A gynaecologist looks after the female reproductive system: from choosing contraception and caring for a pregnancy to treating infections, cycle disorders, fibroids, endometriosis and menopause-related conditions. It is both a medical and a surgical specialty — many gynaecologists operate.

There are divisions within it. An obstetrician manages pregnancy and birth; a fertility specialist handles infertility and IVF; a gynaecological oncologist deals with precancerous change and tumours; a paediatric gynaecologist sees girls under eighteen. In larger Georgian clinics these are different doctors; in smaller towns, more often one broad-profile specialist.

Reasons people come in

The commonest is the preventive visit and screening. This is the one area where seeing a doctor regularly without symptoms is proven to reduce mortality: cervical screening detects changes years before they become disease.

The second group is cycle problems: missed periods, unusually heavy or painful bleeding, bleeding between periods. That last one, and any bleeding after menopause, always warrants investigation.

Third is discharge, itching and discomfort. Most of this is straightforward to treat, but self-treatment from internet advice works particularly badly here: thrush, bacterial vaginosis and sexually transmitted infections produce similar symptoms and are treated in fundamentally different ways.

Fourth is contraception. The right method depends on age, other conditions, smoking and pregnancy plans. That is a conversation, not a default prescription.

Separately: pain. Period pain severe enough to miss work or school is not a normal thing to endure. This is a common reason endometriosis is diagnosed late — women are told for years that everyone has it.

When it is an emergency

Immediately, for sharp one-sided lower abdominal pain, particularly with a missed period — that is how ectopic pregnancy presents, and it is life-threatening. The same goes for ovarian torsion: the ovary is only saved by prompt intervention.

Also urgent: heavy bleeding soaking a pad within an hour over several hours; lower abdominal pain with a fever above 38 °C; any bleeding in pregnancy; acute pain after gynaecological surgery.

What the appointment involves

It starts with the history: date of your last period, what your cycle is like, previous pregnancies and births, operations, chronic conditions, medication, contraception. The questions are personal, but the diagnosis and the safety of what is prescribed depend directly on the answers.

Then, where indicated, examination, swabs and a pelvic ultrasound. If cytology shows changes, colposcopy follows — examining the cervix under magnification, with a biopsy if needed.

You are entitled to know what will happen, to ask why each test is being ordered, and to decline any procedure. That is not being difficult: informed consent is part of ordinary medical practice, not a courtesy.

Choosing a gynaecologist

Start from the task. Pregnancy care needs an obstetrician-gynaecologist and a clinic with a maternity unit; infertility needs a fertility specialist; follow-up for fibroids or endometriosis needs someone who manages those routinely.

It matters that you can ask questions and get answers you understand. A large share of decisions in gynaecology are choices between options rather than a single possible path: contraceptive method, approach to fibroids, how to handle menopause. If the alternatives are not explained, you have been deprived of a choice that is properly yours.

Language matters here especially: describing intimate symptoms through an interpreter is hard, and imprecision leads to the wrong diagnosis.

Read reviews for content. For this specialty, whether the doctor explained what was happening and behaved respectfully during examination is telling — that is not about comfort, it is about quality of care.

Gynaecology in Georgia: what to know

There are many gynaecologists in the country — one of the best-represented specialties in the catalogue. The main choice is in Tbilisi and Batumi, including fertility clinics and maternity hospitals; smaller towns cover the basics and refer complex cases to the capital.

If you arrived in Georgia pregnant or plan to give birth here, establish in advance which clinic provides antenatal care and where the birth is planned (these can be different places), what documents are required and how follow-up is arranged. Check insurance coverage with your insurer — terms vary considerably.

Official information on healthcare in Georgia is published by the Ministry of Health at moh.gov.ge, and epidemiological data and vaccination guidance, including HPV, by the National Center for Disease Control at ncdc.ge.

What actually works for prevention

Cervical screening on schedule works — it is the central tool and it saves lives. HPV vaccination works. Barrier contraception works for protection against sexually transmitted infections: hormonal methods prevent pregnancy but not those.

Douching does not work: it disrupts the normal flora and raises the risk of infection. Neither does self-prescribing antibiotics or antifungals from an old prescription — similar symptoms often have a different cause, and the wrong treatment masks the real one.

And separately: feeling well is not a substitute for screening. Early cervical changes cause no pain and no symptoms at all — that is the entire reason regular checks exist.

Menopause: what is worth discussing

Menopause is not a disease, but it is a period when a great deal shifts: temperature regulation, sleep, mood, bone density, the condition of mucous membranes. Some women pass through it barely noticing, others have a hard time — and the second group does not need to endure it silently. Hormone replacement therapy exists, with real indications and real contraindications, and it is worth discussing individually with a doctor rather than ruling out in advance based on what an acquaintance said.

On bones specifically: bone loss accelerates after menopause, and a hip fracture in later life begins here. The conversation about bone density, calcium and vitamin D belongs at the start of this period, not after the first fracture.

And one rule without exceptions: bleeding after menopause has been established always warrants investigation. The cause may turn out to be harmless, but it is always checked.

Frequently asked questions

How often should I see a gynaecologist with no symptoms?▾

A preventive visit is usually recommended once a year. The point of it is not the examination itself but cervical cancer screening: cytology (Pap test) and HPV testing. The interval between screens depends on age and which test is used — it may be three or five years, and the doctor decides. Regularity matters more than frequency here: cervical cancer develops over years, which is exactly why screening works.

What is HPV and what if it is found?▾

Human papillomavirus is very common, and in most people the immune system clears it within a couple of years. Not all types are dangerous — a few oncogenic ones are, and mainly when they persist. Finding HPV does not mean disease and does not mean a partner was unfaithful: the virus can sit silently for years. What happens next depends on the type and on the cytology result, from simple follow-up to colposcopy. Vaccination exists and works best before sexual activity begins, though it is still used later.

When is this urgent rather than an appointment?▾

Urgently for severe one-sided lower abdominal pain, especially with a missed period: that can be an ectopic pregnancy or ovarian torsion. Also for heavy bleeding that soaks a pad within an hour for several hours running, for pain with a high fever, and for any bleeding during pregnancy. These are treated in hospital and sometimes need surgery the same day.

I am planning a pregnancy — when should I come?▾

Before conceiving rather than after. Preconception care means checking for infections, reviewing chronic conditions and medications (some need switching in advance), and folic acid started at least a month before conception. If pregnancy has not happened after a year of regular unprotected sex — or six months after 35 — that is a reason for the couple to be assessed, both partners rather than the woman alone.

Is a pelvic examination required at every visit?▾

No. What the visit involves follows from why you came: for contraception advice, discussing test results or pregnancy planning, an examination may not be needed at all. You are entitled to ask why it is necessary now and to have it explained before it begins. A good doctor explains that unprompted.

What discharge is normal?▾

Clear or whitish discharge without a strong smell, varying in amount through the cycle, is normal and needs no treatment. See a doctor for itching, burning, an unpleasant smell, unusual colour (greenish, grey), or pain during intimacy. One thing worth knowing: douching does not help and often makes things worse by disrupting the normal flora.

This page is for general information and does not replace a consultation. A diagnosis can only be made in person, after examination and tests.

Updated: 15 September 2026