Frequently Asked Questions

Preventing sexually transmitted infections (STIs) relies on several complementary measures:

• Condoms: the most effective way to protect yourself during every sexual encounter (vaginal, anal, oral).
• HPV vaccination: recommended for girls and boys from age 11, it protects against papillomaviruses responsible for cervical, vulvar and anal cancers.
• Hepatitis B vaccination: essential to prevent this chronic liver infection transmitted sexually.
• Chlamydia screening: systematically recommended for sexually active young people aged 15 to 25, as this infection is often silent.
• Free screening kits: for 18-25 year-olds in France, self-tests are available free of charge at mon-test-ist.ameli.fr.

Any bleeding occurring after menopause (no periods for more than 12 months) requires a prompt consultation. Even if it is often benign, it must be investigated to rule out a serious condition.

The assessment generally includes:

• Endovaginal ultrasound: first-line examination to assess endometrial thickness and detect any abnormalities.
• Endometrial biopsy: sample taken during consultation for analysis if the endometrium is thickened.
• Diagnostic hysteroscopy: if necessary, to directly visualise the uterine cavity.
• Pelvic MRI: depending on results, to complete the assessment.

Hysteroscopy is a procedure that allows visualisation of the inside of the uterus using a small camera (hysteroscope) introduced through the natural passages. There are two types:

• Diagnostic hysteroscopy: performed in the office, without anaesthesia, to investigate abnormal bleeding, ultrasound abnormalities or as part of an infertility assessment.
• Operative hysteroscopy: performed in the operating room under anaesthesia, it allows treatment of polyps, intracavitary fibroids, Asherman syndrome or uterine septa.

A hysterectomy is the surgical removal of the uterus. It is a common procedure performed for various indications (fibroids, endometriosis, gynaecological cancers, prolapse).

4 types of hysterectomy:

• Total: removal of the body and cervix of the uterus.
• Subtotal (supracervical): preservation of the cervix.
• With bilateral salpingo-oophorectomy: removal of the uterus, fallopian tubes and ovaries.
• Radical: extended removal including parametria (in case of cancer).

4 surgical approaches:

• Abdominal (laparotomy): abdominal incision, reserved for complex cases.
• Vaginal: no abdominal incision, faster recovery.
• Laparoscopy: mini-incisions, camera and miniaturised instruments.
• vNOTES: innovative technique combining vaginal and laparoscopic approach, with no visible scar.

Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women of reproductive age (about 10% of women). It comes in 4 phenotypes:

• Type A: hyperandrogenism + ovulation disorders + polycystic ovaries on ultrasound.
• Type B: hyperandrogenism + ovulation disorders.
• Type C: hyperandrogenism + polycystic ovaries.
• Type D: ovulation disorders + polycystic ovaries (without hyperandrogenism).

Symptoms: irregular or absent periods, hirsutism (excessive hair growth), acne, weight gain, difficulty conceiving.

Tests: pelvic ultrasound (multi-follicular ovarian appearance) + hormonal blood test performed between day 2 and day 5 of the cycle (LH, FSH, testosterone, AMH, insulin, blood sugar).

Treatments:

• Lifestyle: balanced diet, regular physical activity, stress management.
• Myo-inositol: dietary supplement improving insulin sensitivity and ovulatory quality.
• Assisted reproduction (ART): when pregnancy is not achieved despite first-line treatments.

Genital prolapse (or "pelvic organ prolapse") refers to the abnormal descent of one or more pelvic organs (bladder, uterus, rectum) into the vagina, due to weakening of the pelvic floor.

Symptoms: sensation of a vaginal lump, pelvic heaviness, urinary problems (incontinence, difficulty emptying the bladder), discomfort during sexual intercourse.

Causes and risk factors: pregnancies and deliveries (especially multiple), menopause (oestrogen deficiency), obesity, chronic constipation, heavy lifting.

Treatments:

• Pelvic floor rehabilitation: strengthening the pelvic floor muscles, an essential first step.
• Vaginal pessary: medical device inserted into the vagina to support the organs, a non-surgical alternative.
• Surgery: if conservative treatments fail, various techniques are available (laparoscopic sacrocolpopexy, vaginal surgery).