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    Gynaecology FAQs

    I am having difficulty getting pregnant. What do I need to do?

    One in five couples will have difficulty getting pregnant and will not be pregnant after one year of unprotected sex. If you are having difficulty getting pregnant please attend your GP who will discuss some first line investigations for you and your partner and will refer you to see one of our specialists in the hospital. In the meantime please continue to take your folic acid. If you are on any additional medication please discuss this with your GP before trying for a baby as they may need to be changed.

    What does the examination in SATU involve?

    A member of An Garda Síochána will bring you to SATU where you will be met by a nurse/midwife. She will introduce you to the other members of the team – a forensic examiner and a support worker from Dublin Rape Crisis Centre. The examination involves talking about your medical history and details of the actual assault. A physical examination will then be performed where forensic samples will be taken. All the details will be recorded in your healthcare record. You will then be allowed to shower and change your clothes. We will give you any medication necessary before you leave the unit and we will give you an appointment for follow-up care.

    I have pelvic pain for the past six months. Is this normal?

    Pelvic pain is pain in the lower abdomen or pelvis. Chronic pelvic pain is pain that is present for six months or longer. In some cases the pain can be worse during your periods but it is also present between periods. The cause of the pain can be related to any of the abdominal or pelvic organs, the supporting muscles or ligaments and occasionally psychological stressors. The investigations undertaken will depend on the nature and location of the pain which will be determined after a detailed history and examination. If you have chronic pelvic pain, please attend your GP who will refer you to the hospital if required.

    I would like to have a Mirena coil inserted. What do I need to do?

    You should discuss this with your GP. Some GPs will insert the Mirena coil for you as an outpatient. A vaginal swab will be taken to ensure you have no infection before insertion of the coil. You will then be asked to return to have the Mirena coil inserted sometime during the first seven days of your period. Insertion is usually quick and relatively painless in women who have had a previous vaginal birth. If your GP does not insert the Mirena coil you will be referred to the hospital for a visit where your history will be taken and a prescription for the Mirena will be provided to you to be filled by your pharmacy. You will be given information on contacting the hospital when you have a period to make arrangements for the coil to be inserted in the outpatient clinic. A small number of women will need to be admitted for the Mirena to be inserted under general anaesthetic in theatre.

    I think I have a vaginal prolapse. What causes this and how is it treated?

    The pelvic organs including the uterus (womb), bowel and rectum and bladder are held in place by muscles, tissues and ligaments. Prolapse happens when these muscles and ligaments become weakened and as a result the support for the pelvic organs is less. It occurs mainly in women who have had children or chronic lung problems and becomes more common with the onset of the menopause. It is also associated with being overweight.
    Treatment will depend on the severity of the prolapse. Mild cases may require pelvic floor exercises and lifestyle changes such as weight loss. More severe cases may require the insertion of a vaginal pessary or ring that helps to keep the prolapsed organ in place. Surgery such as a hysterectomy may eventually be required. If you are concerned that you have a prolapsed womb please attend your GP or your gynaecologist.

    I am having bleeding between periods and occasionally after intercourse. Is this normal?

    Bleeding between periods is not normal but is common. It can be related to hormones and also to changes in the neck of your womb or the lining of your womb. If you have bleeding between periods or after intercourse please attend your GP who will examine you. It is also important that you attend regularly for your smear test. Please find more information on the cervical screening programme on their website www.cervicalcheck.ie

    I do not want to get pregnant. What are my options?

    There are several options for contraception. They include condoms, the oral contraceptive pill, an intrauterine contraceptive device (for example the Mirena coil) and tubal ligation (where the fallopian tubes are surgically closed). Your choice of contraception depends on your age, medical history and the presence of other gynaecological conditions (such as heavy periods). Your GP will discuss your options with you and provide you with information to help you make the right choice.
    Surgical methods of contraception include tubal ligation for women and vasectomy for men. These are permanent and irreversible. There are failure rates with both procedures. We ask all women attending requesting sterilisation that they discuss vasectomy with their partners. This is because tubal ligation for a woman involves a general anaesthetic and surgery while a vasectomy is done under local anaesthetic.

    I have pain during my periods. Is that normal?

    Period pain is common and is normal. However some women have pain that is severe enough to limit their normal daily activities and their ability to work during their periods. This type of pain is rare. There are several treatment options. They include pain relief, the oral contraceptive pill, contraceptive injections and in some cases surgery. If you have concerns please attend your GP to discuss treatment options and investigations.

    If I don’t report the assault to An Garda Síochána can I still attend SATU?

    Yes, you should still attend SATU. Patients who choose not to report the assault to An Garda Síochána will receive the same care as those who report to the Gardaí. However, the forensic samples will not be taken and care is provided during normal working hours – Monday to Friday from 9am to 5pm only. An out of hours service is not provided. If you are unsure whether you wish to report the incident to the Gardaí or not, you should contact your Garda Station or the Rape Crisis Centre to discuss your options in more detail.

    I have been sexually assaulted/raped. What should I do?

    As sexual violence is a crime you should report it to An Garda Síochána. When you report an assault to An Garda Síochána, a guard will contact the Sexual Assault Treatment Unit (SATU) and a time will be agreed for you to attend for a forensic examination as soon as possible. Ideally the examination should take place within 3 hours of the report. Forensic samples can be taken up to 7 days after an assault but the sooner the better. For legal purposes a member of An Garda Síochána must be present for the examination when the forensic evidence is collected to ensure the chain of evidence is maintained.
    Ideally, you should not eat, drink or smoke, have a shower or use the toilet before the examination is carried out, in order to preserve the forensic evidence. If you have any injuries which may need medical treatment you should get these attended to first at your local accident & emergency department before attending SATU. If you are under 18 years of age you must bring a parent or guardian with you, to consent to treatment.

    I have a vaginal discharge. Is this normal?

    It is normal to have a light discharge. It is not normal to have a heavy or smelly vaginal discharge. If you are concerned or think you may have a sexually transmitted infection, please attend your GP who will examine you and do some investigations or refer you to the hospital or a specialist clinic if required.

    I have had a procedure to remove abnormal cells from the neck of my womb 1 week ago and I am having a brown discharge. Is this normal?

    When you have a procedure to the neck of your womb you can have bleeding for up to 4 weeks afterwards. There is also a risk of infection which is why we give you antibiotics and ask that you not use tampons or have intercourse over this time. The bleeding should not be heavy and any discharge should not be excessive or offensive. If the bleeding gets heavy or you have any concerns please consult your GP or the colposcopy clinic.

    I am having hot flushes and I think it is the menopause. What will I do?

    Please make an appointment to see your GP if your symptoms are making your life very difficult or if you are younger than the average age for the start of the menopause. There are many treatments available which aim to reduce the symptoms of the menopause.

    I had a Mirena coil fitted six weeks ago and have been having vaginal bleeding on and off. Is this normal?

    Initially there can be some irregular bleeding following coil insertion which may last up to twelve weeks. If the bleeding is heavy or continues for longer than twelve weeks you should contact your GP or gynaecologist.

    What follow up care is offered by SATU?

    Every patient who attends SATU is offered a sexual health screen. This involves urine, blood tests and swabs being taken to see if you have any sexually transmitted or blood-borne infections, which can then be treated. You will be telephoned with your test results when they are available. You will return to SATU on three occasions to continue your treatment. You will be given the contact details of the people involved in your care so that you can contact them if you have any queries.

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