Gynaecology is the medicinal specialty of diseases of the female reproductive system (uterus, vagina, and ovaries). Almost all modern gynaecologists are also obstetricians.
It is typically a consultant specialty. In most countries women must see a general practitioner (GP; also known as a family practitioner (FP)) first. If their condition requires knowledge or equipment unavailable to the GP they are referred to a gynaecologist. However in the United States law and many health insurance plans allow gynaecologists to provide primary care and some women select that option.
As in all of medicine the main tools of diagnosis are clinical history and examination. Gynaecological examination is special in that it is quite intimate, and it involves special equipment, the speculum. The speculum consists of two hinged blades of concave metal or plastic which are used to retract the tissues of the vagina and permit examination of the cervix the lower part of the uterus located within the upper portion of the vagina. Gynaecologists typically do a bimanual examination (one hand on the abdomen two fingers in the vagina) to palpate the cervix, uterus, ovaries and bony pelvis. It is not uncommon to do a rectovaginal exam for complete evaluation of the pelvis particularly if any suspicious masses are appreciated. Male gynaecologists often have a female chaperone (nurse or medical student) for their examination. An abdominal and/or vaginal ultrasound can be used to confirm any abnormalities appreciated with the bimanual examination or when indicated by the patient's history.