Gynecology

Ongoing gynecological care, from adolescence to menopause. For a routine check-up, a symptom or a diagnosis that needs following.

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OUR APPROACH

At every stage,
for every woman

Gynecological health changes over a lifetime. We start with your history, with what you tell us and with what we learn along the way, and build your plan from there.

The essentials of gynecology, in one place.

Consultations, screening, scans and blood tests, with a Grupo Germano de Sousa collection point inside the clinic. The clinical team looks after you over the years and calls in other clinical areas whenever needed.

REASONS TO BOOK

When to see a gynecologist

Preventing, making sense of a symptom, treating, and following a diagnosis over the years. Any of these is reason enough to book, and follow-up continues even when everything is fine.

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Prevention and regular follow-up

Prevention in adolescence, adult life and menopause
Regular check-ups and cervical screening
Contraception (birth control): starting, reviewing or changing method
HPV vaccination
Screening for sexually transmitted infections (STIs)
Preconception care
A family history of breast or ovarian cancer

When something feels different

Irregular menstrual cycles
Severe period, pelvic or vulval pain
Pain or unexpected bleeding during sex
Vaginal dryness, burning, discharge or a change in odour
Ulcers or changes in the vulval skin
A lump or change in the breast, pain, retraction or nipple discharge
Urinary leakage or pelvic heaviness
Hot flushes, poor sleep or other signs of perimenopause
Bleeding after the menopause
Difficulty conceiving

When you already have a result or a diagnosis

An abnormal smear or a positive HPV test
A sexually transmitted infection (STI)
Endometriosis, adenomyosis, PCOS (also called PMOS) or fibroids
Vulvodynia, lichen sclerosus or another vulval condition
A finding on a gynecological ultrasound
An ovarian cyst, polyp or thickened endometrium
Infertility, or a fertility work-up already under way
Follow-up after cancer treatment

Areas of care

General and specialist gynecology

General gynecology covers the essentials over a lifetime: prevention, contraception, screening and the symptoms that come up along the way. Some situations call for a dedicated work-up, a specific technique or long-term follow-up, and that is where specialist gynecology comes in. The same woman may need both at once.

Prevention and screening

Smear and HPV tests, vaccination, STI screening, ultrasound and blood tests. How often you need them depends on your age, history and previous results.

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Cycle, pelvic pain and endometriosis

Irregular or heavy periods, pelvic pain, pain during sex, endometriosis, adenomyosis, fibroids and PCOS (also called PMOS). A dynamic ultrasound scan maps the pelvis, and hysteroscopy looks inside the uterus.

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Contraception and fertility

Starting, reviewing or stopping a method, preconception advice and IUD or implant fitting. When pregnancy is slow to happen, the assessment may include checking whether the tubes are open.

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Cervix, vagina and vulva

An abnormal smear, a positive HPV test, cervical lesions, warts or vulval conditions. Colposcopy clarifies the result; conisation or CO₂ laser treats the lesion.

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Pelvic floor and bladder

Urinary incontinence, overactive bladder, recurrent urinary infections, prolapse, a feeling of heaviness or of something coming down. Ultrasound helps identify the cause, and treatment may include a pessary or laser.

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Menopause and perimenopause

Vaginal dryness, changes in libido and mood, irregular or absent periods, hot flushes and poor sleep. Diagnosis is made clinically. Treatment may be hormonal or non-hormonal.

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Services

Gynecology consultations, tests and procedures

From routine screening to treatment, it all happens under one roof: consultation, ultrasound, colposcopy, blood tests and minor surgery.

