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Welcome to Womens Health

Women’s Health (WN)

  • Women’s health encompasses a broad spectrum of issues that are central to general practice, including contraception, menstrual health, fertility, pregnancy, menopause, and disorders of the reproductive system. These consultations are frequent and often complex, requiring GPs to be both clinically competent and sensitive to the broader social and emotional contexts of women’s lives.

    In addition to these gender-specific presentations, many health issues, such as physical conditions, mental health conditions and substance misuse, can manifest differently in women and may require a nuanced approach to recognition, diagnosis, and management. GPs must remain attuned to these differences to provide effective, person-centred care.

    Domestic Violence and experiences of coercive control are known to disproportionally affect women across all socioeconomic groups and practitioners must remain alert to the signs of potential abuse and know how to support patients without endangering them further.

    As GPs, we are in a unique position to promote preventive health and empower women to take control of their wellbeing across all stages of life. 

    While this chapter refers to women's health, we acknowledge that not all individuals with female reproductive organs or who were assigned female at birth identify as women. The College curriculum aims to support inclusive, respectful, and person-centred care that is responsive to the needs of all individuals, regardless of gender identity. There are specific professional standards statements regarding the care of transgender and gender diverse individuals in the Equity, Diversity and Inclusion Health and Sexual Health Chapters.

  • General

    WN1. Recognize and address gender-specific differences in the presentation of medical conditions, including atypical symptoms in women, to ensure equitable and effective care.

    Gynaecology

    WN 2. Apply evidence based strategies to identify and manage cancer risk in women.

    WN3. Perform gynaecological examinations in a sensitive manner, including bimanual, speculum and digital rectal examination, assessing pelvic organ anatomy, and identifying abnormalities.

    WN4. Manage common gynaecological presentations in primary care, such as vaginal discharge, pelvic pain, menstrual disorders, and menopause-related symptoms, recognising when to refer to specialist services.

    WN5. Recognise and appropriately investigate red flag gynaecological symptoms, including postmenopausal bleeding, post-coital bleeding, intermenstrual bleeding or severe pelvic pain.

    WN6. Counsel patients effectively regarding cervical screening, including the rationale, schedule, procedure, and implications of results, while addressing concerns and ensuring informed consent.

    Breast Care

    WN7. Competently perform a breast examination in a sensitive manner and manage breast disease appropriately.

    WN8. Counsel patients effectively regarding breast screening, including the rationale, procedure, and implications of results.

    WN9. Recognize and manage common issues associated with breastfeeding.

    Obstetrics

    WN10. Recognize the role of the GP in pre-natal advice and care.

    WN11. Coordinate comprehensive antenatal care in a general practice setting, encompassing routine assessments, risk identification, and collaboration with specialists.

    WN12. Recognize and manage obstetric emergencies and complications in a primary care setting.

    WN13. Recognize and manage common medical disorders that can occur in pregnancy appropriate for a primary care setting.

    WN14. Provide comprehensive postnatal care in a primary care setting.

    WN15. Demonstrate the knowledge and skills to effectively support mothers with infant feeding, including providing evidence-based guidance, addressing challenges, and promoting informed decision-making to ensure optimal infant nutrition and maternal well-being.

    Reproductive Health

    WN16. Assess and manage subfertility, identifying underlying causes, utilising appropriate diagnostic tests, and developing individualised treatment plans.

    WN17. Provide appropriate contraceptive care, taking into consideration the individual needs and preferences of patients, including emergency contraception and long-acting reversible contraceptives (LARCs).

    WN18. Display an understanding of the management of unplanned pregnancies, adhering to national guidelines, addressing legal and regulatory responsibilities, and providing a supportive and non-judgmental environment for patients.

    WN19. Provide appropriate, accurate information to patients seeking termination of pregnancy, addressing emotional and psychological needs as necessary, and ensuring appropriate post-termination follow-up.

    WN20. Understand the legal and ethical considerations surrounding contraception provision for minors, including the consent process, confidentiality requirements, and potential exceptions to parental consent.

    Ethical and Legal Considerations

    WN21. Recognize the obligations of healthcare providers as ‘mandated people’ regarding sexual consent and child protection guidelines.

    WN22. Provide non-judgmental and accessible support to patients suffering gender-based violence.

    WN23. Demonstrate a commitment to providing equitable and inclusive care for all individuals.

    Prescribing in Women's Health

    WN24. Understand safe and effective prescribing in pre-natal, antenatal, postnatal, and breastfeeding care, ensuring risk assessment and patient-centred decision-making.

    WN25. Recognize the importance of medication review in pregnancy, particularly for women with chronic conditions such as epilepsy, asthma, depression, and hypertension.

    For each problem or disease, consider the following areas within the general context of primary care:  

    • the natural history of the condition, including whether acute or chronic
    • the incidence and prevalence, including in different demographic groups
    • typical and atypical presentations
    • recognition of normal variations throughout life
    • risk factors, including lifestyle, socio-economic and genetic factors
    • diagnostic features and differential diagnosis
    • recognition of ‘alarm’ or ‘red flag’ features
    • appropriate and relevant investigations
    • interpretation of test results
    • management, including initial and continuing care, chronic disease monitoring and emergency care
    • patient and carer information and education
    • prognosis

