spelling differences
Despite the various English dialects spoken from country to country and within different regions of the same country, there are only slight regional variations in English orthography, the two most notable variations being British and American ...
) is the area of
medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
that involves the treatment of women's
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
s, especially those of the
reproductive organs
A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female, a ...
. It is often paired with the field of obstetrics, forming the combined area of obstetrics and gynecology (OB-GYN).
The term comes from Greek and means "the
science
Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe.
Science may be as old as the human species, and some of the earli ...
of
women
A woman is an adult female human. Prior to adulthood, a female human is referred to as a girl (a female child or adolescent). The plural ''women'' is sometimes used in certain phrases such as "women's rights" to denote female humans regardl ...
". Its counterpart is
andrology
Andrology (from grc, ἀνήρ, ''anēr'', genitive , ''andros'', "man"; and , ''-logia'') is a name for the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological p ...
, which deals with medical issues specific to the
male reproductive system
The male reproductive system consists of a number of sex organs that play a role in the process of human reproduction. These organs are located on the outside of the body and within the pelvis.
The main male sex organs are the penis and the te ...
.
Etymology
The word "gynaecology" comes from the oblique stem (γυναικ-) of the
Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
word γυνή (''gyne)''
semantically
Semantics (from grc, σημαντικός ''sēmantikós'', "significant") is the study of reference, meaning, or truth. The term can be used to refer to subfields of several distinct disciplines, including philosophy, linguistics and compu ...
attached to "woman", and ''-logia'', with the semantic attachment "study". The word gynaecology in
Kurdish
Kurdish may refer to:
*Kurds or Kurdish people
*Kurdish languages
*Kurdish alphabets
*Kurdistan, the land of the Kurdish people which includes:
**Southern Kurdistan
**Eastern Kurdistan
**Northern Kurdistan
**Western Kurdistan
See also
* Kurd (dis ...
means "jinekolojî", separated word as "jin-ekolojî", so the Kurdish "jin" called like "gyn" and means in Kurdish "woman".
History
Antiquity
The
Kahun Gynaecological Papyrus
The Kahun Gynaecological Papyrus (also Petrie Medical Papyrus, Kahun Medical Papyrus, Lahun Medical Papyrus, or UC32057) is the oldest known medical text in Egypt, although not the oldest in the world as in Philadelphia museum a Sumerian medical c ...
, dated to about 1800 BC, deals with gynaecological diseases,
fertility
Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified demographically. Fertili ...
, pregnancy,
contraception
Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...
, etc. The text is divided into thirty-four sections, each section dealing with a specific problem and containing
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
and treatment; no prognosis is suggested. Treatments are non-surgical, comprising applying medicines to the affected body part or swallowing them. The womb is at times seen as the source of complaints manifesting themselves in other body parts.
Ayurveda
Ayurveda () is an alternative medicine system with historical roots in the Indian subcontinent. The theory and practice of Ayurveda is pseudoscientific. Ayurveda is heavily practiced in India and Nepal, where around 80% of the population rep ...
, an Indian traditional medical system, also provides details about concepts and techniques related to gynaecology.
The
Hippocratic Corpus
The Hippocratic Corpus (Latin: ''Corpus Hippocraticum''), or Hippocratic Collection, is a collection of around 60 early Ancient Greek medical works strongly associated with the physician Hippocrates and his teachings. The Hippocratic Corpus cov ...
contains several gynaecological treatises dating to the 5th and 4th centuries BC. Aristotle is another strong source for medical texts from the 4th century BC with his descriptions of biology primarily found in ''History of Animals, Parts of Animals, Generation of Animals.'' The
gynaecological
Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area ...
treatise ''Gynaikeia'' by
Soranus of Ephesus
Soranus of Ephesus ( grc-gre, Σωρανός ὁ Ἑφέσιος; 1st/2nd century AD) was a Greek physician. He was born in Ephesus but practiced in Alexandria and subsequently in Rome, and was one of the chief representatives of the Methodic ...
(1st/2nd century AD) is extant (together with a 6th-century
Latin
Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...
paraphrase by
Muscio Muscio (also Mustio) is the supposed author of the ''Genecia'' (''Gynaecia''), a treatise of gynecology dating to ca. AD 500, preserved in a manuscript of ca. AD 900. The treatise borrows heavily from Soranus.
Nothing is known about the life of ...
, a physician of the same school). He was the chief representative of the school of physicians known as the " methodists".
