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Experts in Women’s Gynaecological Care

Welcome to Northern Medical Women’s Health Clinic, Ahoghill, Ballymena.

We offer the most up-to-date advice and treatments for women of all ages. This care is provided by a friendly experienced  team in private, professional and comfortable consulting rooms. If surgery or procedures are required, these are performed in the safest surgical environment with state-of-the art equipment and a highly trained team.



Created: Thursday, 02 November 2017


Infertility is very common problem affecting about 1 in 8 couples. This can be defined as “primary” i.e. no previous pregnancies or “secondary” the woman has had a previous pregnancy, even if this ended in a miscarriage. Most gynaecologists would not investigate sub-fertility until the couple have being trying to conceive for 12 months without success.

Infertility causes can simplistically be divided into 4 categories. Ovulatory problems, tubal factors, male factors and “unexplained”. A basic history and examination including a vaginal ultrasound should be undertaken. Other basic investigations namely blood tests; a HSG or hysterosalpingogram (a dye test to check if the fallopian tubes are blocked), semen analysis and sometimes a laparoscopy should be performed before the patient is referred onto a tertiary fertility centre.

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Pelvic Pain

This can be a very simple or a very difficult condition to manage particularly if it is a chronic condition i.e. lasts more than 6 months.The gynaecologist must do his best to try and identify a cause and sometimes after extensive investigation no gynaecological cause is found. This is not necessary a bad thing as the gynaecologist can then refer to another speciality to focus in on another a cause. Again this begins with a detailed history and an examination. Cyclical pain is usually gynaecological in origin especially when associated with painful, heavy periods and deep pain on intercourse (dysparaenia).

This also requires investigations include a transvaginal (internal) scan, abdominal/pelvic ultrasound, genital tract swabs, sometimes CT / MRI scans. If indicated a laparoscopy to try and diagnose a gynaecological cause would be considered a gold standard investigation. There are several gynaecological causes including endometriosis, adenomyosis, ovarian cysts, adhesions, and pelvic infections that should be discussed with your gynaecologist. Depending on the condition suspected or diagnosed there a usually multiple treatment options that can also be offered.

Urinary Incontinence

Our surgeons work to address this set of gynaecology symptoms as part of a multidisciplinary approach with our continence advisors and physiotherapists. Conservative approaches are usually discussed and tried before surgery in considered. Urogynaecology is a sub-specialty of Gynaecology, and in some countries is also known as Female Pelvic Medicine and Reconstructive Surgery. A urogynaecologist manages clinical problems associated with dysfunction of the pelvic floor and bladder. Pelvic floor disorders affect the bladder, reproductive organs, and bowels. Common pelvic floor disorders include urinary incontinence, pelvic organ prolapse and faecal incontinence. Increasingly, Urogynaecologists are also responsible for the care of women who have experienced trauma to the perineum during childbirth.

There is some crossover with the subspecialty of Female Urology - these doctors are urologists who undergo additional training to be able to manage female urinary incontinence, pelvic organ prolapse and interstitial cystitis/PBS. In addition, there are colorectal surgeons who have a special interest in anal incontinence and pelvic floor dysfunction related to rectal function. Contemporary urogynaecological practice encourages multidisciplinary teams working in the care of patients, with collaborative input from urogynaecologists, urologists, colorectal surgeons, elderly care physicians, and physiotherapists. This is especially important in the care of patients with complex problems, e.g. those who have undergone previous surgery or who have combined incontinence and prolapse, or combined urinary and bowel problems.

Multidisciplinary team meetings are an important part of the management pathway of these women. Urogynaecologists manage women with urinary incontinence and pelvic floor dysfunction. The clinical conditions that a urogynaecologist may see include stress incontinence, overactive bladder, voiding difficulty, bladder pain, urethral pain, vaginal or uterine prolapse, obstructed defecation, anal incontinence, and perineal injury. They may also care for women with vesico-vaginal or rectovaginal fistulae with specialist training, and in conjunction with other specialties.


Reflexology is a gentle, non-invasive touch therapy working on the reflex areas of the feet or hands which corresponds to the structures and organs of the body. Reflexology works along holistic principals aiming to treat your mind, body and spirit.  All organs and body systems can be mapped onto areas of the feet called reflex points. By working these reflex points you can bring about a response in the corresponding part of the body and induce a deep sense of relaxation, restores energy and promotes the body’s own ability to restore and heal itself.

It is suitable for a wide range of conditions and for clients of all ages.

Some of the benefits include

  • Reduces stress by generating deep relaxation, helping the body to balance itself and allowing healing energy to flow. This in turn improves circulation.

  • Improves immune system by stimulating the lymphatic system to cleanse the body of toxins and impurities and stimulate the production of endorphins leading to a sense of wellbeing.

  • Stimulates nerve function and can reduce pain.

  • It can help muscle spasm and cramps.

  • It can help ease sciatica and rheumatoid arthritis.

  • It lifts the mood, aids sleep and helps relieve tension leading to a sense of wellbeing.

 Further information about reproductive reflexology can be found here: https://reproductivereflexologists.org


Vulval Discomfort and Pain

Symptoms of itching, burning and pain affect many women of all ages.  This can be very distressing and embarrassing but is often treatable following correct diagnosis.

Skin disorders are a frequent culprit and Lichen sclerosus a frequent offender.  This is not an infection but a chronic inflammatory disorder which affects the skin around the vagina and anus.  It is not contagious and cannot be “caught” from or transmitted to a partner.  As well as burning, itch and pain the condition causes the appearance of the vulva to change.  The skin becomes white and shiny.  In severe cases adhesions (scar tissue) can form making passing urine or intercourse difficult. It is not unusual for the skin to crack or fissure in this condition which makes infections such as thrush or bacterial infections take hold making things worse.

The cause is not fully understood but when one examines the skin from a patient with lichen sclerosus under a microscope one can see the body’s own immune cells attacking the skin.  This process causes the symptoms and signs.

Treatment involves a thorough assessment of factors which may be aggravating the condition.  Products such as shower gels and personal hygiene products, for example panty liners may contribute to the irritation caused by the disorder.  Patients with Diabetes or certain types of anaemia often suffer more symptoms of lichen sclerosus if these conditions are not optimised.

Specific treatment is also required in the form of strong steroid ointments or creams.  These work by stopping the immune system’s cells from attacking the skin.  Moisturising creams or gels are also used to help soften and protect the skin.  This makes  fissuring or cracking of the skin less likely, improving discomfort and reducing the risk of infection.

Over time the steroid cream will improve things to the point were symptoms resolve.  It is a good idea to continue caring for the vulval skin by avoiding soaps, perfumed products etc and keeping the skin soft and supple with moisturiser.  Flares ups of the Lichen sclerosus often occur requiring further use of the steroid cream or ointment but with correct diagnosis and management most patients are able to get on with life and have little disruption to their activities.  We do recommend regular checking of the skin as rarely a type of skin cancer can occur.  We encourage women to self examine regularly but many appreciate the reassurance of an expert assessment annually.

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