Seven groups of gynecological and women’s health concerns, with what each one usually looks like and what a proper assessment involves. Read the section that matches your symptoms — and read the urgent-care list first, because some symptoms should never wait for an online appointment.
An online consultation is the wrong tool for an emergency. If any of the following applies to you right now, contact your own doctor for a same-day appointment, go to an emergency department, or call your local emergency number.
This list is not exhaustive, and it is not a substitute for being seen. If you feel severely unwell, or something feels badly wrong, seek help now rather than waiting to be certain. Our medical disclaimer sets out the limits of the information and advice provided through HeliosCheck.com.
Every condition below is approached the same way, whether you book a single consultation or return for review. The order matters: history first, results second, conclusions last.
A symptom timeline, cycle and obstetric history, medications, family history, and what you have already tried and at what dose. Most of the diagnostic work in gynecology happens here — and it is the part a short appointment cuts first.
Scans, swabs, blood tests and screening letters, read with you on screen, including the lines nobody has translated. Upload them before the appointment and your clinician arrives having read them.
What we think is going on, how confident we are, which alternatives are still on the table, and — stated explicitly — what finding would change the answer.
A test, a treatment trial, a referral, or a review at a set date. It goes into the written summary you receive within 24 hours, so you are never left reconstructing it from memory.
A consultation cannot include a pelvic, speculum or breast examination, a cervical screening test, a coil fitting, a biopsy or a scan. Several conditions on this page — prolapse, postmenopausal bleeding, a palpable lump, a suspected ectopic pregnancy — need a clinician in the room before anything can be concluded. When that is the case we say so during the appointment, write it into your summary, and tell you what to book and how urgently. The full scope of each service, and its limits, is set out on our services page, and the appointment itself is described step by step in how it works.
Periods are the most useful long-run data set most people have about their own health, and the one most often waved through as normal. Changes in volume, timing, pain or predictability are worth explaining rather than tolerating — the NHS guidance on heavy periods is a good starting point, and the NICE heavy menstrual bleeding guideline (NG88) sets the standard we work to.
Heavy bleeding is defined by its effect on you rather than by a volume in millilitres: flooding, clots the size of a coin, changing protection every hour, or planning your week around your cycle. Assessment begins with a bleeding diary, a full blood count and ferritin — iron deficiency is common and frequently missed — and a discussion of whether pelvic ultrasound is warranted to look for fibroids, polyps or adenomyosis.
Cramping that answers to simple analgesia and settles within a day or two behaves very differently from pain that starts days before bleeding, worsens year on year, or drags bowel and bladder symptoms along with it. We map the pain against your cycle, review what you have tried and whether it was taken at an effective dose and timing, and decide together whether endometriosis belongs in the conversation.
Cycles shorter than 21 days or longer than 35, variation of more than a week between one cycle and the next, or three months with no period and no pregnancy all deserve a cause rather than reassurance. Assessment covers weight change and training load, thyroid function, prolactin and androgen markers, and — where it is relevant to your plans — a realistic conversation about ovarian reserve.
Premenstrual symptoms become a working diagnosis when they track the luteal phase reliably and lift within a few days of bleeding starting. PMDD sits at the severe end, with mood symptoms heavy enough to disrupt work and relationships. Two months of prospective daily tracking is the single most useful thing you can bring to an appointment, so we send you a chart to complete before we meet.
Hormonal problems announce themselves through the cycle, the skin and the scales, which is why they are so often treated as three separate complaints. We look at the pattern as one picture. Background reading on PCOS from the NHS is worth having open before your appointment.
Diagnosis rests on two of three features — infrequent or absent ovulation, androgen excess clinically or on bloods, and polycystic ovarian morphology on scan — with other causes excluded. We go through which of the three you actually meet, because a great many people are labelled on a scan finding alone. Cycle control, metabolic risk and fertility planning each need a different part of the plan.
An underactive or overactive thyroid often changes bleeding before it changes anything else: heavier and more frequent with hypothyroidism, lighter or absent with hyperthyroidism. TSH and free T4 are inexpensive and easy to overlook when a cycle problem is assumed to be gynecological. We read yours alongside the cycle history rather than in isolation, and say when antibodies are worth adding.
