Gynaecology (or gynecology in American English) is the area of medicine concerned with conditions affecting the female reproductive system. It is sometimes combined with the field of obstetrics, which focuses on pregnancy and childbirth, thereby forming the combined area of obstetrics and gynaecology (OB-GYN).
Gynaecology encompasses preventative care, sexual health and diagnosing and treating health issues arising from the female reproduction system, such as the uterus, vagina, cervix, fallopian tubes, ovaries, and breasts; subspecialties include family planning; minimally invasive surgery; paediatric and adolescent gynaecology; and pelvic medicine and reconstructive surgery. Gynaecological care is discussed in the Kahun Gynaecological Papyrus and the Hippocratic Corpus, showing the ancient origins of the subject. J. Marion Sims contributed to the advancement of the specialism developing instruments such as the Sims speculum, Pantaleoni completed the first hysteroscopy in 1869 and Papanikolaou first wrote about the pap smear in 1928. Transgender, intersex and nonbinary individuals can require gynaecological care. Health disparities exist within gynaecology, which can impact women in low and middle income countries, minority groups in some countries and the LGBTQ+ community.
Etymology The word gynaecology comes from the oblique stem (γυναικ-) of the Greek word γυνή (gyne) meaning 'woman', and -logia meaning 'study'. Literally translated, it means 'the study of women'. Its counterpart is andrology, which deals with medical issues specific to the male reproductive system.
History
Antiquity The Kahun Gynaecological Papyrus, dated to about 1800 BC, deals with gynaecological diseases, fertility, pregnancy and contraception. The text is divided into thirty-four parts, each dealing with a specific problem and containing diagnosis and treatment; no prognosis is suggested. Treatments are non-surgical, consisting of applying medicines to the affected body part or delivering medicines orally. During this time, the womb was sometimes seen as the source of problems manifesting in other body parts. Ayurveda, an Indian traditional medical system, also provides details about concepts and techniques related to gynaecology, addressing fertility, childbirth complications, and menstrual disorders amongst other things. The Hippocratic Corpus contains several gynaecological treatises dating to the 5th and 4th centuries BC. Aristotle is another source for medical texts from the 4th century BC. The gynaecological treatise Gynaikeia by Soranus of Ephesus (1st/2nd century AD) is extant (together with a 6th-century Latin paraphrase by Muscio, a physician of the same school). He was the chief representative of the school of physicians known as the "methodists".
Middle ages and renaissance period During the Middle Ages, midwives dominated women's health concerns through experienced-based knowledge, traditional remedies, and herbal medicines. Midwifery was often regarded as unscientific and was challenged with the rise of gynaecology as an official medical field. The Renaissance period, 16th century, brought about a resurgence of classical scientific advancements, including the rise of medical advancements in the field of gynaecology and obstetrics. Figures like Ambroise Pare were imperative in improving obstetrics techniques during this period. Peter Chamberlen developed the forceps, an important surgical tool that transformed childbirth and lessened maternal mortality.
18th, 19th and 20th centuries As medical institutions continued to expand in the 18th-19th centuries, the authority of midwives was challenged by men who dominated medical professions. The formalization of midwifery training by male doctors and advancements in medical knowledge of women's health and anatomy occurred during this period. Figures such as William Smellie, William Hunter, Paul Zweifel, Franz Karl Naegele, and Carl Crede contributed to the understanding of childbirth and women's health in Europe. In the early 18th and 19th centuries, in the United States, the field of gyneacology, as with most medical specialities, had ties to black women and therefore slavery. Brothers Henry and Robert Campbell were editors of the first medical journal in the deep south. Henry worked as gynaecologist including on enslaved women, whilst publishing medical case narratives of operations in the journal the brothers edited. Others, such as Dr. Mary Putnam Jacobi, challenged the exclusion of women from medical education and shifted gynaecology to a scientific practice. J. Marion Sims is regarded as the father of modern gynaecology. Some of his published medical contributions included the development of the Sims' position (1845), the Sims' speculum (1845), the Sims' sigmoid catheter, and gynaecological surgery. He was the first to develop surgical techniques for the repair of vesico-vaginal fistulas (1849), a consequence of protracted childbirth which at the time was without treatment. He founded the first women's hospital in the country in Alabama 1855 and subsequently the Woman's Hospital of New York in 1857. He was elected president of the American Medical Association in 1876. Sims conducted experimental operations on black enslaved women, without anaesthesia. Historically, white women were also subjected to experimental medical procedures. In terms of common procedures within gynaecology, the first hysteroscopy was completed in 1869 by Pantaleoni, to treat an endometrial polyp, using a cystoscope. Obstetrics and gynaecology were recognized as specialties in the mid-19th century, in the United Kingdom. Specialist societies came into being but it became clear that to become disciplines in their own right, a separate college was required. William Fletcher Shaw (Professor of Midwifery at Manchester University) and William Blair-Bell (Professor of Obstetrics at Liverpool University) worked to establish The British College of Obstetricians and Gynaecologists in 1929, this later became the Royal College of Obstetricians and Gynaecologists.
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