Obstetrics and Gynecology · MU Sofia

43. Cardinal symptoms in gynecology

Covers the key gynaecological symptoms, taking abnormal bleeding first, then pain, vaginal discharge and other complaints, each with its main causes. Includes tables for bleeding patterns and discharge types, with clues such as pH, discharge appearance and smell. Notes the rule that a pregnancy test comes first in reproductive-age women with bleeding, pain or amenorrhoea.

Inside: 5 sections · 2 tables · 16 flashcards · 2 min

Topic 43 of 61 in the MU Sofia syllabus for Obstetrics and Gynecology (Medicine, Year 5). The free AceMed note covers it in 5 sections, about 122 words (2 min of reading), with 16 flashcards.

In this note

  1. Introduction
  2. Abnormal bleeding
  3. Pain
  4. Vaginal discharge (leucorrhoea)
  5. Other symptoms

Introduction

Most gynaecological problems present with a few key symptoms. Knowing the main causes of each guides the investigation.

Pain

  • Acute pelvic pain: ectopic pregnancy, torsion or rupture of an ovarian cyst, PID, miscarriage, degenerating fibroid; also appendicitis and urinary causes.
  • Dysmenorrhoea: primary (prostaglandins, young women, NSAIDs and the pill) or secondary (endometriosis, adenomyosis, PID).
  • Chronic pelvic pain (> 6 months): endometriosis, adhesions, chronic PID, irritable bowel, interstitial cystitis.
  • Dyspareunia: superficial (vulvitis, atrophy, vaginismus) or deep (endometriosis, PID).

Other symptoms

  • Pelvic mass: pregnancy, fibroids, ovarian cysts and tumours, full bladder.
  • Pruritus vulvae: candida, dermatitis, lichen sclerosus, VIN.
  • Prolapse symptoms ("something coming down"), urinary incontinence, infertility, hirsutism, menopausal symptoms.

In every woman of reproductive age with bleeding, pain or amenorrhoea, the first test is a pregnancy test.

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