I provide a structured private gynaecology pathway for pelvic pain, bleeding changes, menopause, fertility and other women’s health concerns. Pelvic ultrasound, clinically targeted blood tests and cervical screening may be arranged where appropriate; no GP referral is needed for most services.
Gynaecological symptoms are frequently dismissed, normalised, or attributed to stress — particularly in primary care settings where appointment time is limited. Research published in Fertility and Sterility found that women with endometriosis report delays of 4 to 11 years from first symptom onset to surgical diagnosis, with many describing negative experiences in the primary care setting where their pain was minimised or disbelieved. A scoping review of international evidence confirmed an average diagnostic delay of 6.8 years across studies, with delays occurring at both patient and clinician level.
Pelvic pain, heavy periods, irregular cycles, menopausal symptoms, and fertility concerns warrant individual assessment. At Victoria Medical, the clinic confirms the appropriate appointment route and availability at booking.
Our gynaecologist works within a multidisciplinary team that includes GMC-registered GPs and diagnostic sonographers. Pelvic ultrasound, hormone blood tests and cervical screening may be arranged where appropriate. If specialist onward care is needed, the appropriate route is explained in the clinical context.
Written & reviewed by
Dr George XynopoulosConsultant Physician & Cardiologist · GMC 3502763 · Reviewed by Dr George Xynopoulos, GMC 3502763
Clinical review date: 21 August 2026
View full profileWhat Is a Private Gynaecology Consultation?
A private gynaecology consultation is a specialist women’s-health appointment outside the NHS system. The clinician assesses your symptoms, decides whether investigations are useful, discusses treatment options within the clinic’s scope and explains when a surgical, subspecialist or NHS pathway is more appropriate.
The appointment format and any investigations depend on the clinical question. The clinic confirms appointment availability, the intended clinician and whether ultrasound, blood tests or screening can be included when you book.
The conditions managed in private outpatient gynaecology span the full reproductive lifespan — from adolescent menstrual disorders through to postmenopausal bleeding and gynaecological cancer surveillance. Our consultant gynaecologist has particular expertise in endometriosis, PCOS, menopause management, and fertility assessment.
Gynaecological Conditions We Assess and Manage
Our consultant gynaecologist assesses and manages the full range of conditions encountered in private outpatient gynaecology practice. The conditions below represent the most common presentations, but patients are welcome to book for any gynaecological concern.
- Pelvic pain — acute and chronic, including endometriosis and adenomyosis assessment
- Irregular periods — oligomenorrhoea, amenorrhoea, intermenstrual bleeding
- Heavy periods (menorrhagia) — investigation and management including hormonal and non-hormonal options
- Fibroids (uterine leiomyomata) — diagnosis, monitoring, and treatment planning
- Ovarian cysts — assessment, monitoring, and surgical referral where indicated
- Polycystic ovary syndrome (PCOS) — diagnosis using Rotterdam criteria, metabolic assessment, and management
- Endometriosis — clinical assessment, investigation, and management
- Menopause and perimenopause — symptom assessment, clinically targeted testing where appropriate, and treatment discussion
- Premature ovarian insufficiency (POI) — diagnosis and management
- Cervical screening (smear test) — including colposcopy referral for abnormal results
- Vulval conditions — vulvodynia, lichen sclerosus, recurrent thrush
- Fertility assessment — initial investigation including AMH, AFC ultrasound, and referral for assisted conception
- Contraception — advice and fitting of long-acting reversible contraception (LARC)
- Post-menopausal bleeding — urgent assessment and investigation
Endometriosis: Diagnosis and the Problem of Diagnostic Delay
Endometriosis affects an estimated 10% of women of reproductive age worldwide. It is characterised by the presence of endometrial-like tissue outside the uterus — most commonly on the ovaries, fallopian tubes, and peritoneum — causing chronic inflammation, adhesions, and pain. The cardinal symptoms are dysmenorrhoea (painful periods), deep dyspareunia (pain during intercourse), chronic pelvic pain, and subfertility.
The diagnostic delay for endometriosis is one of the most documented failures in women's healthcare. A clinical review in the American Journal of Obstetrics and Gynecology, citing data from multiple countries, reported delays of 4 to 11 years from first symptom onset to surgical diagnosis. A 2024 scoping review found an average delay of 6.8 years across international studies, with delays occurring at both patient level — where symptoms are normalised — and clinician level, where pain is dismissed or attributed to primary dysmenorrhoea.
