Women’s Health and Office Gynecology

Overview

Women’s health embraces the spectrum of health-related issues for women, from screening and

prevention to management of acute and chronic illness. Its knowledge base focuses on the

specific risk factors, physiologic variables, and therapeutic options that apply to women across

the life cycle. Its knowledge base overlaps with and draws from the fields of gynecology,

endocrinology, nutrition, psychiatry, and general internal medicine. Some general internists

focus their practice on women’s health issues, but all general internists should be well informed

and competent in this area.

Women’s health addresses conditions that are unique to, more common in, or more serious in

woman or that have manifestations, risk factors, or interventions that are different in women.

Conditions affecting women, in which sex-and gender-based differences are not known, are

listed under other categories in this document. In this section, the emphasis is on diseases

specific to or more prevalent in women.

Common Clinical Presentations

· Abnormal menstruation, vaginal bleeding

· Abnormal Papanicolaou smear

· Bladder pain

· Breast symptoms (lump, tenderness, nipple discharge)

· Contraception-request for

· Cystocele, rectocele, enterocele, uterine prolapse

· Dyspareunia

· Galactorrhea, nipple discharge

· Genital warts and ulcers

· Hirsutism

· Incest

· Incontinence (urinary & fecal)

· Infertility

· Life-phase issues

· Menopausal symptoms

· Pelvic mass

· Pelvic pain

· Physical/emotional abuse

· Post-trauma stress disorder

· Preconception and postconception counseling--request for

· Pregnancy

· Premenstrual syndrome

· Rape, symptoms of violence and assault

· Sexuality issues

· Vaginal symptoms (discharge, itching, odor, dryness)

· Varicose veins, venous disease

Procedure Skills

· Counseling about cosmetic/reconstructive surgery

· Crisis counseling/psychosocial counseling

· Fitting of diaphragm

· Rape protocol

· Removal of foreign body from vagina

· Colposcopy (optional)

· Endometrial biopsy (optional)

· Insertion and removal of intrauterine device (optional)

· Office urodynamics (optional)

· Administration of contraceptives

· Administration of hormone replacement therapy

Primary Interpretation of Tests

· Urine Pregnancy test

· Pelvic ultrasound

Ordering and Understanding Tests

· Aspiration of breast mass

· Bladder function tests

· Bone densitometry

· Chlamydia culture

· Colposcopy and biopsy

· Computed tomography of the abdomen, pelvis

· Dilatation and curettage

· Endometrial biopsy

· Fertility studies

· Incision and drainage of breast abscess

· Laparoscopy

· Mammography

· Papanicolaou pathology report

· Sex hormone assays