Specialist Nurse Consultation

Contraceptive advice, screening and care for sexually transmitted infections, from adolescence to menopause.
Gynecology consultation

Regular check-ups, screening, contraception and assessment of any new concern, at every age.
Adolescent gynecology consultation

Care designed for teenagers: the menstrual cycle, period pain, contraception, screening, prevention and the vaccination schedule.
Gynecology Consultation – Cervix, Vagina and Vulva

Assessment and follow-up of an abnormal smear or a positive HPV test, cervical and vaginal lesions, lichen sclerosus and other conditions of the lower genital tract.
Endometriosis consultation

Diagnosis and follow-up of endometriosis, adenomyosis and chronic pelvic pain, with a plan matched to the impact of your symptoms and where you are in life.
Menopause consultation

Care dedicated to the symptoms of perimenopause and menopause: hot flushes, sleep, mood, vaginal dryness and libido.
Pelvic floor consultation

Assessment and follow-up of pelvic floor dysfunction, such as urinary leakage, pelvic heaviness and pain.
Fertility support consultation

Clinical assessment and specialist follow-up when pregnancy is taking longer than expected.
Breast care consultation

Assessment and follow-up of breast health

Smear test and HPV test

Screening for cervical cell changes, and for the virus behind them.
Sexually transmitted infection (STI) screening

Screening for STIs, with or without symptoms. The panel is decided in the appointment.
Gynecological ultrasound with a transvaginal probe (Doppler when indicated)

Assessment of the uterus, ovaries and pelvic structures. The first scan in pelvic pain, abnormal bleeding, cysts and fibroids.
Colposcopy

Magnified view of the cervix to assess suspicious lesions or follow up an abnormal smear.
Dynamic ultrasound scan for endometriosis

Specialist ultrasound protocol for mapping and staging endometriosis and adenomyosis.
Abdominal and vaginal gynecological ultrasound

The two approaches combined, for a complete view of the pelvis.
Pelvic floor ultrasound

Assessment of the pelvic floor structures in incontinence, prolapse and pain or difficulty with sex.
3D gynecological ultrasound

Detailed view of the shape of the uterus, of polyps and of the position of an IUD.
Pelvic cavity scan

Ultrasound assessment of the whole pelvic cavity, including neighbouring organs and the spaces between them.
Vaginoscopy / Vulvoscopy

Endoscopic examination of the vagina and vulva to assess lesions, infections and changes caused by HPV.
Blood and hormone tests

Hormone and thyroid profiles, and any other tests requested in the appointment, with samples taken at the clinic by the nursing team.

Hysteroscopy

Endoscopic view of the uterine cavity to diagnose polyps, fibroids and adhesions.
Tubal patency scan (HyCoSy)

Saline infusion through a fine catheter, with ultrasound, to assess the uterine cavity and the tubes.
IUD and contraceptive implan

Fitting, replacement or removal of long-acting contraception.
Gynecological biopsies

A sample taken from the vulva, vagina, cervix or endometrium and sent to the laboratory.
Cervical polypectomy

Removal of cervical polyps during the appointment, with no need for an operating theatre.
CO₂ laser conisation or diathermy loop

Removal of abnormal tissue from the cervix, after a smear or biopsy that shows changes.
CO₂ laser surgery of the cervix, vagina and vulva

Minimally invasive treatment of lesions and anatomical changes in the lower genital tract, carried out at the clinic.
Vaginal laser regeneration

Laser applied to the vaginal lining to treat dryness, atrophy and loss of elasticity.
Fractional laser of the vulva

Treatment of lichen sclerosus, vulval atrophy and pain during sex (dyspareunia).
Injectable treatment for vulvovaginal dryness and pain

Hyaluronic acid or botulinum toxin, chosen according to the cause.
Pessary fitting and replacement

A silicone device fitted in the vagina to support the pelvic organs without surgery, changed periodically at the clinic.
Laser treatment of Bartholin’s gland cyst

Drainage or removal of the cyst with CO₂ laser, under local anaesthetic.
Treatment of genital warts (condylomas)

Removal of the HPV lesions by laser or electrocoagulation, under local anaesthetic.
HPV vaccination

The full vaccination course, given at the clinic in adolescence or adulthood.
Vulvovaginal injectable treatments

Hyaluronic acid for dryness and botulinum toxin for vulval pain and vaginismus.

Gynecological Check-up+

Gynecology consultation, pelvic ultrasound and smear test at a single visit. HPV test included when indicated. Your full annual check-up, without booking each test separately.
Breast Diagnostic Pathway

When you find a change in your breast, how quickly you get an answer is what weighs most. Imaging within 24 hours, biopsy when indicated with a preliminary result the same day, and a definitive answer the following week. You leave with the diagnosis settled and the full work-up in hand, ready to decide the next step.

