Chapter 7: Gynecology

The content addresses menstrual disorders, beginning with amenorrhea in both primary and secondary presentations, where primary amenorrhea reflects the absence of menarche while secondary amenorrhea involves cessation of previously established menses due to pregnancy, hormonal dysfunction, or systemic disease. Dysmenorrhea is distinguished between primary pain related to prostaglandin excess and secondary pain stemming from underlying pelvic pathology such as endometriosis. Premenstrual syndrome and its severe variant present as cyclical physical and psychological symptoms managed through lifestyle modification and pharmacological intervention. Abnormal uterine bleeding is systematically categorized using the PALM-COEIN framework to differentiate structural from functional causes, guiding diagnostic workup and treatment decisions. Uterine conditions including leiomyomas, endometriosis, and endometrial cancer are examined for their clinical presentations, diagnostic approaches, and management options ranging from conservative observation to surgical intervention. Polycystic ovary syndrome emerges as a complex endocrinopathy characterized by anovulation, hyperandrogenism, and metabolic dysfunction requiring multifaceted treatment. Ovarian malignancy and cervical dysplasia linked to human papillomavirus infection represent significant preventable cancers requiring appropriate screening protocols and risk stratification. Breast disorders encompass both benign conditions such as fibrocystic changes and mastalgia alongside breast cancer as the most prevalent malignancy in women, managed through multimodal therapy. The chapter reviews contraceptive options spanning hormonal, mechanical, and permanent methods tailored to individual patient circumstances. Finally, infertility evaluation incorporates assessment of ovulatory, tubal, uterine, and male factors with treatment options including medical management and assisted reproductive technologies, while pelvic inflammatory disease is addressed as an acute or chronic infection of the upper genital tract frequently associated with sexually transmitted infections requiring prompt antimicrobial therapy.