    Signs, Symptoms & Presentations

    • Abdominal Pain during pregnancy
    • Abnormal pregnancy symptoms and signs – abnormal abdominal palpation, bleeding, hyperemesis, abdominal pain, pelvic pain, preterm labour, reduced fetal movements
    • Abnormal Vaginal Bleeding
    • Amenorrhea
    • Bleeding in pregnancy
    • Breast Lumps
    • Breast Pain
    • Breast Skin Changes
    • Contraception requirement
    • Dysfunctional uterine bleeding
    • Dysmenorrhea
    • Dyspareunia
    • Early Pregnancy Loss
    • Hot flushes
    • Mastalgia
    • Menorrhagia
    • Menstrual Irregularity
    • Need to postpone menstruation
    • Newborn feeding Issues
    • Nipple Changes
    • Non specific signs and symptoms of ovarian cancer
    • Normal signs and symptoms of pregnancy
    • Pelvic pain
    • Pelvic/ Abdominal Masses
    • Pelvic/ Abdominal Pain
    • Perinatal Mental Health Symptoms
    • Post Coital Bleeding
    • Post-menopausal bleeding (PMB)
    • Pregnancy
    • Subfertility
    • Urinary incontinence (urge and stress)
    • Vaginal Discharge
    • Vaginal Dryness
    • Vulval Pain, lumps, irritation, ulceration, pigmentation, lucoplakia

    Common and Important Conditions

    • Adenomysosis
    • Breast abscess
    • Breast Cancer
    • Caesarean Section
    • Cervical Cancer
    • Ectopic pregnancy
    • Endometriosis
    • Female Genital Mutilation
    • Fibroids
    • Genital Herpes
    • Gestational diabetes
    • Gynaecological cancers
    • Hypertension in pregnancy
    • Mastitis
    • Menopause
    • Miscarriage
    • Multiple Pregnancy
    • Pelvic floor dysfunction
    • Pelvic inflammatory disease
    • Polycystic ovary syndrome (PCOS)
    • Post Natal Depression
    • Post Natal Psychosis
    • Post-partum haemorrhage
    • Pre Eclampsia
    • Premature Ovarian Failure
    • Premature rupture of membranes
    • Premenstrual syndrome (PMS)
    • Prolapse
    • Pubic symphysis dysfunction
    • Recurrent Miscarraige
    • Recurrent UTIs
    • Retained Products of Conception
    • Stillbirth
    • Thyroid disorders of pregnancy
    • Vaginal Candidiasis
    • Vaginal prolapse
    • Vulvovaginitis

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed 

    Blended Learning Resources (Education Platform)

    Managing Menopause in General Practice

    Early Medical Abortion

    Managing Common Problems in Pregnancy (not created yet)

    Contraception Theory

    Supporting Breastfeeding in GP

    Useful Websites

    Women’s Health Irish College of GPs

    UKMEC for Contraceptive use

    Vaccines in Pregnancy

    Safe Food in Pregnancy

    Women in Sport

    Diet and Lifestyle advice during pregnancy

    Women’s Aid

    Myoptions for Unplanned Pregnancy

    START Ireland – Termination of Pregnancy

    Drugs and Lactation Database

    Breastfeeding advice

    Association of Lactation Consultants Ireland

    Menopause Matters

    British Menopause Society

    Obs & Gynae Emergencies Podcast UCD

    National Screening Services Resources

    Mna Feasa

    Endo Zone – Endometriosis

    BUMPS – Best Use of Medicines in Pregnancy

    Breastfeeding Network

    Endometriosis Ireland

    NCCP resources on Breast Cancer

    NCCP resources on Ovarian Cancer

    Workplace Based Learning

    Workplace-based learning during obstetrics and gynaecology rotations and in general practice offers GP trainees valuable, hands-on experience in managing women’s health across a range of settings. In hospital placements, trainees gain exposure to antenatal care, labour and delivery, gynaecological procedures, and emergency presentations. In general practice, they learn to manage common issues such as menstrual disorders, contraception, menopause, and early pregnancy problems in the community. Engaging in case discussions, supervised clinics, and reflective practice helps trainees develop clinical confidence and a holistic, patient-centred approach to women’s health.

    Day Release

    Day release teaching provides a dedicated space for GP trainees to consolidate their learning in women’s health through interactive, peer-supported education. These sessions offer the opportunity to explore common and complex topics (such as contraception, menstrual disorders, menopause, antenatal and postnatal care, and safeguarding) within the context of primary care. Using case-based discussions, role play, and guideline reviews, trainees can deepen their understanding, share experiences, and reflect on real-world challenges. Day release helps bridge the gap between hospital-based experience and the realities of managing women’s health in the community.

    Registrar Tutorials

    Registrar tutorials offer a focused and flexible setting for in-depth learning about women’s health, tailored to the needs and interests of GP trainees. These sessions provide an ideal environment for exploring both routine and complex presentations; such as abnormal bleeding, contraception choices, fertility concerns, menopause management, and early pregnancy care. Tutorials can include case-based learning, practical demonstrations (e.g., speculum or bimanual examination), and updates on current guidelines. They also create a safe space to discuss sensitive topics like domestic violence or safeguarding, helping trainees build confidence in managing these issues with empathy and professionalism.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

     EPA 14: Manage a pregnancy

    A patient presenting for a first antenatal appointment provides an opportunity to demonstrate EPA 14. If the GP Trainer observes the consultation and examination, including pregnancy confirmation, risk assessment, and discussion of antenatal screening, a PIP-C and PIP-P can be used to assess structured history-taking, sensitive communication, and coordination of care. A succinct case entry could be: “first antenatal visit and booking.” 

    Core Knowledge Test (CKT)

    • Assessment of dysmenorrhoea

    • Management of post-menopausal bleeding

    • Prescribing of Hormone Replacement Therapy

    Clinical Competency Test (CCT)

    • A patient presenting for a contraception consultation.
    • A patient presenting with amenorrhea.
    • A patient presenting with post-menopausal bleeding.

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.