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Integral Gynecology
Gynecology was born as a science oriented to studying and treating the
problems of the women’s genital apparatus.
In the beginning of the XX century it was hardly a surgical specialty with
limited objectives (the gynecologist was the “ladies’ surgeon”). However, in
a few years an accelerated development was observed, mainly based on
hormonal studies, pathologic anatomy, neuroendocrinology, and later on,
imaging diagnosis such as scans, and others.
But it is in the second part of that century when the unusual progress in
certain areas such as human reproduction and oncology vastly widened the
action field of gynecology as a consequence, also of the new women’s role in
the society and the world.
I believe that in this evolution it has been and is currently necessary to
leave behind the limited concept of the genital apparatus in order to assume
the responsibility of the whole women’s illnesses.
The essence of any gynecological problem such as a sexual conflict, an
amenorrhea (lack of menstruation) or a metrorrhagia (genital hemorrhage),
menstruation pain, a sterility problem, or a contraception consultation,
etc. is biologically similar in all cases.
It is only the individuality of the case, that is to say, the woman herself
and her personal circumstances, what allows us to see her as different and
unique. This is how I intend to treat her.
The gynecological exam, the cytology, the scan, and other studies required
to diagnose are fundamental in the gynecological consultation…being them not
enough, however, to be able to understand the woman in front of us.
Many times, behind the manifested reason for consulting, lies a latent one,
which is sometimes transmitted almost without any words, but with attitudes…like
crying, feeling restless or uneasy waiting for an answer. The gynecologic
doctor has to take these expressions into account since, to my understanding;
there lies the true reason for consulting.
What was exposed doesn’t mean that we need to look for any emotional
disorder in a patient who is just coming for a simple gynecological revision
or a problem in the genital apparatus, but it is important not to disregard
signs which could be signaling something beyond the physical pain.
The fear in the view of menopause, the ambivalence facing maternity, the
terror of suffering from cancer…are some other aspects of the daily
gynecological consultation which explain its complexity and difficulties in
defining the action boundaries of the gynecologist.
Moreover, we very often assist the patient along the different biological
periods of their lives, becoming the “reliable or family doctor”, so
necessary but at the same time absent these days, due to a very
technological medicine.
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