Coarse, dark hair on the face, chest or abdomen — often with scalp thinning or persistent adult acne — points towards androgen excess. What matters most is the speed of onset: a gradual pattern since your late teens is assessed quite differently from a change over months, which needs prompt investigation. We arrange the right bloods and explain in advance what each possible result would mean.
Pelvic pain is where women’s health most often goes wrong: symptoms are normalised, a single scan is treated as the final word, and years pass. These conditions need a timeline, not a snapshot. The NHS endometriosis pages describe the delay honestly.
Cyclical pain that outgrows the period itself, pain with sex, bowel or bladder symptoms arriving at the same point each month, and fatigue that comes with the pain form a pattern worth taking seriously. A normal ultrasound does not exclude it. We build a structured symptom map, discuss medical management honestly, and advise when referral for laparoscopy is proportionate rather than reflexive.
Endometrial-type tissue growing within the muscle wall of the uterus tends to produce a heavy, dragging period and a bulky, tender uterus. It is often missed because it falls between the heavy-bleeding and the pelvic-pain conversation. Assessment usually involves transvaginal ultrasound or MRI, and the options — hormonal, ablative or surgical — depend heavily on your age and whether you want a pregnancy.
Common, benign and frequently symptomless, but position matters far more than size. A small submucosal fibroid distorting the cavity can cause more bleeding than a much larger one sitting on the outer wall. We translate your scan report into plain language and set out which options — medical treatment, ablation, embolisation, myomectomy — fit your symptoms, your anaemia and your fertility plans.
Most are functional, follow the cycle and resolve without any treatment at all. What determines the plan is size, appearance on ultrasound, your age and menopausal status, and whether the cyst is still there on a repeat scan. Sudden severe one-sided pain with nausea or vomiting can mean torsion or rupture — that is an emergency, not an appointment to book.
Pain lasting six months or more usually has more than one contributor: gynecological, bowel, bladder, musculoskeletal and central pain sensitisation can all be present at once. One more scan rarely settles it. We take a long history, separate the strands, and build a plan that is honest about involving more than one discipline — because the single-cause version of this story is usually the wrong one.
Recurrent symptoms here are rarely bad luck; they usually mean the original diagnosis, the treatment schedule or an underlying driver was never addressed. The NHS pages on bacterial vaginosis are a useful primer on how often it returns.
Four or more confirmed episodes in a year counts as recurrent and is managed quite differently from a one-off. The first task is confirming it really is candida: irritation, discharge and soreness have several causes, and repeated over-the-counter treatment of the wrong thing makes matters worse. Assessment covers diabetes screening, a proper induction-and-maintenance schedule, and the skin conditions that mimic thrush.
A thin, greyish discharge with a fishy odour, often worse after sex or a period, reflects a shift in the vaginal bacterial balance rather than an infection caught from a partner. It returns in a majority of people after treatment, so the plan matters as much as the antibiotic. We look at what triggers it for you, and at what genuinely reduces recurrence versus what merely sells well.
Two infections in six months, or three in a year, is recurrent UTI and deserves a strategy rather than another prescription. We review culture results, fluid and bladder habits, and — after the menopause — local vaginal oestrogen, which is a common, treatable and under-used part of the answer. Visible blood in the urine outside an infection, or infection with flank pain and fever, needs assessment the same day.
We can advise which tests are appropriate for your situation, how long after exposure a test becomes meaningful, and what a result you already hold actually says. Testing itself is performed by a laboratory or a sexual health service, and some infections are genuinely better managed there because of partner notification and treatment on site. We will tell you plainly which route is right.
The questions here are time-sensitive and often asked in the wrong room. A specialist appointment before you commit to private testing usually saves both money and months. The ACOG patient FAQ library is a reliable place to read around the subject beforehand.
