Blog
I write about what patients ask most often. No generalities: timings, numbers, and what to do next.
Heartbeat on ultrasound: when it shows and what to do if it does not yet
In short: on a transvaginal scan the embryo’s heartbeat usually shows from 5+5 to 6+2 weeks, and from 6+3 to 7+0 weeks in practically every developing pregnancy. If it is not there at 6 weeks, the most common reason is that the pregnancy is younger than the calendar suggests, and the scan should be repeated in 7 to 14 days. Here is what the timing depends on, which heart rate is normal, and when an absent heartbeat is considered final.
Read · 7 min read CervixCIN 1, CIN 2, CIN 3: how I read a cervical biopsy result
In short: CIN is not cancer. It describes changed cells within the surface layer of the cervix, found in a tissue sample taken at colposcopy. CIN 1 most often clears on its own and is observed. CIN 3 is always treated. CIN 2 sits in between: it is usually treated, but observation is acceptable for young women planning a pregnancy. Here is what the number stands for, what is known about the odds, and what follow-up looks like.
Read · 7 min read UltrasoundEndometrium on ultrasound: how I read the thickness and the report
In short: during a period the endometrium measures about 2–4 mm on ultrasound, just after it 5–7 mm, before ovulation up to 11 mm with a “three-layer” pattern, and in the second half of the cycle 7–16 mm. But a number without the cycle day and a description of the structure says very little: 12 mm on day 22 is normal, on day 6 it is a question. Here is how I read the endometrium on screen, what the words in the report stand for, and when not to wait.
Read · 9 min read CervixPap test: what the test is and how it differs from a swab
The same test goes by several names: Pap test, Pap smear, cervical cytology, and in Poland simply cytologia. Half the questions come from that — have I already had it, and is something else still needed? Here is what the test is, how it is taken, how it differs from a vaginal swab and an HPV test, and how long the result takes.
Read · 7 min read Planning a pregnancyDominant follicle: how many millimeters, and when you will ovulate
The scan report says “dominant follicle 14 mm”, and the question follows at once: is that a lot or a little, and when should ovulation come? Here is what this follicle is, how fast it grows, how many days it usually takes to rupture at each size, and when size promises nothing at all.
Read · 7 min read PregnancyGestational sac on ultrasound: when it shows, its size, and what "empty" means
The gestational sac is the first thing visible in a pregnancy and the first thing people worry about: small, empty, irregular. Here is when it appears on screen, how to estimate the week from its size, when the yolk sac and the embryo are due to appear inside it, and when the word "empty" genuinely means something.
Read · 8 min read CervixLSIL and HSIL: the difference and what happens next
LSIL and HSIL differ by one letter and, in meaning, fundamentally: the first usually resolves on its own, the second is treated to prevent cancer. Neither is a diagnosis, and neither is cancer. Here is what each abbreviation stands for, how they relate to CIN 1–3, and what follows in each case.
Read · 9 min read UltrasoundCorpus luteum on ultrasound: how it looks and what it means
"You have a corpus luteum" is a sentence that delights some patients, alarms others, and puzzles most. In fact it is the most ordinary finding of the second half of the cycle and usually good news. Here is how it looks on screen, what size it reaches, when it appears and fades, and when it genuinely needs attention.
Read · 8 min read CervixNILM on a Pap result: what it means and what happens next
NILM is the most common cytology result and the most underrated one: it contains the word "negative", and that is exactly what worries people. In fact it is the best thing that can be written on the report. Here is what the abbreviation stands for, why a normal result does not replace HPV testing, when the next test is due, and what the notes often printed beside it mean.
Read · 7 min read CervixASC-US on a Pap result: what it means and what happens next
ASC-US frightens people more than any other result on a cytology report — precisely because it is unclear. Literally it means "the cells do not look entirely ordinary, and why is uncertain". It is not a diagnosis and almost never cancer. Here is where the result comes from, what is done next in Poland, and what you do not need to do.
Read · 8 min read UltrasoundFibroid or ovarian cyst: the difference, and which is more serious
"Are a cyst and a fibroid the same thing?" is one of the most common questions after an ultrasound. They are not: they are different growths in different organs, they grow differently, go away differently and follow different treatment rules. Here is how they differ, which is more serious, and what to do when one or both words appear in your report.
Read · 8 min read TestsVaginal swab for flora: what it shows and how to read the result
The vaginal flora swab is one of the most frequently ordered tests in gynecology and one of the least understood. It gets confused with cytology, done "as a precaution" with no symptoms, and then a line on the report gets treated instead of the patient. Here is what it actually shows, when it is needed, how to prepare, and what the words on the result mean.
Read · 9 min read PreventionThe annual gynecological check-up
"Get checked once a year" is the right instinct, but the list is usually assembled from memory or a friend’s advice. It almost always contains something unnecessary that you pay for, and almost always misses the one or two items the whole exercise was for. Here is what is needed at what age, what is needed less often than yearly, and what is not needed at all.
Read · 9 min read CervixCervical "erosion": what it really is
"You have an erosion, it needs cauterising" is a sentence almost every patient from the post-Soviet world has heard, and it is also the one most often wrong. In Poland you will most likely be told there is nothing to treat, and that is not indifference: what is habitually called erosion is usually not a disease at all.
Read · 8 min read UltrasoundWhich gynecological ultrasound you need
"I need an ultrasound" begins half the phone calls, and a pause almost always follows: which one? There are four gynecological ultrasound examinations, they answer different questions, they are done on different days of the cycle and they cost different amounts. Here is which one fits your situation — and what ultrasound will not show at all.