What to expect

How your gynecology
appointment works

Your history

Symptoms, medical history, previous tests and what brought you here this time.

The examination

Matched to why you came. You are told what it involves before it starts, and it only goes ahead with your consent.

The tests you need

Blood tests, ultrasound, colposcopy or an in-clinic procedure, according to what the assessment shows.

Where things stand

Your situation and your options from here, with time for the questions you want to ask.

You leave with a clear plan

Monitoring, treatment or shared care with another clinical area if needed. Your next appointment can be booked there and then.

Schedule your gynecology appointment

Clinical team

Gynecologists
and specialist nurses

A team with expertise in the pelvic floor and urogynecology, menopause, endometriosis, fertility, and conditions of the cervix, vagina and vulva. The nursing team supports appointments, tests and treatments.

Carlos Veríssimo

Obstetrician and gynecologist

General High-risk pregnancy Specialist ultrasound

Virgínia Monteiro

Obstetrician and gynecologist

General Cervix, vagina and vulva Pelvic floor

Amália Martins

Obstetrician and gynecologist

Menopause

Manuela Costa

Obstetrician and gynecologist

General Pelvic floor Menopause

Isabel Grilo

Obstetrician and gynecologist

General Pelvic floor Menopause

Patrícia Isidro Amaral

Obstetrician and gynecologist

General Pelvic floor

Sara Valadares

Obstetrician and gynecologist

General

José Reis

Obstetrician and gynecologist

Endometriosis

Sofia Figueiredo

Obstetrician and gynecologist

General Fertility High-risk pregnancy

Dusan Djokovic

Obstetrician and gynecologist

Endometriosis

Filipa Ribeiro

Obstetrician and gynecologist

Cervix, vagina and vulva Pelvic floor

Inês Rodrigues

Obstetrician and gynecologist

General Endometriosis

Bruna Abreu

Obstetrician and gynecologist

General

Mariana Gamito

Obstetrician and gynecologist

General

Ana Figueiredo

Obstetrician and gynecologist

General

Edite Cardoso

Obstetrician and gynecologist

General High-risk pregnancy

Catarina Reis de Carvalho

Obstetrician and gynecologist

General

Joana Ribeiro

Obstetrician and gynecologist

General

Catarina Castro

Obstetrician and gynecologist

General

Margarida Seixas

Specialist nurse

Nursing

Céu Barros

Specialist nurse

Nursing

Joana Costa

Specialist nurse

Nursing

Daniela Santos

Specialist nurse

Nursing

SHARED CARE

When other clinical areas come in

Sometimes a gynecological condition calls in another clinical area: when urinary leakage starts, when heavy periods lead to anemia, when sleep does not recover in menopause.

Breast Health

A lump, a change or discharge found in the gynecology consultation. Breast surveillance where there is a family history, a personal history of cancer or a suspicion raised at a previous screening.

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Pelvic Floor Physiotherapy

Urinary incontinence, prolapse or loss of pelvic floor tone. Pain and involuntary muscle tightening, in endometriosis, in recurrent vaginal infections, or when they make the gynecological examination difficult.

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Endocrinology

PCOS and thyroid disease that disrupt the menstrual cycle and fertility, and raised prolactin, which affects ovulation.

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Pain Medicine

Chronic pelvic or vulval pain, and pain when passing urine with no infection found. Pain that continues after gynecological treatment or surgery, endometriosis in particular.

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Nutrition

How diet shapes ovulation, the gut and the symptoms of endometriosis or PCOS. Anemia caused by heavy periods.

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Psychology

A recent diagnosis, pain that drags on, difficulty conceiving or menopause symptoms, when the emotional weight also needs care.

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Human Sexuality

Pain or involuntary tightening during sex, desire that has changed with menopause or with contraception, and returning to sex after gynecological surgery.

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Sleep Medicine

Insomnia and night-time waking caused by hot flushes and night sweats, in perimenopause and menopause, when sleep does not improve as the symptoms come under control.

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Rheumatology

Bone loss and osteoporosis from the fall in estrogen at menopause, more so when menopause is early or surgical, and autoimmune conditions that shape contraception or hormone therapy.

