GP gynaecology entry: GP, consultant, menopause, coil or smear

You have a period that will not stay in its lane, a pelvic ache you have been explaining away, a smear letter, a menopause list, or a coil that is due. Search results then offer several doors at once: a GP, a consultant gynaecologist, a menopause clinic, a coil diary, a private smear, a Well Woman MOT, or A&E. Those are not interchangeable, and picking the wrong door is how people sit in a planned menopause slot with bleeding that needed a specialist look, or how they wait on Harley Street with a pregnancy bleed that belonged in an ambulance.

The consultant gynaecology visit at Medical Express Clinic is a consultation with Dr Hikmat Naoum, Consultant Gynaecologist, GMC 3047637, at 117a Harley Street. It is not a GP appointment, the menopause clinic, a coil fitting, a smear on its own, or an emergency early-pregnancy unit.

When it is 999 or A&E

Call 999 or go to A&E for a life-threatening emergency.

Which concern belongs in which visit.

NHS guidance is plain. For this clinic, that includes severe pain or heavy bleeding in pregnancy. The early-pregnancy clinic here is a booked consultation for pregnancy-related concerns when it is safe to wait for an arranged appointment. It is not an emergency EPAU. If you are reading this while that pain or bleed is on, stop reading and call 999. NHS.uk also says to call 999 or go to A&E for pelvic pain that is severe, getting worse, or hurts when you move or touch the area. The same applies if you feel faint, dizzy or lightheaded, have pain in the tip of your shoulder, difficulty breathing or heavy bleeding from the vagina, or suddenly feel confused.

NHS 111 is the route NHS.uk names when symptoms are urgent but not life-threatening, or when you are not sure whether 999 is required. You can check symptoms online, or call 111. A private gynaecology diary is not a substitute for that public emergency system.

When a GP is the right person

A women's health question can start with a GP. NHS.uk says to see a GP if heavy periods are affecting your life, if you have had them for some time, or if you have severe pain during your periods. The same advice applies if you bleed between periods or after sex, or if heavy periods come with other symptoms such as pain when peeing, pooing or having sex. It also says to see a GP if pelvic pain comes and goes or does not go away, and for postmenopausal bleeding even if it has happened only once, even if there is only a small amount, and even if you are not sure it is blood.

A GP at this clinic can take a history, examine you where it would help, arrange bloods in the same building if they would change the plan, and decide whether a specialist look, a smear or a menopause visit would help.

A GP can also write the letter you later bring to Dr Naoum. Do not use a gynaecology booking as a way of skipping a GP when the problem is a cough, a urine infection, a contraception chat that is not a coil, or a medicine review. Those remain GP work.

When the menopause clinic is the visit

Perimenopause or HRT questions start with the menopause clinic, not with consultant gynaecology. Dr Penny Sheehan, a GP with a menopause interest, GMC 6056535, consults on Mondays and Wednesdays at 117a Harley Street. You can book without a referral. HRT prescribing and later monitoring sit with the HRT clinic when that is already the question.

Hot flushes, night sweats, broken sleep, mood change and brain fog while periods are still happening are menopause-clinic work, whereas heavy, irregular or postmenopausal bleeding, or pelvic pain, belongs with consultant gynaecology. Any bleeding after the menopause should be checked promptly.

When a coil or a smear is the booking

Copper or hormonal coil fitting, removal or replacement is booked through contraceptive services, not through this consultant consultation. Dr Naoum carries out those procedures personally, with a nursing chaperone, on the coil diary. Do not use a planned insertion to investigate pelvic pain, abnormal bleeding, fertility or early pregnancy.

A private smear is its own service. Do not book consultant gynaecology because you wanted a smear, and do not treat a smear as an answer to pain or a heavy bleed.

Screening is not this appointment

A Well Woman MOT is planned screening when you feel well. At Elite and Ultimate level it can include a gynaecology component. That is still screening rather than a symptom-led consultation. If you have a current pelvic, menstrual, fertility or early-pregnancy concern, book the visit that answers that concern.

