Definition and Overview

Women of certain age require gynaecological care to ensure the health of their reproductive system. To receive the best care, they are typically scheduled for follow-up consultations with a gynaecologist.

The female reproductive system is responsible for conception and childbirth and it is composed of the following:

  • Ovaries – These are the small almond-shaped glands that are found on each side of the lower body. They are responsible for storing the eggs (sex cells).

  • Fallopian tubes – These coil-shaped tubes are attached to the edge of the ovaries, connecting them to the uterus or the womb. These serve as a passageway for the egg as it proceeds to the uterus for implantation.

  • Uterus – The uterus is a muscular organ that contains the embryo, which grows into a fetus. It is generally hollow but expands as the baby grows inside. Around the uterus is the lining known as the endometrium. During fertile days, the endometrium thickens to prepare the womb for the implantation. However, in case there’s no conception, the endometrium sheds in a process known as menstruation.

  • Cervix – This is the long narrow canal that connects the end of the uterus to the vagina.

  • Vagina – A part of the vagina is found outside the body. It serves multiple purposes including passage for the baby, urine and menstrual blood.

To a certain extent, the mammary glands or the breasts are also related and considered part of the female reproductive system. Hormones that are released by the ovaries, for example, can affect the physiology and activities of the breasts. They are also responsible for providing nourishment for the baby.

The presence of different organs plus their interaction with metabolism and hormones, as well as the patient’s environment and lifestyle, can lead to the development of various conditions and diseases that may require gynaecology follow-ups to ensure they are prevented, treated and managed on a timely manner.

Who Should Undergo and Expected Results

A gynaecologic follow-up is performed when the patient has been diagnosed with certain conditions that affect at least one of the reproductive organs. These conditions can be congenital, cancer, infection or sexually transmitted diseases. They may also be related to fertility and pregnancy. During this time, the patient may undergo treatment, which can range from surgery to medications and other forms of therapy.

The purpose of the follow-up is to (1) monitor the risks and complications associated with the treatment, (2) determine the effectiveness of such treatment, (3) manage the complications or prevent them and (4) ascertain whether another or more treatment methods are necessary to effectively treat the condition.

A follow-up may also be conducted even if no treatment has been applied. This happens when:

  • The patient has already completed the treatment for some time and the follow-up is meant to detect recurrence (e.g., cancer or infection).

  • The gynaecologic tests reveal abnormal results, which may require close surveillance for a certain period.

How Does the Procedure Work?

The gynaecology follow-up is discussed during the initial consultation and is part of the post-treatment care. The method on how follow-ups are conducted significantly differs depending on the disease, health of the patient, age, test results, and response to the treatment. For instance, patients who are diagnosed with an advanced stage of gynaecological cancer, like ovarian or cervical cancer, may have to be monitored for symptoms and recurrence every three months during the first year and once in the succeeding years.

Meanwhile, a woman who has an ordinary yeast infection may be required to see the gynaecologist for only one follow-up to determine whether the infection has already cleared. On the other hand, if the woman is diagnosed with polycystic ovary syndrome (PCOS), she may have to see the gynaecologist many times as the condition can progress and trigger other potential health conditions such as infertility.

In certain cases, gynaecologist also work alongside other health professionals such as endocrinologist (for hormone balance), surgeon, radiologist (for those undergoing radiotherapy), or a weight loss specialist (as obesity can have a major impact on reproductive health) to address the specific needs of their patients.

During the follow-up, the patient can expect the gynaecologist to:

  • Perform a thorough review of her medical records, including the effects of the treatment
  • Request for follow-up tests
  • Conduct a comprehensive interview on her general health, including symptoms
  • Provide counselling for better prevention or management of the condition
  • Make referrals to other specialists
  • Recommend additional treatment when and as needed

Possible Risks and Complications

Many patients continue to have a difficult time meeting their follow-up schedules for a variety of reasons including lack of interest, miscommunication, distrust on the doctor’s skill, poor doctor-patient relationship, geography, worsening conditions, death and anxiety over the results of the follow-up.

References:

  • Freund K. Approach to women's health. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 245.

  • Schrager SB, Paladine HL, Cadwallader K. Gynecology. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 25.

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