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Medical Oncology

Early menopause, dryness and pain caused by cancer treatment, and contraception or fertility when hormones are contraindicated.

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QUESTIONS AND ANSWERS

Frequently asked questions

Common questions about prevention, symptoms and when to seek care. The answers are for guidance and do not replace a medical consultation.

When should I have a smear and an HPV test?

Portugal’s national cervical screening programme covers ages 30 to 69 and uses HPV testing, repeated every five years after a negative result. That timing is designed for population screening. In an individual appointment, at any age, how often you are tested depends on your history, previous results, HPV status and other risk factors, and your next test can be sooner. The smear, or Pap test, is taken at the same time and shows any changes already present in the cells.

Is the HPV vaccine worth having as an adult?

In April 2026, Portugal’s national immunisation programme extended free HPV vaccination to the age of 26. After that age it is no longer free, but it can still be given on prescription until 45. The vaccine works best before exposure to the types it covers, so whether it is worth having is decided from your history and previous results, rather than from age alone. The full course is given at the clinic, and vaccination lowers the risk of cervical cancer without replacing screening.

Does the gynecological examination hurt?

The gynecological examination should not hurt. What it involves is shaped by the reason you came and may include looking at the vulva and vagina, viewing the cervix with a speculum, feeling the uterus and ovaries and, where indicated, taking a smear. It is explained first and carried out with your consent. If it hurts, say so: it can be stopped or adjusted, and pain usually has a treatable cause, such as dryness, infection or pelvic floor tension.

Irregular menstrual cycles: what could they mean?

A cycle is counted from the first day of one period to the first day of the next. Most cycles last between 24 and 38 days, and their length varies by up to about a week over the course of a year. Cycles are often irregular in the first years after periods start and again in the years before menopause. Outside those stages, irregularity can follow a change in contraception, marked weight change, intense exercise, stress or illness, and can also be linked to PCOS, thyroid disease or raised prolactin, among other causes. Three months without a period, outside pregnancy, should be assessed.

Heavy periods: when is it too much?

A period is heavy when you need to change a pad or tampon every hour or two, when bleeding lasts more than eight days, when there are large clots, or when it forces you to change your plans. Repeated blood loss can lead to iron deficiency anemia, with fatigue and breathlessness on exertion. The most common causes are fibroids, adenomyosis, polyps and hormonal changes, and assessment starts with blood tests and an ultrasound.

Severe period pain: when is it a warning sign?

Period pain is a warning sign when it keeps you from work or school, worsens over the years, appears outside your period or during sex. Pain with these signs should be investigated: it can come from endometriosis, adenomyosis, fibroids or polyps, among other causes.

How do I know if I have endometriosis?

The most frequent signs are severe period pain, pelvic pain outside menstruation, pain during sex, pain on opening your bowels or passing urine during your period, and difficulty conceiving. Diagnosis starts in the appointment, with your history and an examination. A dedicated dynamic ultrasound protocol then maps the lesions and assesses how far they extend. The average delay to a diagnosis is seven to nine years, most of it spent treating the pain as normal.

Is bleeding after the menopause normal?

No: any bleeding after 12 months without a period needs to be assessed, even if it happens only once and in small amounts. The most frequent cause is benign, such as endometrial atrophy, but this is also how endometrial cancer presents, and early diagnosis changes the outcome. Assessment includes an ultrasound and, where indicated, an endometrial biopsy or hysteroscopy.

Is it normal to have pain during sex?

No, although it is common: pain during sex has identifiable causes, such as vaginal dryness, endometriosis, infection, lichen sclerosus, or tension and involuntary tightening of the pelvic floor. Each of those can be treated, and it should not be accepted as part of your sex life.

When should a teenager have her first gynecology appointment?

International guidance places the first gynecological appointment between the ages of 13 and 15, and it does not depend on having started a sexual life. Those ages are a general reference: questions about the menstrual cycle, period pain, discharge or contraception often bring the first appointment forward. HPV vaccination is given at age 10 under Portugal’s national immunisation programme, and the appointment is the moment to check that the course is complete. Once sexual life begins, the appointment also covers contraception and protection from sexually transmitted infections.

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