Initial gynaecology consultation

What is an initial gynaecology consultation?

An initial consultation is your first appointment with a Consultant Gynaecologist to assess a new symptom, concern, or clinical question that has not been reviewed at this clinic before. It is a thorough review of your history, a clinical examination where appropriate, and a discussion of what comes next: whether that is reassurance, investigations, medical treatment, or referral for a procedure.

This appointment is with Mr Hikmat Naoum (MRCOG), not a GP or registrar. The distinction matters because a Consultant can make diagnostic and treatment decisions at the first visit rather than referring you onwards for another opinion.

If you have already been seen at the clinic and need a planned review, choose a follow-up consultation instead.

Conditions assessed at this appointment

An initial consultation covers any gynaecological concern. Common reasons women book include:

• Pelvic pain. Persistent or cyclical pain, pain during sex, or pain with bowel or bladder function. This may indicate endometriosis, adhesions, or other pelvic pathology.
• Abnormal bleeding. Heavy periods, bleeding between periods, post-coital bleeding, or post-menopausal bleeding. Causes include fibroids, polyps, and hormonal imbalance.
• Ovarian cysts and pelvic masses. Investigation and monitoring of ovarian cysts found on imaging or suspected from symptoms.
• PCOS. Assessment of irregular periods, excess hair growth, weight changes, and hormonal concerns consistent with polycystic ovary syndrome.
• Fertility concerns. Initial evaluation if you are having difficulty conceiving, with pathways to fertility assessment or couple investigation.
• Contraception. Discussion of contraceptive options including the coil (IUD/IUS) and other methods.
• Menopause and HRT. Symptom assessment and treatment discussion, with dedicated pathways via the menopause clinic.
• Abnormal smear results. Review and management after an abnormal cervical smear or HPV finding, including colposcopy.

If your concern does not appear in this list, call the clinic. The appointment covers any gynaecological presentation.

What happens during your appointment

The consultation follows a clear structure:

• History. Mr Naoum will ask about your symptoms, their timing and severity, your menstrual cycle, previous pregnancies, surgical history, medications, and family history. Be as specific as you can; it helps narrow the diagnosis.
• Examination. A pelvic examination is carried out when clinically appropriate. It is not always necessary at the first visit; the Consultant will explain whether it is needed and what it involves before proceeding. A chaperone is available on request.
• Discussion. Based on what the history and examination show, Mr Naoum will explain the likely diagnosis and recommend next steps. This might be reassurance, blood tests, a scan, a procedure, or a combination.
• Plan. You leave with a clear plan: what needs to happen, in what order, and what the expected timeline is. If tests are needed, many can be arranged the same day.

Investigations that can follow

Depending on your presentation, Mr Naoum may recommend one or more of the following. Several can be arranged on the same day as your consultation:

• Pelvic ultrasound (transvaginal and/or abdominal) for fibroids, cysts, endometriosis, or uterine assessment. From £350, often done same day.
• Blood tests including hormone profiles, ovarian reserve (AMH), thyroid function, and PCOS panels.
• Cervical smear if you are overdue or if symptoms warrant screening.
• Referral for further imaging (MRI) or surgical procedures where clinically indicated.

Why see a Consultant rather than a GP?

A GP can assess gynaecological symptoms and refer you onwards, but that referral adds weeks or months before you see a specialist. On the NHS, non-urgent gynaecology referrals typically take 12-26 weeks. During that time, symptoms continue, uncertainty builds, and conditions that respond best to early treatment may progress.

At this clinic, you see a Consultant Gynaecologist at the first appointment, not a trainee or registrar. Diagnostic decisions happen on the day. If an ultrasound is needed, it can be done in the same visit. If treatment is straightforward, it can start immediately.

This is not about bypassing your GP. Many women attend with a GP referral or after having been told to "wait and see" for months. The consultation provides the specialist opinion your symptoms warrant, on a timeline that does not leave you waiting.

Frequently asked questions