The CCG service offers care to adolescents and adults with structural differences in how the uterus, vagina and vulva may have formed differently, or did not form, before birth.
Complex congenital gynecology (CCG) conditions can cause pain from obstructed menstruation, can affect sexual function, fertility and routes to parenthood.
Some conditions may be associated with congenital (from birth) differences in bladder and bowels.
The multi-disciplinary service includes gynecology, specialist nursing, psychology, urology, and radiology.
There is an overlap with our DSD service and some patients with CCG conditions may identify as having a DSD condition.
Please view our welcome pack for new patients: Complex Congenital Gynaecology and Differences of Sex Development.
Patient contact
General enquiries
Service management
Shelly-Ann Young
Address
Complex Congenital Gynaecology
2nd floor North Wing
250 Euston Road
NW1 2PG
Other referral information
To make a referral, please download and complete this form including as much information as possible regarding the patient’s clinical history and current symptoms. Please send the completed referral forms to uclh.pag.referrals@nhs.net.
If you have any questions about submitting a referral ahead of sending the referral form, please email uclh.pag.referrals@nhs.net
Menstrual obstruction management
For patients with obstructed menstruation hormonal treatment for endometrial suppression is recommended to manage pain and reduce further obstructed menstrual blood accumulating.
Norethisterone is recommended as first line (note not licensed contraception).
Norethisterone 5mg; orally three times daily continuously (i.e. no break).
Contraindications/cautions:
- VTE history or thrombophillia
- Arterial thrombosis risk factors (eg obesity, cardiac disease, migraines)
- Hepatobiliary conditions
Where contradictions to Norethisterone consider Medroxyprogesterone acetate 10mg two-three times daily
If menstrual obstruction is already well managed with continuous hormonal contraception then this can be continued.
If advice on endometrial suppression is required, please contact the team (uclh.pag.queries@nhs.net)
CCG conditions that the team UCLH see (this list is not exhaustive):
- MRKH (uterovaginal agenesis)
- Transverse Vaginal Septum
- Obstructed hemi-vagina
- Vaginal agenesis (congenital absence of vagina with functional uterus)
- Accessory Cavitated Uterine Mass (ACUM
- Unicornuate uterus with obstructed rudimentary uterine horn
- MRKH with functioning rudimentary uterine structure
- Longitudinal vaginal septum
- Cloacal anomalies (also view adolescent urology)
- Bladder exstrophy (also view adolescent urology)
