Preface

This course is designed to be a relatively broad discussion on the topic of gynecology. Gynecologists must care for the healthy woman with minor gynecological problems as well as the sick woman who has life-threatening problems such as the various kinds of gynecological cancers seen in women. Both well gynecological care and the care of sick women with gynecological problems will be discussed.

The first chapter of the course is a discussion of menstruation, which is a natural phenomenon that happens from the age of about twelve to the age of about fifty. Normal menstruation takes place every twenty-eight days and may or may not be associated with premenstrual symptoms, which might be debilitating to some women.

The second chapter of the course covers the topic of premenstrual syndrome and premenstrual dysphoric disorder. This can be a problem of both young and old menstruating women who have both physical and psychological symptoms related to the premenstrual state. There are medications that can be given to women who suffer from premenstrual syndrome and premenstrual dysphoric disorder as well as lifestyle changes that can happen as a result of hormonal changes.

The third chapter of the course is a thorough discussion of the topic of amenorrhea. The most common cause of amenorrhea is pregnancy although there are a host of other mental and physical things that can be associated with amenorrhea in women of all ages.

The fourth chapter of the course a discussion of both hyperprolactinemia and galactorrhea, which is the most common symptom women complain of when the prolactin level is too high. The various causes of hyperprolactinemia will be discussed as well as the most common reasons why a woman would have this problem.

Abnormal uterine bleeding is the main topic in the fifth chapter of this course. Abnormal uterine bleeding can happen to young women or older women and may represent mild menstrual difficulties or a serious underlying gynecological problem. The various causes of abnormal uterine bleeding will be covered in this chapter as there are many possible underlying problems that can cause this symptom.

Endometriosis is discussed in the sixth chapter of this course. Endometriosis has several symptoms associated with it, some of which are mild, while others are severe and debilitating. The woman with endometriosis can suffer from infertility as a major problem or can only have dyspareunia or pain with intercourse.

Cervical cancer is the topic of discussion in the seventh chapter of this course. Cervical cancer can affect young women who become infected with the human papillomavirus and is rarely a problem affecting women who were never infected with the virus.

Endometrial cancer, on the other hand, is a disease mainly of older women and is discussed in the eighth chapter of this course. Women who have had years of unopposed estrogen run the risk of endometrial hyperplasia and endometrial cancer that will manifest itself as abnormal vaginal bleeding and pelvic pain.

Ovarian cancer is the focus of the ninth chapter. Women with ovarian cancer are diagnosed usually in the later stages of the disease process and are very ill, even after being treated maximally for the disorder. The death rate from endometrial cancer is very high because many women aren’t diagnosed until they have advanced cancer.

Vulvar and vaginal cancer are discussed together as part of the tenth chapter of this course. Women who have these types of cancer face extremely disfiguring surgery and chemotherapy— both things that will prolong their life if they are done soon enough to help the woman before the cancer metastasizes.

Sexually transmitted diseases and their treatments are the focus of the eleventh chapter of this course. Women can get sexually transmitted diseases from having sexual contact with many different sexual partners or having unprotected sex with an individual who transmits the disease to them.

Breast cancer is the main topic in the twelfth chapter of this course. Breast cancer affects mainly women over the age of forty but can affect younger women who carry the various genes associated with breast cancer that can be inherited and may result in breast cancer at a very young age.

The thirteenth and concluding chapter of the course is a discussion of the menopausal process. Women go through menopause at about the age of fifty, after which they have no menstrual periods and begin to have an increased risk for several various kinds of diseases, such as osteoporosis and coronary artery disease. The treatment of menopausal symptoms is a major part of this last chapter on gynecology.