Gynaecology: why the same examination yields two different answers
In gynaecology the definition chosen changes the result more often than the examination does. Polycystic ovary syndrome affects 7.9% or 12.7% of women depending on which criterion is applied, on the same data (Neven, Human Reproduction Update, 2026). Ultrasound finds fibroids in 51% of premenopausal women who had no prior diagnosis (Baird, Am J Obstet Gynecol, 2003). And “26% more breast cancer” on hormone therapy means 8 extra cases per 10,000 woman-years (WHI, JAMA, 2002). A prevalence figure or a relative risk is not a personal verdict. Noria Health arranges a full gynaecological work-up near Brussels within 24 to 48 hours.
The questions we are asked
- I have had severe period pain for years, why has nobody found anything?
- Ultrasound found fibroids, do they need operating on?
- Is there an alternative to hysterectomy?
- My cycles are irregular, is that PCOS?
- Does this diagnosis need an ultrasound or an AMH assay?
- Does menopausal hormone therapy cause breast cancer?
- How long do hot flushes last?
What the figures say
| What is measured | The figure | Source and year |
|---|---|---|
| Women affected by endometriosis worldwide | 190 million | World Health Organization, 2023 |
| Delay before an endometriosis diagnosis | 4 to 12 years depending on the country | World Health Organization, 2023 |
| Premenopausal women with no prior diagnosis in whom ultrasound finds fibroids | 51% | Baird, Am J Obstet Gynecol, 2003 |
| Fibroids clinically significant enough to justify an intervention | about 25% | ACOG Practice Bulletin 228, 2021 |
| PCOS prevalence depending on the criterion applied | 7.9% to 12.7% | Neven, Human Reproduction Update, 2026 |
| Women with PCOS satisfied with the information they received | 15.6% | Gibson-Helm, JCEM, 2017 |
| Absolute excess of breast cancer on oestrogen plus progestin | 8 per 10,000 woman-years | WHI, JAMA, 2002 |
| Excess clotting risk of transdermal hormone therapy | none, odds ratio 0.93 (0.87 to 1.01) | Vinogradova, BMJ, 2019 |
Those eight lines say one thing. In gynaecology the gap between what an image shows and what justifies a procedure is wider than in almost any other specialty. An abnormality found in one woman in two cannot, on its own, be a surgical indication. And a risk stated as a relative percentage only becomes interpretable once it is expressed as a number of cases per 10,000.
What Noria Health does in gynaecology, and what it does not do
Noria Health arranges a full gynaecological work-up near Brussels within 24 to 48 hours: clinical examination, transvaginal pelvic ultrasound, hormonal and androgen profile where indicated, diagnostic hysteroscopy or pelvic MRI when mapping the lesions requires it, and assessment of cardiovascular and thrombotic risk factors before any hormonal discussion. The report is issued within 24 hours, follow-up is structured at D14, D30 and D90, and surgery is considered only around day 10 if it is needed.
What Noria Health does not do: set a surgical indication on an image alone, or prescribe or advise against hormone therapy at a distance. Sudden heavy bleeding with faintness, acute pelvic pain or fever are matters for the emergency services in your country, immediately, not for an appointment.
Who reviewed this page
Noria Health editorial team.
The gynaecology articles
- Endometriosis: 190 million women, up to 12 years to diagnosis
- Fibroids: 1 woman in 2 has them without knowing
- PCOS: 7.9% or 12.7% of women, depending on the criterion
- HRT: “26% more breast cancer” means 8 cases per 10,000
Have your case reviewed. Noria Health arranges a specialist consultation near Brussels and confirms feasibility within 24 to 48 hours. Open a case.