At Victoria Medical, our gynaecologist approaches endometriosis as a clinical diagnosis supported by imaging and history, not solely a surgical one. A pelvic ultrasound with specific attention to the ovaries, uterosacral ligaments, and pouch of Douglas, combined with a detailed symptom history, allows clinical diagnosis in most cases without requiring immediate laparoscopy. Where surgical assessment is indicated, we arrange prompt referral to a specialist endometriosis surgeon.
| Symptom | Endometriosis Association | Investigation |
|---|---|---|
| Severe dysmenorrhoea | Strong — particularly if progressive | Pelvic ultrasound, clinical history |
| Chronic pelvic pain | Common — present in ~90% of cases | Pelvic ultrasound, laparoscopy if indicated |
| Deep dyspareunia | Highly suggestive of deep infiltrating disease | Pelvic ultrasound, MRI pelvis |
| Subfertility | Endometriosis in 30–50% of infertile women | AFC ultrasound, AMH, laparoscopy |
| Cyclical bowel/bladder symptoms | Suggests deep infiltrating endometriosis | MRI pelvis, specialist referral |
Polycystic Ovary Syndrome (PCOS): Diagnosis and Management
Polycystic ovary syndrome is one of the most common endocrine disorders in women of reproductive age, affecting 5–18% of women depending on the diagnostic criteria applied. It is defined by the Rotterdam criteria as the presence of at least two of three features: hyperandrogenism (clinical or biochemical), ovulatory dysfunction, and polycystic ovarian morphology on ultrasound. The clinical presentation is heterogeneous — some women present primarily with menstrual irregularity, others with hirsutism and acne, and others with subfertility.
Insulin resistance affects 50–70% of women with PCOS, and is associated with a significantly elevated risk of metabolic syndrome, type 2 diabetes, and cardiovascular disease. A comprehensive PCOS assessment therefore extends beyond reproductive symptoms to include a metabolic screen — fasting glucose, lipid profile, and blood pressure measurement.
Management of PCOS at Victoria Medical is guided by the Endocrine Society Clinical Practice Guideline and the international evidence-based guideline published in 2018. First-line treatment for menstrual irregularity and hyperandrogenism is the combined oral contraceptive pill. Metformin is used where insulin resistance or metabolic features are prominent. For patients with subfertility, ovulation induction with letrozole or clomiphene is the first-line approach, with referral to a fertility specialist where indicated.
| PCOS Feature | Prevalence | Clinical Implication |
|---|---|---|
| Menstrual irregularity (oligomenorrhoea/amenorrhoea) | 70–80% | Endometrial hyperplasia risk — requires management |
| Hyperandrogenism (hirsutism, acne, alopecia) | 60–80% | Hormonal blood panel, COCP or anti-androgen therapy |
| Polycystic ovarian morphology on ultrasound | ~75% | Transvaginal ultrasound — antral follicle count |
| Insulin resistance | 50–70% | Fasting glucose, HbA1c, lipid profile, metformin |
| Subfertility | ~40% | Ovulation induction, fertility specialist referral |
Menopause and HRT Management
Menopause is a natural biological transition, but its symptoms — hot flushes, night sweats, mood changes, vaginal dryness, sleep disturbance, and cognitive changes — can significantly affect quality of life. A randomised controlled trial published in the BMJ found that combined HRT produced significant improvements in vasomotor symptoms, sexual functioning, and sleep problems compared with placebo, with hot flushes reducing from 29% to 9% in the treatment group at one year.
A 2025 meta-analysis of 24 randomised controlled trials involving 5,089 patients confirmed that HRT significantly reduces Kupperman Menopause Index scores, improves MENQOL quality-of-life scores, and increases lumbar and hip bone density, with no significant increase in adverse events compared with control groups. A 2017 review in Nature Reviews Endocrinology concluded that in women aged 50–60 years initiating HRT within 10 years of menopause, the risk-benefit balance is positive, with reductions in coronary heart disease and all-cause mortality.
Hormone blood tests are not routinely needed to diagnose menopause in otherwise healthy women aged 45 or over (NICE guidance); testing may be appropriate in younger women, atypical presentations, or where another diagnosis is being considered. A menopause consultation focuses on symptoms, medical history, risks, preferences and the appropriate treatment discussion. HRT prescribing follows NICE guideline NG23 where it is clinically suitable.
- Full menopause symptom assessment (Menopause Rating Scale)
- Blood tests only where clinically appropriate
- Cardiovascular and bone health risk assessment
- HRT initiation and optimisation — oestrogen, progesterone, testosterone
- Non-hormonal alternatives — SSRIs, clonidine, cognitive behavioural therapy referral
- Vaginal oestrogen for genitourinary syndrome of menopause (GSM)
- Follow-up and monitoring at 3 and 12 months
Fertility Assessment
Fertility concerns are among the most emotionally significant issues a woman can face. Whether you are planning to conceive and want to understand your reproductive health, have been trying to conceive without success, or want to assess your ovarian reserve before making decisions about family planning, our gynaecologist provides a thorough and compassionate fertility assessment.
A fertility assessment at Victoria Medical includes a detailed reproductive history, a pelvic ultrasound with antral follicle count (AFC) — a key marker of ovarian reserve — and a hormone blood panel including AMH (anti-Müllerian hormone), FSH, LH, and oestradiol. AMH is the most reliable single marker of ovarian reserve and is not cycle-dependent, making it the preferred first-line investigation for ovarian reserve assessment. For patients in a relationship, semen analysis can also be arranged.