Read · 8 min read CervixCervical cytology: how to read your result
A cytology result — the Pap test — arrives as a sheet of paper with a short abbreviation on it, and the days between reading it and seeing a doctor are usually spent searching. Here is what each line of the report means, what happens next, and why none of those letters says cancer.
Read · 10 min read PricesHow much does a gynecologist cost in Warsaw
"How much will this cost" is the question asked most often before booking, and price lists rarely answer it: a line, a number, nothing else. Here is the answer, using my own prices — what the fee covers, what is billed separately, and where a combination is genuinely cheaper rather than merely called a package.
Read · 8 min read PregnancyPregnancy care in Poland: how to start
The test is positive, and the question is immediately where to go and what to do. The Polish system is not built the way newcomers usually expect, and the first attempt to "register the pregnancy" runs into the fact that no such procedure exists here. Here is the sequence: how care begins, what karta ciąży is, which tests happen when, and which documents you will need.
Read · 11 min read CervixHPV test: who needs it and what a positive result means
People ask about HPV in two situations: when it has just been found and feels frightening, and when they are trying to work out whether to be tested at all. Both are covered here: what a positive result means, how the test differs from cytology, who needs it and from what age, and what happens next.
Read · 9 min read Women’s healthVaginal discharge: normal, thrush, or not thrush at all
Almost every woman has treated "thrush" with something from a pharmacy at least once, and in roughly half of those cases it was not thrush. Hence the familiar pattern: better for three days, then back again. Here is how to tell them apart from the symptoms, and what to test so you are not guessing.
Read · 9 min read PolandPolish gynecology glossary
The report is in Polish, the prescription is in Polish, and so is the reception desk — while an interpreter in the consulting room is far from guaranteed. These are the words that actually turn up: not a textbook, but what is printed on your piece of paper, plus the false friends that cause the most expensive misunderstandings.
Read · 8 min read AppointmentsA first gynecologist visit in Poland: referral, PESEL, cost
What makes booking a doctor in a new country difficult is not the language but not knowing the rules: whether a referral is needed, what to do without a PESEL number, what it will cost. Here are the answers in order, so that nothing is still open by the time you arrive.
Read · 8 min read Pregnancy planningOvulation on ultrasound: the follicle, the corpus luteum and the fluid
Tests show a hormone surge, an app counts from the calendar, and ultrasound shows the follicle itself: how many millimetres it measures today and whether it ruptured yesterday. Here is what is actually visible on the screen before ovulation, on the day, and afterwards.
Read · 8 min read PregnancyThe first ultrasound in pregnancy — and how many follow
The test is positive, and the next question is when to book. Too early and there is nothing to see; too late and you can miss windows that are tied to specific weeks. Here is the whole schedule in order: what happens before week ten, what happens at 11–13, what comes after, and why those windows cannot be moved.
Read · 9 min read UltrasoundOvarian ultrasound: cysts, reserve, and what “polycystic” means
The commonest finding in an ovary is a cyst, and the commonest cyst goes away by itself within one to three cycles. Telling that kind apart from the kind that needs watching can be done at the appointment — from its appearance, its size and the day of the cycle. Here is how it works and what to do with a report in hand.
Read · 9 min read CervixColposcopy: does it hurt, how to prepare, what the result means
A referral for colposcopy almost always follows an abnormal smear, and the fear comes not from the procedure but from what it implies. Here it is in order: what happens at the appointment, what it feels like, and what the words in the report actually mean.
Read · 9 min read MenopauseHormone tests in menopause: which ones matter and which do not
The commonest question before an appointment is “which hormones should I test”. The surprising answer is: usually none. At the typical age, menopause is diagnosed from the calendar, not from a result. Here is when tests do matter, which ones, and how not to read more into a single number than it can bear.
Read · 8 min read UltrasoundBreast ultrasound: when to have it and what BI-RADS means
The report says "BI-RADS 2" or "BI-RADS 3" and stops there. Below is the whole scale in order, and along the way: which day of the cycle to book, and when an ultrasound does not replace a mammogram.
Read · 8 min read PregnancyWhen a pregnancy shows on ultrasound: sac, embryo, heartbeat
A positive test and an ultrasound that shows nothing yet is the most common reason for worry in early pregnancy. Below are the weeks at which each thing becomes visible, and what to do if the scan came too early.
Read · 7 min read UltrasoundPelvic ultrasound: how to prepare and what it shows
Two questions come up before every scan: whether to drink water, and which day of the cycle to book. Both answers depend on which probe will be used — and that is the only thing you really need to know in advance.
Read · 8 min read Planning a pregnancyFolliculometry: which day of the cycle and how many visits
An app puts ovulation on day fourteen because that is where it falls in a 28-day cycle. Follicle tracking shows when it falls for you — and that can be several days off, which is enough to miss the fertile window for that cycle.
Read · 7 min read PregnancyEctopic pregnancy: when and how it shows on ultrasound
An ectopic pregnancy occurs in about one pregnancy in a hundred and is the leading cause of maternal death in the first trimester. That is why nobody suggests waiting when the test is positive and the uterus is empty. Below: what the scan shows, why one scan is rarely enough, and the signs that mean hospital rather than an appointment.
Read · 8 min read Planning a pregnancyWhat tests to do before pregnancy
A sensible list fits on one page and costs less than people expect. The point is not to test everything, but to find what can be fixed in advance: anaemia, an untreated thyroid, no immunity to rubella.
Read · 9 min readNeed an ultrasound or a consultation?
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