How to Recognize an Urgent Gynecologic Problem

woman in Doctor's office with abdominal discomfortAs ObGyn physicians, most of the care we provide on an urgent basis involves pregnancy and childbirth. For gynecologic problems, we more typically provide medical treatment at an office visit or surgery, if necessary, at a planned time in the future. But this is not always the case. Certain conditions in gynecology represent true emergencies, requiring immediate treatment to prevent long term consequences and even loss of life. We want our patients to be aware of the signs of these more urgent problems.

As you would expect, gynecologic problems generally manifest themselves with pain and/or abnormal bleeding. Most women have experienced these symptoms at one time or another without considering them an emergency. But how can you recognize when urgent care is necessary? Consider these factors:

  • Are you or could you possibly be pregnant? Bleeding or pain requires our immediate attention if there is a possibility of pregnancy.
  • Have you had recent GYN surgery or childbirth?
  • Is your pain significantly more intense than menstrual cramps or significantly different from what you have experienced in the past? Did it arise suddenly?
  • Are you experiencing extremely heavy bleeding?
  • Are you experiencing other significant symptoms like fever, shortness of breath, dizziness or fainting?
  • Is there an area on one leg which is swollen, tender, red, or warm to the touch; especially after surgery or childbirth?
  • Sexual assault is always an emergency.

In these situations, you should call us. These emergency situations are not common, but it is important to recognize them. Depending on the severity of the symptoms they may alert us to problems of the ovary or fallopian tube, pelvic infection, deep vein thrombosis (blood clots), or another condition that requires treatment to preserve your health and future fertility. Some examples of urgent gynecologic problems include:

  • Ectopic pregnancy. If a pregnancy implants inside the fallopian tube, rather than in the uterus, this serious condition requires immediate treatment.
  • A ruptured and bleeding ovarian cyst. In most cases this is not an emergency, but it is possible for a ruptured cyst to cause excessive internal bleeding and require surgical treatment.
  • A torsed (twisted) ovary and fallopian tube. This condition may require prompt surgery to preserve the ovary.
  • Hemorrhage (loss of a large amount of blood in a short time) after childbirth or surgery.  Although rare, a major bleeding episode requiring treatment can occur even several days after you have left the hospital.
  • An infection of the pelvic organs. Pelvic infection requires early treatment to reduce the risk of loss of fertility.
  • Deep vein thrombosis (blood clots). A blood clot in the leg can move to a vital organ like the lung and become immediately life-threatening.
  • Non-gynecologic problems. Abdominal pain may also be caused by urgent non-gynecologic problems (ex., appendicitis) for which we would refer you to the appropriate specialty.
  • The situations listed above require immediate medical care. To this list, I would add any bleeding or spotting after menopause. Although a moderate amount of blood loss does not generally indicate an emergency, this symptom should never be ignored. Endometrial (uterine) cancer often presents with this early warning sign, and prompt treatment  will reduce your risk of developing an advanced cancer. You will want to call our office (or request an appointment using the patient portal) even if the bleeding seems to go away.
  • We provide 24-hour care for urgent gynecologic problems. Click here for our office and after-hours phone numbers.