CONSULTANT GYNAECOLOGIST
MY SPECIALTIES
RECURRENT MISCARRIAGE
ENDOMETRIOSIS
Key points
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Recurrent miscarriage is when you have had three or more early miscarriages.
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Most cases of recurrent miscarriage are unexplained. However, there are many different things which may make a miscarriage more likely. These include being older, being very under or overweight, smoking, and drinking excessive alcohol or caffeine. There can be problems with the way your blood clots, the shape of your womb, your hormones or genetics.
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You will be offered investigations to see if there is a reason for recurrent miscarriage. If a possible reason is found, there may be treatment available to improve your chances of a successful pregnancy.
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If recurrent miscarriage is unexplained, most women will have a good chance of a successful pregnancy in the future, with support from their healthcare team.
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Leaflet: Recurrent miscarriage | RCOG
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Further support
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The Miscarriage Association
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Phone line: +44 (0)1924 200799
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Tommy’s
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Saying Goodbye
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Sands
Endometriosis can be a long-term condition, and can have a significant physical, sexual, psychological and social impact. Women may have complex needs and require long-term support.
Leaflet: Endometriosis | RCOG
SUBFERTILITY AND REPRODUCTIVE ENDOCRINOLOGY
People who are concerned about their fertility should be informed that over 80% of couples in the general population will conceive within 1 year if:
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the woman is aged under 40 years and
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they do not use contraception and have regular sexual intercourse. Of those who do not conceive in the first year, about half will do so in the second year (cumulative pregnancy rate over 90%).
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Patients can undergo testing for subfertility if they have any symptoms/concerns and get advice for ​any changes/options that will help. Seeking advice early in such situations is always recommended.
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Further information: British Fertility Society (BFS) | RCOG
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Information hub » British Fertility Society
WELL WOMAN CLINIC
At the Well Woman Clinic, I will prioritise a holistic approach to women's health, ensuring that each patient receives detailed history taking and thorough examinations when appropriate. By understanding the expectations and incorporating informed decision-making into personalised care plans she strives to empower you on your journey.
MENSTRUAL PROBLEMS
This service focuses on addressing menstrual problems experienced by women of all ages. I will conduct thorough analysis of your clinical history and necessary investigations to accurately diagnose your condition, guiding personalised treatment plans for effective management.
COMPLEX FIBROID MANAGEMENT
Fibroids can occur at any ages and can be very symptomatic. Small fibroids are usually managed conservatively based on the location and symptoms. However where symptomatic and large and when fertility is a consideration, the treatment may involve medical or surgical options. I have extensive experience in guiding patients through managing fibroids and providing medical and surgical care.
OVARIAN CYSTS
Ovarian cysts when large (>5 cm in women less 50 years of age) will be symptomatic and may need surgical treatment. This is done with a laparoscopic (key hole) surgery and as a day case generally. There are usually 3-4 5 mm openings on the abdominal wall which are glued for good healing and best cosmetic results. All information will be provided in details at the consultation.
PAEDIATRIC GYNAECOLOGY
Paediatric gynaecology involves treating young girls under the age of 18 for various menstrual and gynaecological problems. Many young girls suffer from heavy and painful periods, which can be erratic or can present with various premenstrual syndrome (PMS) like symptoms. This can often be debilitating and affect their quality of life, including their attendance and performance in school.
Increasingly, younger girls are more empowered in seeking help, and it is extremely important that their concerns are dealt with extreme sensitivity and empathy. This involves understanding the pathophysiology of the condition, linking with hormonal tests where necessary, and then instituting a management plan that suits them best.
Miss Mukhopadhaya specialises in seeing younger girls from any age and will be happy to help and advise.
PELVIC FLOOR STRENGTHENING
Advice on perineal muscle strengthening
1. ​Using a daily mindfulness app such as headspace or calm, and/or meditation can be great for releasing tension held in the PF musculature
2. Mark Williams for meditation https://www.youtube.com/watchv=fUeEnkjKyDs&list=PLbTuZkZyHw9I7-YcOp27YgOVuo1tCJUFE
3. Try 2-5 minutes of ‘diaphragmatic/abdominal/belly’ breathing daily and then continue with 3-5 breaths hourly throughout the day.
4. This is a you tube links to demonstrate diaphragmatic/ abdominal/belly breathing https://www.youtube.com/watch?v=kgTL5G1ibIo
5. Just to confirm regarding the abdominal breathing- when you breathe in your tummy swells out gently into your hand, when you breathe out it moves in towards your back.
Try a few synchronised squeezes of your PF muscles (contracting as you exhale and release as you inhale)
6. Gentle pelvic stretches- daily and to use belly breathing through the stretch https://www.pelvicpain.org.au/easy-stretches-to-relax-the-pelvis-women/?v=ef10366317f4
This will be good to do for a few weeks before you begin strengthening your muscles.
Meanwhile please look at this link which is general advice for pelvic healthcare after childbirth which is useful for everyone.
MENOPAUSE
•Miss Mukhopadhaya is a BMS recognised Menopause Specialist and Trainer. She delivers talks on Menopause Nationally and Internationally (6-10 invited talks on Menopause each year).
She has a deep understanding of various hormonal strategies and Menopause transition which is an unique phase in life
She will focus on
•Symptoms
•Assessment
•What is different in women of colour?
•Risks and Benefits
•Management strategies
•Complimentary and Alternative options including newer therapies with evidence
Other resources
Information for women with premature ovarian insufficiency”
Risk-Reducing Salpingo-Oophorectomy and the Use of Hormone Replacement Therapy Below the Age of Natural Menopause (Scientific Impact Paper No. 66) · https://www.rcog.org.uk/sip66
Support groups - Daisy network
https://www.womens-health-concern.org/
Royal Osteoporosis Society (https://theros.org.uk/) for information on lifestyle and bone health. ROS website. https://theros.org.uk/information-and-support/osteopenia/
Women’s Health Concern Website Factsheet Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms: https://www.womens-health-concern.org/help-and-advice/factsheets/cognitive-behaviour-therapy-cbt-menopausal-symptoms/
Women’s Health Concern Website Factsheet Complementary/alternative therapies for menopausal women https://www.womens-health-concern.org/help-and advice/factsheets/ complementaryalternative-therapies-menopausal-women/
Managing Hot Flushes and Night Sweats: a cognitive behavioural self-help guide to the menopause Dr Myra Hunter and Melanie Smith
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PROCEDURES
HAVING A HYSTERECTOMY
Abdominal Hysterectomy for Benign Conditions (Consent Advice No. 4) | RCOG
Surgical Management of Miscarriage and Removal of Persistent Placental or Fetal Remains
​Surgical Management of Miscarriage
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HYSTEROSCOPY AND RESECTION OF POLYPS AND FIBROIDS
Diagnostic Hysteroscopy Under General Anaesthesia (Consent Advice No. 1) | RCOG
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