxious. More monitoring, and a plan made early rather than in a hurry.

Planning a pregnancy

Preconception advice before you start trying — folic acid, existing medication, thyroid and diabetes control, vaccination, and anything in your history worth sorting out first.

Vaginal birth

Where it is the right and safe choice, it is usually the one I would recommend: shorter recovery, fewer complications. I have written a plain-English guide to what actually happens — read it here.

Caesarean section

Planned or in an emergency. Whichever way your delivery goes, the decision should be one you understood in advance rather than one that happened to you.

Postnatal recovery

The weeks after birth get much less attention than the nine months before. Bleeding, pain, pelvic floor recovery, feeding, mood — all of it is worth raising.

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Gynaecology

Much of this is the everyday work of the specialty, and much of it has been put up with for far too long before anyone examines it properly.

Polycystic ovary syndrome (PCOS)

A hormonal condition causing irregular periods, raised androgen levels and multiple ovarian follicles. It affects periods, skin, hair, weight and fertility, and it responds well to being managed properly rather than being lived around.

Endometriosis

Tissue similar to the lining of the uterus growing outside it, causing pelvic pain, heavy periods and sometimes difficulty conceiving. It is commonly diagnosed years later than it should be.

Uterine fibroids

Non-cancerous growths in the uterus. They can cause heavy bleeding, pelvic pressure and reproductive problems — or nothing at all, in which case they may not need treating.

Painful periods (dysmenorrhoea)

Cramping severe enough to interfere with work, school or ordinary life is not something to be tolerated. It usually has a cause, and the cause usually has a treatment.

Heavy or irregular bleeding

Menorrhagia can cause anaemia and exhaustion. Irregular cycles may point to a hormonal cause worth identifying.

Vaginitis

Inflammation or infection causing abnormal discharge, itching or irritation. Common, treatable, and frequently self-treated for months with the wrong thing.

Painful intercourse (dyspareunia)

Pain during or after sex, which may be caused by infection, hormonal change, endometriosis or scarring. It is a medical complaint, and I am very used to hearing it.

Vaginismus

Involuntary tightening of the vaginal muscles that makes penetration difficult or impossible. There are several effective treatments — I have written about them here.

Difficulty conceiving

An initial fertility work-up for both partners, tracking of ovulation, and ovulation induction where that is what is needed. Where treatment beyond that is required I will say so and refer you on rather than keep you waiting.

Menopause

The years around the menopause bring hot flushes, disturbed sleep, mood changes, vaginal dryness and discomfort during sex. All of it is treatable, and none of it is something you simply have to get through.

Minimally invasive (laparoscopic) surgery

Where an operation is needed, doing it laparoscopically usually means smaller incisions, less pain and a quicker return to ordinary life than open surgery. I hold the FMAS and DMAS qualifications in minimal access surgery.

Stress urinary incontinence

Leaking with a cough, a sneeze, a laugh or a run. It is common after childbirth and around the menopause, and it is not something you have to accept as part of getting older. Treatment runs from pelvic floor physiotherapy, through office-based options, to a mid-urethral sling where surgery is the right answer. Most women start with physiotherapy.

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Cosmetic gynaecology

Some of these procedures are done for comfort and function, some for appearance, and often it is both. There is no version of this conversation in my consulting room that involves embarrassment.

Labiaplasty

Reshaping the labia minora or majora, whether for appearance or because their size causes discomfort during exercise, in clothing, or during sex. It covers reduction of the labia minora, and either reduction or volume restoration of the labia majora. Sixty to ninety minutes, local or general anaesthetic, as a day case; most women are back to ordinary activity in one to two weeks. More detail here.

Hymenoplasty

Reconstruction of the hymen using dissolvable sutures, under local anaesthetic, as a day case. Recovery is short and scarring is not visible. Women choose it for cultural, religious or personal reasons, and I do not ask you to justify it — the consultation is confidential from first call to last follow-up. More detail here.

Vaginoplasty

Surgical tightening of the vaginal canal and the surrounding muscles, most often sought after childbirth or with age-related change. General or spinal anaesthetic as a day-care procedure. Ordinary activity returns within about two weeks; full recovery takes four to six.

Clitoral hoodectomy

Reduction of the excess tissue covering the clitoris, for comfort or appearance. A thirty to forty-five minute outpatient procedure under local anaesthetic, healing over two to three weeks. Often done alongside labiaplasty.

Monsplasty

Lifting and reshaping the mons pubis, usually after significant weight change or childbirth.

Laser vaginal therapy

Fractional CO₂ or Er:YAG laser stimulates collagen and elastin in the vaginal wall, improving tone and lubrication and easing the dryness and irritation of atrophy. No surgery and no general anaesthetic; a course of about three sessions is usual.

PRP and volume restoration

Platelet-rich plasma prepared from your own blood, used to support tissue healing and quality; and fillers where volume in the labia majora has been lost with age or weight change. Both are minimally invasive and done in clinic.

Not everything needs surgery

A good number of the concerns women bring me can be treated without an operation, and where that is a realistic option it is the one I will suggest first — shorter recovery, lower risk, and surgery is still available afterwards if it does not achieve what you hoped. If a procedure will not give you what you are hoping for, I will tell you that too.

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What to expect

Whichever procedure you are considering, the sequence is the same.