# Gynaecological Conditions — Topic Guide > Irregular bleeding, discharge, fibroids and cysts; smear and HPV screening. Irregular bleeding, discharge, fibroids and cysts; smear and HPV screening. ## Pages on this subject ### [HPV (Human Papillomavirus)](https://www.muratalpay.com.tr/en/tedaviler/hpv/) HPV (human papillomavirus) is a common group of viruses passed on through sexual contact; almost everyone who is sexually active meets it at some point in their life. In about 90% of people the body clears the infection on its own within 1–2 years. Some types cause genital warts, while high-risk types that persist can lead to cervical cancer over the years. There is no medicine for the virus itself; vaccination and regular screening protect. ### [Smear and HPV Testing](https://www.muratalpay.com.tr/en/tedaviler/pap-smear-ve-hpv/) A smear (Pap) test is a screening test that looks for changes that come before cancer in cells taken from the cervix. An HPV test looks not at the cells but at the cause, that is, the high-risk HPV types that can lead to cancer; in guidelines, screening with the HPV test alone is the preferred method. The sample is taken by a doctor; for people at average risk, a vaginal sample they take themselves is also acceptable. The HPV vaccine is important for protection but does not replace screening. ### [Colposcopy](https://www.muratalpay.com.tr/en/tedaviler/kolposkopi/) Colposcopy is examination of the cervix with a magnifying instrument (colposcope) and a strong light. It is usually requested after an abnormal smear or HPV test result and takes 15–20 minutes: a dilute vinegar solution is applied to the cervix and, if a suspicious area is seen, a small tissue sample (biopsy) is taken. The definitive diagnosis comes from the laboratory examination of the biopsy, not from colposcopy itself. ### [Genital Warts Treatment](https://www.muratalpay.com.tr/en/tedaviler/genital-sigil/) Genital warts (condylomata) are "cauliflower-like" growths caused by the low-risk HPV types 6 and 11; the HPV types that cause cancer are different. The diagnosis is usually made by examination. Treatment options are freezing (cryotherapy), cautery (burning with heat), surgical removal, laser vaporisation or topical treatments applied to the skin; the HPV vaccine is recommended for prevention. Whichever method is chosen, recurrence is common. ### [Polycystic Ovary Syndrome](https://www.muratalpay.com.tr/en/tedaviler/polikistik-over-sendromu/) Polycystic ovary syndrome (PCOS) is a common condition in women of reproductive age that concerns hormones, the menstrual cycle, the skin, metabolism and mental health together. Diagnosis requires at least two of excess male hormone, irregular periods and the appearance of the ovaries on ultrasound, with similar conditions ruled out. The foundation of treatment is a sustainable lifestyle; medicines are aimed at symptoms. Because of diabetes and heart and vascular risks, lifelong follow-up is needed. ### [Irregular and Abnormal Bleeding](https://www.muratalpay.com.tr/en/tedaviler/adet-duzensizligi/) Abnormal uterine bleeding covers heavy menstrual bleeding, bleeding between periods, bleeding after intercourse and bleeding after menopause. The measure is not the calendar alone but how much the bleeding affects daily life. Pregnancy is ruled out first; ultrasound and, if needed, a biopsy (a small tissue sample from inside the womb) follow, and treatment with medicines or surgery is planned according to the cause. Every episode of bleeding after menopause must be investigated. ### [Vaginal Discharge](https://www.muratalpay.com.tr/en/tedaviler/vajinal-akinti/) Vaginal discharge is not always a sign of illness; normal discharge is small in amount, clear or white and odourless, and does not cause itching or burning. The three most common causes of discharge due to infection are bacterial vaginosis (disturbance of the balance of the protective bacteria in the vagina), thrush (fungal infection) and trichomoniasis, which is sexually transmitted. They are told apart by examination and microscopy, and treatment is planned according to the cause. More than half of self-made diagnoses are wrong. ### [Urinary Incontinence](https://www.muratalpay.com.tr/en/tedaviler/idrar-kacirma/) Urinary incontinence is a common complaint that can affect women of any age. Its main types are the stress type, with coughing or laughing; the urge type, with a sudden, strong need to pass urine; and the mixed type, where both occur together. The first step is not an operation but supervised pelvic floor muscle training (exercises for the muscles at the base of the pelvis) and bladder training. Medicines and surgery come later. ### [Hysteroscopy](https://www.muratalpay.com.tr/en/tedaviler/histeroskopi/) Hysteroscopy (viewing the inside of the womb with a camera) is looking directly inside the womb with a fine telescope; treatment can be carried out in the same session. It is used to remove polyps and fibroids (benign