Modern gynaecology. J. Marion Sims
In the medical schools of the early nineteenth century, doctors did not study female reproductive anatomy, seen as repulsive, nor train in pregnancy and childbirth management. That women, because of their anatomy and the risks of the dangerous birthing process, had unique medical concerns and challenges, enough that a doctor might specialize in them, is an innovation widely credited to
J. Marion Sims
James Marion Sims (January 25, 1813November 13, 1883) was an American physician in the field of surgery. His most famous work was the development of a surgical technique for the repair of vesicovaginal fistula, a severe complication of obstruc ...
and to a lesser extent his trainee and partner
Nathan Bozeman
Nathan Bozeman (March 25, 1825 — February 16, 1905), was a physician and early gynecologist, first in Montgomery, Alabama, and then in New York City. He studied medicine at the University of Louisville, graduating in 1848.
He was collaborator o ...
, physicians from
Montgomery, Alabama
Montgomery is the capital city of the U.S. state of Alabama and the county seat of Montgomery County. Named for the Irish soldier Richard Montgomery, it stands beside the Alabama River, on the coastal Plain of the Gulf of Mexico. In the 202 ...
. Sims is widely considered to be the father of modern gynaecology. While there have been isolated precedents for some of his innovations, he was the first to have published on the
Sims' position
The Sims position, or left lateral Sims position, named after the gynaecologist J. Marion Sims, is usually used for rectal examination, treatments, enemas, and examining women for vaginal wall prolapse.
The Sims Position is described as in th ...
, the Sims' speculum, the Sims sigmoid catheter, and on gynecological surgery, first on repair of
vesico-vaginal fistulas
Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF).
Presentation
Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder ('' vesica'') and the vagina that allows the continuous involu ...
, a socially devastating consequence of protracted childbirth, at the time without treatment of any sort. He founded the first women's hospital in the country, first in his backyard in Montgomery, limited to Black enslaved women, then the
Woman's Hospital
Mount Sinai Morningside, formerly known as Mount Sinai St. Luke's, is a teaching hospital located in the Morningside Heights neighborhood of Manhattan in New York City. It is affiliated with the Icahn School of Medicine at Mount Sinai and the ...
of New York.
He was elected president of the
American Medical Association
The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016.
The AMA's sta ...
, and was the first American physician of whom a statue was erected..
Sims developed his new specialty using the bodies of enslaved women, who could not refuse the extended glance of any white male that cared to observe any part of their anatomy. They could not "consent" in the sense modern medical research requires. No one did. Sims did not use anesthesia, for which he would be severely criticized 160 years later.
At the time anesthesia was itself a research area, and the first experiments (in dentistry) were being published. Using early anesthesia (in 1845, say) was much more dangerous and difficult than it would be a century later. In addition, it was widely believed that Blacks did not feel pain as much as whites, and white women proved unable to endure the pain.
At the time, Sims was seen as a hero. Even his enemies, Bozeman chief among them, did not attack him for either experimenting on the enslaved, or for not using anesthesia. Abolitionists such as
William Lloyd Garrison
William Lloyd Garrison (December , 1805 – May 24, 1879) was a prominent American Christian, abolitionist, journalist, suffragist, and social reformer. He is best known for his widely read antislavery newspaper '' The Liberator'', which he foun ...
were quick to put in print any mistreatment of the enslaved; Garrison's influential '' The Liberator'' has been completely indexed, but it never mentions Sims. Nor does the digitized portion of the Black press mention him. When he left Alabama in 1853, a local newspaper called him "an honor to our state".
In the late 20th century, Sims has come to be villainized. Now criticized for his practices, Sims developed some of his techniques by operating on slaves, many of whom were not given anaesthesia. Sims performed surgeries on 12 enslaved women in his homemade backyard hospital for four years. While performing these surgeries he invited men physicians and students to watch invasive and painful procedures while the women were exposed. On one of the women, named Anarcha, he performed 30 surgeries without anesthesia. Due to having so many enslaved women, he would rotate from one to another, continuously trying to perfect the repair of their fistulas. Physicians and students lost interest in assisting Sims over the course of his backyard practice, and he recruited other enslaved women, who were healing from their own surgeries, to assist him. In 1855, Sims went on to found the Woman's Hospital in New York, the first hospital specifically for female disorders.
Examination
In some countries, women must first see a general practitioner (GP; also known as a family practitioner (FP)) prior to seeing a gynaecologist. If their condition requires training, knowledge, surgical procedure, or equipment unavailable to the GP, the patient is then referred to a gynaecologist. In the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
, however, law and many health insurance plans allow gynaecologists to provide
primary care
Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care ...
in addition to aspects of their own specialty. With this option available, some women opt to see a gynaecological surgeon for non-gynaecological problems without another physician's referral.