If the assessment identifies a cause for subfertility — a structural abnormality, a hormonal imbalance, or a significant reduction in ovarian reserve — we arrange prompt referral to a fertility specialist with a comprehensive clinical summary.
Cervical Screening and Colposcopy Referral
Cervical screening (the smear test) is one of the most effective cancer prevention interventions available. The NHS cervical screening programme invites women aged 25–64 every 3–5 years, but many women find it difficult to access screening promptly through their NHS GP, or prefer to have their smear taken in a private setting where they feel more comfortable.
Cervical screening may be arranged as a standalone appointment or as part of a gynaecology consultation where appropriate. Samples are processed through the applicable laboratory pathway; the clinic confirms reporting arrangements at booking.
If your smear result shows high-risk HPV or abnormal cytology, we arrange urgent colposcopy referral with a detailed clinical summary. We can refer to both NHS and private colposcopy services, depending on your preference.
What Happens at a Gynaecology Consultation
A gynaecology consultation at Victoria Medical begins with a detailed clinical history. Your gynaecologist will ask about your menstrual cycle, any symptoms you are experiencing, your obstetric history, contraceptive use, and relevant family history. This history is taken in a private, confidential setting; the clinic confirms the appointment format and expected duration at booking.
A physical examination is performed where clinically indicated, including abdominal palpation and, where appropriate, a pelvic examination. Cervical screening can be performed at the consultation if you are due or overdue for screening.
Pelvic ultrasound and blood tests may be considered according to symptoms, history and the clinical question. The clinic confirms availability and reporting and follow-up arrangements at booking.
Gynaecology Consultation Pricing
Current gynaecology fees are published on the Pricing page. The clinic confirms the appropriate consultation, investigations and applicable fees before booking.
The Pricing page is the current public fee source. The clinic confirms applicable fees before booking.
| Service | Fee |
|---|---|
| Gynaecology consultation pathway | See Pricing page |
| Pelvic ultrasound, blood-test and screening pathways | See Pricing page |
Patients Often Ask About...
Many patients arrive at a gynaecology consultation having already researched their symptoms online. The guides below are written by Dr Xynopoulos to answer the questions our patients ask most frequently — covering irregular periods, endometriosis, ovarian cysts, and uterine fibroids.
How to Book a Private Gynaecology Appointment
Booking a private gynaecology appointment at Victoria Medical is straightforward. Use the online booking request or telephone the clinic during clinic hours. No GP referral needed for most services. The clinic confirms appointment availability, the intended clinical route and any investigation requirements at booking.
All gynaecology consultations are conducted in a private, confidential setting. You are welcome to bring a partner, friend, or family member to your appointment if you would find this helpful.
The clinic is at 170 Vauxhall Bridge Road, London SW1V 1DX — two minutes from Victoria Station (Victoria, Circle, and District lines, and National Rail).
What to Expect at Your Appointment
Request a Gynaecology Consultation
Contact the clinic online or by phone. No GP referral needed for most services. The clinic confirms availability, the intended appointment route and any preparation at booking.
Clinical History and Examination
Your gynaecologist will take a full medical and gynaecological history, discuss your symptoms in detail, and perform a clinical examination where indicated.
Investigations Where Appropriate
Pelvic ultrasound, blood tests or cervical screening may be considered where they answer a defined clinical question. The clinic confirms availability, sequencing, reporting and follow-up arrangements at booking.
Diagnosis and Treatment Plan
Your gynaecologist will explain findings clearly and discuss all treatment options with you, including prescriptions, hormonal management, and specialist referral where needed.
Follow-Up and Ongoing Care
The appropriate follow-up, prescriptions, referral or ongoing-care route depends on the clinical findings and the agreed pathway. The clinic confirms how results will be shared at booking.
Frequently Asked Questions
References
- [1]Agarwal SK, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019;220(4):354.e1–354.e12.
- [2]Fryer J, et al. Understanding diagnostic delay for endometriosis: A scoping review using the social-ecological framework. Health Care Women Int. 2024;45(1):1–28.
- [3]Ballard K, et al. What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis. Fertil Steril. 2006;86(5):1296–1301.
- [4]Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018;14(5):270–284.
- [5]Joham AE, et al. Polycystic ovary syndrome. Lancet Diabetes Endocrinol. 2022;10(9):668–680.
- [6]Legro RS, et al. Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2013;98(12):4565–4592.
- [7]Welton AJ, et al. Health related quality of life after combined hormone replacement therapy: randomised controlled trial. BMJ. 2008;337:a1190.
- [8]Tang Y, et al. Effectiveness and safety of hormone replacement therapy in the treatment of menopausal syndrome: a meta-analysis. Am J Transl Res. 2025;17(1):1–18.
Related Services at Victoria Medical