Gynaecology or gynecology (see spelling differences) refers to the surgical specialty dealing with health of the female reproductive system (uterus, vagina and ovaries). Literally, outside medicine, it means "the science of women". Almost all modern gynaecologists are also obstetricians; see Obstetrics and gynaecology.

History

The Kahun Gynaecological Papyrus is the oldest known medical text, (dated to about 1800 BCE) dealing with women's complaints—gynaecological diseases, fertility, pregnancy, contraception etc. The text is divided into thirty-four sections, each section dealing with a specific problem and containing diagnosis 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.

According to the Suda, the ancient Greek physician Soranus practiced in Alexandria and subsequently Rome. He was the chief representative of the school of physicians known as "Methodists." His treatise Gynaikeia is extant (first published in 1838, later by V. Rose as Gynaecology, in 1882, with a 6th-century Latin translation by Moschio, a physician of the same school).

In the United States, J. Marion Sims is considered the father of American gynaecology.

Examination

Gynaecology is typically considered a consultant specialty. 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 technique, or equipment unavailable to the GP, the patient is then referred to a gynaecologist. In the United States, however, law and many health insurance plans allow/force gynaecologists to provide primary care in addition to aspects of their own specialty. With this option available, some women opt to see a gynaecological surgeon without another physician's referral.

As in all of medicine, the main tools of diagnosis are clinical history and examination. 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 exam for complete evaluation of the pelvis, particularly if any suspicious masses are appreciated. Male gynaecologists often have a female chaperone (nurse or medical student) for their examination. An abdominal and/or vaginal ultrasound can be used to confirm any abnormalities appreciated with the bimanual examination or when indicated by the patient's history.