Obstetrics & Gynecology

1. Menstrual Disorders

A. Heavy Menstrual Bleeding (Menorrhagia)

• Medications: Hormonal treatments like birth control pills, IUDs (intrauterine devices), or oral progestins to regulate bleeding.
• D&C (Dilation and Curettage): A procedure to scrape the uterine lining and stop excessive bleeding.
• Endometrial Ablation: A minimally invasive procedure to destroy the uterine lining, reducing bleeding.
• Hysterectomy: In severe cases, the removal of the uterus is considered.

B. Irregular Menstrual Cycles

• Hormonal Therapy: Birth control pills or progestins to regulate cycles.
• Lifestyle Modifications: Addressing underlying factors like stress, diet, and exercise, which can influence menstrual cycles.

C. Dysmenorrhea (Painful Periods)

• NSAIDs: Nonsteroidal anti-inflammatory drugs (e.g., ibuprofen) to reduce pain and inflammation.
• Hormonal Birth Control: Pills, patches, or IUDs can reduce menstrual cramps.
• Laparoscopy: Surgery may be needed if there’s an underlying condition like endometriosis.

2. Endometriosis

• Pain Management: NSAIDs to control pain.
• Hormonal Therapy: Birth control pills, IUDs, or GnRH agonists (e.g., Lupron) to reduce estrogen levels and slow endometrial tissue growth.
• Surgical Treatment: Laparoscopic surgery to remove endometrial tissue and scar tissue (adhesions).
• Hysterectomy: In severe cases, removing the uterus and ovaries may be necessary.

3. Polycystic Ovary Syndrome (PCOS)

• Ovulation Induction: Clomiphene citrate or letrozole to stimulate ovulation in women trying to conceive.
• Metformin: To improve insulin resistance and regulate menstrual cycles.
• Hormonal Birth Control: To regulate periods and reduce excess hair growth.
• Anti-Androgens: Medications like spironolactone to control excess male hormone levels and reduce symptoms like hirsutism (excess hair).
• Laparoscopic Ovarian Drilling: A surgical option for women who don’t respond to medications.

4. Uterine Fibroids

• Medications: GnRH agonists (e.g., Lupron) to shrink fibroids temporarily.
• Uterine Artery Embolization: A minimally invasive procedure to block blood supply to the fibroids, causing them to shrink.
• Myomectomy: Surgical removal of fibroids, preserving the uterus.
• Hysterectomy: Removal of the uterus in cases where fibroids are large or causing severe symptoms.

5. Ovarian Cysts

• Observation: Small, asymptomatic cysts may resolve on their own without treatment.
• Medications: Birth control pills can help prevent the formation of new cysts.
• Laparoscopy: A minimally invasive surgery to remove large or problematic cysts.
• Cystectomy: Surgical removal of the cyst without removing the ovary.
• Oophorectomy: Removal of the affected ovary in severe cases or if cancer is suspected.

6. Pelvic Inflammatory Disease (PID)

• Antibiotics: Broad-spectrum antibiotics are used to treat bacterial infections (commonly caused by sexually transmitted infections like gonorrhea or chlamydia).
• Hospitalization: For severe PID, intravenous antibiotics and supportive care may be necessary.
• Surgery: In cases where there is an abscess or damage to reproductive organs, surgery may be needed to drain abscesses or remove infected tissue.

7. Urinary Tract Infections (UTIs)

• Antibiotics: Common antibiotics include trimethoprim-sulfamethoxazole, ciprofloxacin, or nitrofurantoin, depending on the bacteria causing the infection.
• Hydration: Drinking plenty of fluids to flush out bacteria.
• Probiotics: In some cases, probiotics may be recommended to restore the healthy bacteria in the urinary tract.
• Preventive Antibiotics: For recurrent UTIs, long-term, low-dose antibiotics may be used.

8. Urinary Incontinence

• Pelvic Floor Exercises (Kegels): To strengthen pelvic muscles and improve bladder control.
• Medications: Anticholinergic drugs (e.g., oxybutynin) to reduce urgency and frequency.
• Bladder Training: Techniques to increase the interval between urinations.
• Pessary: A device inserted into the vagina to support the bladder.
• Surgical Options: Sling procedures or bladder neck suspension to treat stress incontinence.

9. Pelvic Organ Prolapse

• Pelvic Floor Therapy: Exercises to strengthen the muscles of the pelvic floor.
• Pessary: A device inserted into the vagina to support the prolapsed organ.
• Surgical Repair: Vaginal or abdominal surgery to repair or suspend the prolapsed organs.
• Hysterectomy: In some cases, removing the uterus may be necessary.

10. Vaginal Infections

• Bacterial Vaginosis (BV):
  • Antibiotics: Metronidazole or clindamycin are commonly used.
• Yeast Infections:
  • Antifungal Medications: Oral or topical treatments (e.g., fluconazole, clotrimazole).
• Trichomoniasis:
  • Antiprotozoal Medication: Metronidazole or tinidazole.
• Vaginal Atrophy:
  • Estrogen Therapy: Vaginal creams, tablets, or rings to restore vaginal health in postmenopausal women.

11. Cervical Cancer

• Colposcopy: A procedure to examine the cervix for abnormal cells.
• Cryotherapy: Freezing abnormal cervical tissue.
• Loop Electrosurgical Excision Procedure (LEEP): Removal of abnormal tissue using a wire loop.
• Surgery: Removal of the cervix (conization) or hysterectomy, depending on cancer stage.
• Radiation & Chemotherapy: For advanced stages of cervical cancer.

12. Ovarian Cancer

• Surgery: Removal of the ovaries (oophorectomy), fallopian tubes (salpingectomy), and possibly the uterus (hysterectomy).
• Chemotherapy: Typically used after surgery to destroy any remaining cancer cells.
• Targeted Therapy: Drugs that target specific molecules involved in cancer growth (e.g., bevacizumab).
• Hormone Therapy: Used for certain types of ovarian cancer that are hormone-sensitive.

13. Endometrial (Uterine) Cancer

• Surgery: Hysterectomy to remove the uterus, and sometimes removal of ovaries and fallopian tubes.
• Radiation Therapy: Used after surgery to kill any remaining cancer cells.
• Chemotherapy: Often used in combination with surgery or radiation for more advanced cases.
• Hormone Therapy: Progestins can be used to treat certain types of endometrial cancer.

14. Breast Cancer

• Surgical Options: Mastectomy (removal of the breast) or lumpectomy (removal of the tumor and a portion of the breast).
• Radiation Therapy: To destroy any remaining cancer cells after surgery.
• Chemotherapy: To target cancer cells throughout the body.
• Hormone Therapy: For hormone-receptor-positive breast cancers (e.g., tamoxifen).
• Targeted Therapy: Targeted treatments for HER2-positive breast cancer (e.g., trastuzumab).

15. Menopausal Symptoms

• Hormone Replacement Therapy (HRT): To alleviate hot flashes, night sweats, and vaginal dryness.
• Non-Hormonal Medications: Antidepressants (e.g., SSRIs) or gabapentin for hot flashes.
• Vaginal Estrogen: To treat vaginal dryness and atrophy.
• Bone Health: Bisphosphonates or other medications to prevent osteoporosis.