The usual threshold for investigation is a year of regular unprotected sex — earlier if you are over 36, or where there is a known factor such as irregular cycles, previous pelvic surgery, endometriosis or chemotherapy. We assess both partners wherever possible, set out which tests to request and in what order, and say plainly whether you should be waiting, investigating or being referred.
Early loss is common, and the majority of first-trimester losses are chromosomal and could not have been prevented. Structured investigation is generally offered after two or three consecutive losses and covers uterine anatomy, thyroid function, antiphospholipid antibodies and, in selected cases, parental karyotype. We explain what each test can and cannot tell you, and which interventions the evidence actually supports.
Medication safety, supplements, existing conditions, unfamiliar symptoms and what the early scans are for. One boundary is absolute: pain with bleeding, severe one-sided or shoulder-tip pain, or feeling faint in early pregnancy needs same-day in-person assessment. That is an ectopic pregnancy until proven otherwise, and an online appointment is the wrong route for it.
Midlife symptoms are frequently managed one at a time by people who never see them together. A single appointment that considers sleep, mood, cycle, joints and libido as one process changes the plan. The NHS menopause pages set out the symptom range well.
It can begin seven to ten years before the final period, and it rarely introduces itself as hot flushes. A cycle that quietly shortens by a few days, sleep that fragments at three in the morning, new anxiety, joint aches and word-finding difficulty usually arrive separately and get treated separately. In the over-45s the diagnosis is clinical — a single FSH result is seldom the answer.
Twelve months without a period marks menopause itself. The HRT conversation is a personal risk conversation: type and route of oestrogen, whether you need a progestogen for endometrial protection, migraine with aura, clotting and breast history, and what you actually want. We give benefits and risks in absolute numbers you can weigh, not the relative percentages that make headlines.
Any bleeding a year or more after your final period must be investigated, however light and however brief. Most causes turn out to be benign — thin vaginal tissue, a polyp, an HRT-related pattern — but endometrial cancer has to be excluded first, and it is far more treatable when it is found early. This needs an urgent in-person referral rather than a routine online booking, and we will say so immediately.
These are among the most treatable conditions in gynecology and the least likely to be mentioned, often years after they began. Nothing here is an inevitable consequence of childbirth or age. The NHS prolapse guidance and its incontinence pages explain the options.
Leaking with coughing, laughing or running (stress incontinence) behaves differently from a sudden urge you cannot defer (urgency incontinence), and a great many people have both at once. Supervised pelvic floor muscle training for at least three months is first-line for stress symptoms and works properly when it is done properly. We identify which pattern you have, and what to do in what order.
Heaviness or dragging, a bulge you can feel, or difficulty emptying bladder or bowel are the usual descriptions. How severe it looks on examination and how much it bothers you often do not match — and treatment should follow the second. Options run from pelvic floor training through vaginal pessaries to surgery; confirming the type and stage requires an in-person examination, which we help you arrange.
Perineal pain that has not settled, urinary or bowel leakage, pain with sex months later, or scar tissue that simply feels wrong are not things to accept quietly. A great deal of this improves with specialist pelvic health physiotherapy and a proper assessment. We will tell you which symptoms need examining, and which can be worked on with a plan you can start this week.
This page covers what we are asked about most; it is not the boundary of what a consultant gynecologist can assess. Vulval skin conditions, contraception decisions with a complicated history, bleeding on HRT, a scan report nobody has explained, or a second opinion before surgery all belong here too.
Describe the problem in a few lines. A clinician reads it and tells you which consultation fits, which one does not, or that you do not need an appointment at HeliosCheck.com at all — that last answer is free and given more often than you might expect.
Every condition above is assessed against published guidance from
How we select, cite and review sources — and how often this page is checked — is set out in our editorial policy. Descriptions here are general health information, not a diagnosis; see our medical disclaimer and who we are.
Longer explainers on the conditions above — what the symptoms actually mean and what a proper assessment involves.Browse all articles.
Thirty to forty-five minutes with a consultant gynecologist, a written summary within 24 hours, and fourteen days of follow-up messaging with the same clinician. That is what every condition on this page gets at HeliosCheck.com.