When Dr Naoum is the visit

For a pelvic, menstrual, fertility or early-pregnancy concern that you want a consultant gynaecologist to hold, the usual visit is a consultation with Dr Hikmat Naoum at 117a Harley Street, with an initial gynaecology consultation as the sister service. He leads this service.

People come with pelvic pain that has lasted weeks, heavy or irregular bleeding, bleeding between periods or after the menopause, difficulties conceiving, or a pregnancy-related concern that can wait for an arranged appointment.

NICE guideline NG88 on heavy menstrual bleeding is public. It asks clinicians to recognise that heavy bleeding has a major impact on a woman's quality of life, and that any intervention should aim to improve that rather than focusing only on measured blood loss. It also says to consider specialist care if treatment has been unsuccessful, if the woman declines pharmacological treatment, or if symptoms are severe, and to consider specialist referral for fibroids of 3 cm or more in diameter. NHS.uk says a GP will usually refer you for tests or to a specialist if treatments do not work or if they think a condition may be causing the bleeding. On Harley Street you can request that specialist look without a referral.

For postmenopausal bleeding, NHS.uk says a GP should refer you to hospital or a special postmenopausal bleeding clinic, and you should not have to wait more than 2 weeks to see a specialist. A consultant visit here, with examination and same-visit ultrasound when indicated, is one way to have that specialist look promptly. The NHS two-week route remains the public pathway.

Fertility and recurrent miscarriage have dedicated assessments. Book that assessment rather than hoping a standard consultation will become one. Dr Naoum reviews difficulties conceiving, orders or interprets investigations, and refers on to specialist fertility services when that is the right place. Couples can attend together.

Medical Express Clinic has practised at 117a Harley Street since 1984 and is CQC-registered. Dr Naoum is on the GMC Specialist Register for obstetrics and gynaecology, and was appointed Senior Consultant Gynaecologist at Oxford University NHS Trust in 2000. Specialist areas include diagnostic ultrasound, pain, abnormal bleeding, IUD procedures and HPV treatment.

What the Harley Street consultation covers

The visit includes a history, an examination with a nursing chaperone when that would help, same-visit ultrasound when it is indicated, and a plan in the room. If an intimate examination would change the plan, a member of the nursing team is present as a chaperone. He explains each part as he goes, and you may ask him to pause.

If ultrasound is indicated, he performs it on site and talks through what he can see then and there. The scan is not a separate online booking.

You leave with an explanation and a plan. That may include treatment here, a private smear booked as its own service, or referral to fertility, breast, menopause or another specialty. Appointments are by arrangement.

What to bring

Bring any referral letter, scans or smear reports you already have, a medication list, and the date of your last period if you know it. You do not need a referral to request the consultation, but a letter that exists should still travel with you.

Tips and tricks

• Decide which door you are walking through before you book.
• 999 for severe pain, a faint-making bleed, or severe pain or heavy bleeding in pregnancy.
• NHS 111 when it is urgent but not life-threatening.
• A milder new question often starts with a GP.
• Flushes, sleep, mood and HRT sit with Dr Sheehan on Monday and Wednesday.
• Coils and smears have their own diaries.
• Well Woman is screening when you feel well.
• Dr Naoum is for a pelvic, menstrual, fertility or early-pregnancy concern.
• Put results you already hold in one place.
• If fertility or recurrent miscarriage is the real question, say that when you book.

Things to avoid

• Do not sit on severe pelvic pain or a pregnancy bleed because you have a clinic appointment later in the week.
• Do not treat a smear as a diagnosis of pain, or a clear scan as a promise that bleeding cannot return.
• Do not book Well Woman screening for a current symptom, or a gynaecologist for a cough.
• Do not book consultant gynaecology for a coil or a smear on its own.
• Do not book the menopause clinic for heavy, irregular or postmenopausal bleeding, or for pelvic pain.
• Do not use this early-pregnancy clinic as an emergency EPAU.
• Do not arrive without letters you already hold.

If you do want the consultant gynaecology visit, the details sit on the gynaecology clinic page, or you can contact the clinic on 020 7499 1991.

Related guides: choosing a coil appointment and whether you need a blood test before a menopause appointment.