muscle masses) growing into the cavity of the womb, to open adhesions inside the womb, to cut a septum (a dividing wall inside the womb) and to remove a lost coil. Routine preventive antibiotics are not recommended. A rare but serious risk is perforation of the wall of the womb. ### [Laparoscopic (Keyhole) Surgery](https://www.muratalpay.com.tr/en/tedaviler/laparoskopik-cerrahi/) Laparoscopic (keyhole) surgery is an operation carried out with a camera and fine instruments through openings of a few millimetres made in the abdomen. Compared with open surgery there is less pain, a shorter hospital stay, fewer adhesions and a very small scar. But it is not without risk: some bowel injuries are not noticed during the operation, so increasing abdominal pain after you go home means you should seek help without delay. ### [LEEP](https://www.muratalpay.com.tr/en/tedaviler/leep/) LEEP is the removal of the area of abnormal cells on the cervix with a fine loop of electrical wire. It is mainly used for high-grade cell changes (CIN 2 and CIN 3). It both clears the diseased tissue and provides a sample in one piece for pathological examination (examination of the tissue in the laboratory). The disease can still persist or recur; the margins of the removed tissue give guidance on this. ### [Uterine Fibroids](https://www.muratalpay.com.tr/en/tedaviler/miyom/) A fibroid (myoma) is a non-cancerous lump growing from the muscle wall of the womb and the most common tumour of the lower abdomen (pelvis) in women. Most women with fibroids have no symptoms and need only check-ups. With heavy bleeding, pressure or pregnancy problems, medicines, surgery or non-surgical methods are chosen by fibroid position, age and wish for children. ### [Endometrial Polyps](https://www.muratalpay.com.tr/en/tedaviler/rahim-ici-polip/) An endometrial polyp is a mostly benign (non-cancerous) growth that forms when the lining of the womb overgrows in one area. It is found in about 8–35% of women; its most common symptom is bleeding between periods or after the menopause. Ultrasound and hysteroscopy (viewing the inside of the womb with a camera) are used for diagnosis. In women with bleeding, after the menopause and in infertility, the polyp is usually removed by hysteroscopy. ### [Ovarian Cysts](https://www.muratalpay.com.tr/en/tedaviler/yumurtalik-kisti/) An ovarian cyst is a small sac, usually filled with fluid, that forms in the ovary. Most cysts seen before the menopause are non-cancerous and are temporary cysts linked to ovulation; simple cysts smaller than 5 cm usually disappear on their own within 1–3 menstrual cycles. Surgery by keyhole (laparoscopic) technique is considered for cysts that grow, persist, look suspicious or cause pain. ### [Vaginal Infection Treatment](https://www.muratalpay.com.tr/en/tedaviler/vajinal-enfeksiyon-tedavisi/) The three most common causes of vaginal infection are bacterial vaginosis (an imbalance of the helpful bacteria), thrush (a yeast infection) and trichomoniasis, which is sexually transmitted. Their symptoms are similar but their treatments differ: bacterial vaginosis and trichomoniasis are treated with antibiotics, thrush with antifungal medicine. Treating the partner is essential only in trichomoniasis. For the right treatment, the diagnosis is made by examination and simple tests. ## Posts on this subject - [HPV in Men: Testing, Vaccination and What Partners Should Do](https://www.muratalpay.com.tr/en/blog/erkeklerde-hpv-testi-asi-ve-partnerin-yapmasi-gerekenler/) - [HPV in Pregnancy: Can It Pass to the Baby, and Can I Have a Normal Birth?](https://www.muratalpay.com.tr/en/blog/gebelikte-hpv-bebege-gecer-mi-normal-dogum-olur-mu/) - [Genital warts (HPV): causes, treatment and prevention](https://www.muratalpay.com.tr/en/blog/genital-sigil-hpv-nedir-belirtileri-ve-tedavi-yontemleri/) - [HPV 16 and 18 Positive: What Does Genotyping Mean?](https://www.muratalpay.com.tr/en/blog/hpv-16-18-pozitif-genotipleme-ne-anlama-gelir-kolposkopi-gerekir-mi/) - [The HPV vaccine: what it is, who it is for and when it is given](https://www.muratalpay.com.tr/en/blog/hpv-asisi-nedir-kimlere-ne-zaman-yapilir-antalya/) - [Do I Still Need a Smear Test After the HPV Vaccine?](https://www.muratalpay.com.tr/en/blog/hpv-asisi-yaptirdim-smear-testi-hala-gerekir-mi/) - [What is the difference between a smear test and an HPV test?](https://www.muratalpay.com.tr/en/blog/smear-testi-ile-hpv-testi-arasindaki-fark-nedir/) - [Spotting or Bleeding After a Smear Test: Is It Normal?](https://www.muratalpay.com.tr/en/blog/smear-testi-sonrasi-lekelenme-kanama-normal-mi-ne-zaman-doktora-gidilir/) [All posts →](https://www.muratalpay.com.tr/en/blog/) --- Original page: https://www.muratalpay.com.tr/en/kadin-hastaliklari/ Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya 0505 351 77 88 · Monday – Saturday 09:00 – 18:00 · Closed on Sunday *This information is for general guidance only and does not replace examination, diagnosis or treatment.*