As in all of medicine, the main tools of diagnosis are clinical history, examination and investigations. Gynaecological examination is quite intimate, more so than a routine physical exam. It also requires unique instrumentation such as the speculum. The speculum consists of two hinged blades of concave metal or plastic which are used to retract the tissues of the vagina and permit examination of the cervix, the lower part of the uterus located within the upper portion of the vagina. Gynaecologists typically do a bimanual examination (one hand on the abdomen and one or two fingers in the vagina) to palpate the cervix, uterus, ovaries and bony pelvis. It is not uncommon to do a
rectovaginal examination A rectovaginal examination is a type of gynecological examination used to supplement a pelvic examination. In the rectovaginal examination, a doctor or other health care provider places one finger in the vagina and another in the rectum to assess ...
for a complete evaluation of the pelvis, particularly if any suspicious masses are appreciated. Male gynaecologists may have a female chaperone for their examination. An abdominal or vaginal
ultrasound
Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...
can be used to confirm any abnormalities appreciated with the bimanual examination or when indicated by the patient's history.
Diseases
Examples of conditions dealt with by a gynaecologist are:
*
Cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
and pre-cancerous diseases of the reproductive organs including ovaries, fallopian tubes, uterus, cervix, vagina, and vulva
*
Incontinence
Incontinence or Incontinent may refer to:
*Fecal incontinence, the involuntary excretion of bowel contents
*Urinary incontinence, the involuntary excretion of urine
* Lack of moderation or self-control, especially related to sexual desire - see I ...
of urine
*
Amenorrhoea
Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation (breastfeeding). Outside the reproductive years, there is absence of mense ...
(absent
menstrual periods
The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...
)
*
Dysmenorrhoea
Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation. Its usual onset occurs around the time that menstruation begins. Symptoms typically last less than three days. The pain is usually in the ...
Prolapse
In medicine, prolapse is a condition in which organs fall down or slip out of place. It is used for organs protruding through the vagina, rectum, or for the misalignment of the valves of the heart. A spinal disc herniation is also sometimes ca ...
of pelvic organs
*
Infections
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
of the vagina (
vaginitis
Vaginitis, also known as vulvovaginitis, is inflammation of the vagina and vulva. Symptoms may include itching, burning, pain, discharge, and a bad smell. Certain types of vaginitis may result in complications during pregnancy.
The three main ...
), cervix and uterus (including
fungal
A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, separately from th ...
,
bacteria
Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were among ...
Urinary tract infections
A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidne ...
*
Polycystic ovary syndrome
Polycystic ovary syndrome, or PCOS, is the most common endocrine disorder in women of reproductive age. The syndrome is named after the characteristic cysts which may form on the ovaries, though it is important to note that this is a sign and no ...
*
Premenstrual dysphoric disorder
Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized by emotional, cognitive, and physical symptoms that cause significant distress or impairment in menstruating women during the luteal phase of the menstrual cycle. The symptom ...
vaginal disease
A vaginal disease is a pathological condition that affects part or all of the vagina.
Types
Sexually transmitted infections
Sexually transmitted disease that affect the vagina include:
* Herpes genitalis. The herpes simplex virus (HSV) can infect ...
s
There is some crossover in these areas. For example, a woman with urinary incontinence may be referred to a
urologist
Urology (from Greek οὖρον ''ouron'' "urine" and '' -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive org ...
.
Therapies
As with all surgical specialties, gynaecologists may employ medical or surgical therapies (or many times, both), depending on the exact nature of the problem that they are treating. Pre- and post-operative medical management will often employ many standard drug therapies, such as
antibiotics
An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...
,
diuretics
A diuretic () is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. A diuretic tablet is sometimes colloquially called a water tablet. There are several categories of diuretics. All diuretics i ...
,
antihypertensives
Antihypertensives are a class of drugs that are used to treat hypertension (high blood pressure). Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Evidence suggests that r ...
, and
antiemetics
An antiemetic is a drug that is effective against vomiting and nausea. Antiemetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer. They may be ...
. Additionally, gynaecologists make frequent use of specialized
hormone
A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are require ...
-modulating therapies (such as
Clomifene
Clomifene, also known as clomiphene, is a medication used to treat infertility in women who do not ovulate, including those with polycystic ovary syndrome. Use results in a greater chance of twins. It is taken by mouth once a day, with a course ...
citrate and hormonal contraception) to treat disorders of the female genital tract that are responsive to
pituitary
In vertebrate anatomy, the pituitary gland, or hypophysis, is an endocrine gland, about the size of a chickpea and weighing, on average, in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain. The hypoph ...
or
gonad
A gonad, sex gland, or reproductive gland is a mixed gland that produces the gametes and sex hormones of an organism. Female reproductive cells are egg cells, and male reproductive cells are sperm. The male gonad, the testicle, produces sper ...
al signals.
