• Menstrual Disorders : this includes women with heavy and / or painful menses; irregular menses; bleeding in-between menses; bleeding following intercourse; and bleeding after the menopause.
  
  
• Polycystic Ovarian Syndrome: women in this group present with a variety of complaints including irregular menses; long menstrual cycles; acne; excessive body hair; difficulty keeping weight down and infertility. Once the diagnosis is confirmed - based on a history, some hormonal blood tests and an ultrasound scan of the pelvis, further management is tailored to meet the patient's priorities eg ovulation stimulation if infertility is the problem; Dianette if acne and excess hair are the dominant problems; metformin with dietary and exercise advice if weight control is the main issue.
  
  
• Premenstrual Syndrome: A wide range of treatment options exist, including alternative therapies. In reality the treatment of the PMS is a trial and error approach as there is no panacea that cures all women, even if their symptoms appear similar.
  
  
• Infertility: baseline investigations are undertaken including sperm analysis; tests of ovulation; tests to confirm that the tubes are open etc. Mr Manyonda has access to colleagues who undertake more specialised treatments such as IVF, and regularly refers patients to the appropriate units.
  
  
• Menopause - please see link to the Wimbledon Menopause Clinic
  
  
• Recurrent Miscarriage - please see link to Recurrent Miscarriage Clinic
  
  
• Fibroid Disease - please see link to Fibroid Centre
  
  
• Gynaecological Ultrasound: ultrasound is now an indispensable tool in modern gynaecological practice. Mr Manyonda performs ultrasound scans as part of investigations for gynaecological problems and for early pregnancy problems. He works with a female colleague who is a Superintended Sonographer, and this is especially relevant as most of the scans are internal.