Surgery, however, is the mainstay of gynaecological therapy. For historical and political reasons, gynaecologists were previously not considered "surgeons", although this point has always been the source of some controversy. Modern advancements in both general surgery and gynaecology, however, have blurred many of the once rigid lines of distinction. The rise of sub-specialties within gynaecology which are primarily surgical in nature (for example urogynaecology and gynaecological oncology) have strengthened the reputations of gynaecologists as surgical practitioners, and many surgeons and surgical societies have come to view gynaecologists as comrades of sorts. As proof of this changing attitude, gynaecologists are now eligible for fellowship in both the American College of Surgeons and Royal Colleges of Surgeons, and many newer surgical textbooks include chapters on (at least basic) gynaecological surgery.
Some of the more common operations that gynaecologists perform include:
#
Dilation and curettage
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage). It is a gynecolog ...
(removal of the uterine contents for various reasons, including completing a partial miscarriage and diagnostic sampling for dysfunctional uterine bleeding refractive to medical therapy)
# Hysterectomy (removal of the uterus)
#
Oophorectomy
Oophorectomy (; from Greek , , 'egg-bearing' and , , 'a cutting out of'), historically also called ''ovariotomy'' is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term is mostly used in reference ...
(removal of the ovaries)
#
Tubal ligation
Tubal ligation (commonly known as having one's "tubes tied") is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus the ...
(a type of permanent sterilization)
#
Hysteroscopy
Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy).
Hysteroscope
A hyst ...
(inspection of the uterine cavity)
# Diagnostic
laparoscopy
Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.Medlin ...
– used to diagnose and treat sources of pelvic and abdominal pain. Laparoscopy is the only way to accurately diagnose pelvic/abdominal endometriosis.
# Exploratory
laparotomy
A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy.
Origins and history
The first successful laparotomy was performed without ane ...
– may be used to investigate the level of progression of benign or malignant disease, or to assess and repair damage to the pelvic organs.
# Various surgical treatments for
urinary incontinence
Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. It has been identified as an important issue in geri ...
, including
cystoscopy
Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope.
The urethra is the tube that carries urine from the bladder to the outside of the body.
The cystoscope has lenses like a telescope or microscop ...
and sub-
urethra
The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra c ...
l slings.
# Surgical treatment of pelvic organ
prolapse
In medicine, prolapse is a condition in which organs fall down or slip out of place. It is used for organs protruding through the vagina, rectum, or for the misalignment of the valves of the heart. A spinal disc herniation is also sometimes ca ...
rectocele
In gynecology, a rectocele ( ) or posterior vaginal wall prolapse results when the rectum bulges ( herniates) into the vagina. Two common causes of this defect are childbirth and hysterectomy. Rectocele also tends to occur with other forms of pe ...
.
# Appendectomy – often performed to remove site of painful endometriosis implantation or prophylactically (against future acute
appendicitis
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ru ...
staging
Staging may refer to:
Computing
* Staging (cloud computing), a process used to assemble, test, and review a new solution before it is moved into production and the existing solution is decommissioned
* Staging (data), intermediately storing data b ...
operation for
ovarian cancer
Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different c ...
.
# Cervical Excision Procedures (including
cryosurgery
Cryosurgery is the use of extreme cold in surgery to destroy abnormal or diseased tissue; thus, it is the surgical application of cryoablation. The term comes from the Greek words cryo (κρύο) ("icy cold") and surgery (''cheirourgiki'' – χ ...
) – removal of the surface of the cervix containing pre-cancerous cells which have been previously identified on
Pap smear
The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), cervical smear (BE), cervical screening (BE), or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in t ...
.
Specialist training
In the UK the
Royal College of Obstetricians and Gynaecologists
The Royal College of Obstetricians and Gynaecologists (RCOG) is a professional association based in London, United Kingdom. Its members, including people with and without medical degrees, work in the field of obstetrics and gynaecology, that ...
, based in London, encourages the study and advancement of both the science and practice of obstetrics and gynaecology. This is done through postgraduate medical education and training development, and the publication of clinical guidelines and reports on aspects of the specialty and service provision. The RCOG International Office works with other international organisations to help lower maternal morbidity and mortality in under-resourced countries.
Gynaecologic oncology is a subspecialty of gynaecology, dealing with gynaecology-related
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
.
Urogynaecology
Urogynecology or urogynaecology is a surgical sub-specialty of urology and gynecology.
History
In 1893, Howard Kelly, a gynecologist and pioneering urogynecologist, invented an air cystoscope which was simply a handheld, hollow tube with a glass ...
is a subspecialty of gynaecology and urology dealing with urinary or fecal incontinence and pelvic organ prolapse.
Gender of physicians
Improved access to education and the professions in recent decades has seen women gynaecologists outnumber men in the once male-dominated medical field of gynaecology. In some gynaecological sub-specialties, where an over-representation of males persists, income discrepancies appear to show male practitioners earning higher averages.
Speculations on the decreased numbers of male gynaecologist practitioners report a perceived lack of respect from within the medical profession, limited future employment opportunities and questions to the motivations and character of men who choose the medical field concerned with female sexual organs.
Surveys of women's views on the issue of male doctors conducting intimate examinations show a large and consistent majority found it uncomfortable, were more likely to be embarrassed and less likely to talk openly or in detail about personal information, or discuss their sexual history with a man. The findings raised questions about the ability of male gynaecologists to offer quality care to patients. This, when coupled with more women choosing female physicians has decreased the employment opportunities for men choosing to become gynaecologists.
In the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
, it has been reported that 4 in 5 students choosing a residency in gynaecology are now female. In several places in
Sweden
Sweden, formally the Kingdom of Sweden,The United Nations Group of Experts on Geographical Names states that the country's formal name is the Kingdom of SwedenUNGEGN World Geographical Names, Sweden./ref> is a Nordic country located on ...
, to comply with discrimination laws, patients may not choose a doctor—regardless of specialty—based on factors such as ethnicity or gender and declining to see a doctor solely because of preference regarding e.g. the practitioner's skin color or gender may legally be viewed as refusing care. In
Turkey
Turkey ( tr, Türkiye ), officially the Republic of Türkiye ( tr, Türkiye Cumhuriyeti, links=no ), is a list of transcontinental countries, transcontinental country located mainly on the Anatolia, Anatolian Peninsula in Western Asia, with ...
, due to patient preference to be seen by another female, there are now few male gynaecologists working in the field.
There have been a number of legal challenges in the US against healthcare providers who have started hiring based on the gender of physicians. Dr. Mircea Veleanu argued, in part, that his former employers discriminated against him by accommodating the wishes of female patients who had requested female doctors for intimate exams. A male nurse complained about an advert for an all-female obstetrics and gynaecology practice in
Columbia, Maryland
Columbia is a census-designated place in Howard County, Maryland. It is one of the principal communities of the Baltimore–Washington metropolitan area. It is a planned community consisting of 10 self-contained villages.
Columbia began with ...
claiming this was a form of sexual discrimination. Dr. David Garfinkel, a New Jersey-based OB-GYN sued his former employer after being fired due to, as he claimed, "because I was male, I wasn't drawing as many patients as they'd expected".
See also
*
Obstetrics and gynaecology
Obstetrics and Gynaecology (also spelled as Obstetrics and Gynecology; abbreviated as Obs and Gynae, O&G, OB-GYN and OB/GYN) is the medical specialty that encompasses the two subspecialties of obstetrics (covering pregnancy, childbirth, and t ...
*
Howard Atwood Kelly
Howard Atwood Kelly (February 20, 1858 – January 12, 1943) was an American gynecologist. He obtained his B.A. degree and M.D. degree from the University of Pennsylvania. He, William Osler, William Halsted, and William Welch together are know ...
*
Childbirth and obstetrics in antiquity
Childbirth and obstetrics in Classical Antiquity (here meaning the ancient Greco-Roman world) were studied by the physicians of ancient Greece and Rome. Their ideas and practices during this time endured in Western medicine for centuries and many ...
*
Genital schistosomiasis
Schistosomiasis, also known as snail fever, bilharzia, and Katayama fever, is a disease caused by parasitic flatworms called schistosomes. The urinary tract or the intestines may be infected. Symptoms include abdominal pain, diarrhea, bloody ...
Gynography
Gynography (Spanish: ''ginógrafo''ginógrafo wordmagicsoft.com) is defined as "
List of bacterial vaginosis microbiota
Bacterial vaginosis is caused by an imbalance of the naturally occurring bacteria in the vagina. The normally predominant species of ''Lactobacilli'' are markedly reduced. This is the list of organisms that are found in the vagina that are assoc ...
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Pediatric gynaecology
Pediatric gynaecology or pediatric gynecologySee American and British English spelling differences. ''Gynecology'' is the American spelling, but it is also common in international contexts, e.g. International Federation of Gynecology and Obstet ...