Pioneers in patient care: consultants leading change
North East
Innovations: Reproductive endocrinology clinic divided into two areas : a polycystic ovary syndrome clinic and paediatric and adolescent gynaecology clinic
Adam Balen
Leeds General Infirmary
Job title: Consultant obstetrician and gynaecologist
Specialty: Reproductive medicine and surgery
Polycystic ovary syndrome is the commonest endocrine condition to affect women yet it is generally poorly understood and managed, says Leeds consultant obstetrician and gynaecologist Adam Balen.
He says: “One in three women has it and 75 per cent of those women have some symptoms. Our clinic, set up in 1997, provides support for women with PCOS of all ages from the adolescent with acne and or hirsutism, the young woman with menstrual irregularity or obesity and the woman with infertility. We are performing studies on innovative methods to treat hirsutism, weight control, metabolic control, menstrual cycle control and ovulation induction.
“The clinic was introduced because there was a need for the co-ordinated management of all problems experienced by women with PCOS. Many women believe that the distressing symptoms are ‘normal’ and go undiagnosed for years – our clinic enables us
to support them.”
Mr Balen also runs a paediatric and adolescent gynaecology service for children, adolescents and adults with developmental abnormalities of the reproductive organs and external genitalia. Examples include children born with ambiguous genitalia – a girl who is born with female internal reproductive structures such as a uterus and a vagina but has an enlarged clitoris that looks like a penis.
He says: “Some patients are referred by their general practitioner, but most are referred by consultants in district general or other teaching hospitals and we provide an appropriate clinic setting for the sensitive management of complex conditions with full access to the necessary medical, nursing and psychological care.
“I see about 60 cases a year which have been picked up at birth and some need surgery and some don’t. What is most important is that here the patients have access to paediatric and adolescent experts as well as a plastic surgeon, urologist, paediatric endocrinologist, a psychologist and a consultant psychiatrist who have long-standing interests in the management of complex intersex and reproductive endocrinological conditions.
“Patients attending these clinics have rare conditions which require specific expertise, not commonly available. The presence of a psychologist and specialist nurse in every clinic is an uncommon development and provides additional support.”
Mr Balen co-ordinates the requirements of each patient seen on an individual basis and tries to provide a seamless network of care that encompasses the medical, surgical, fertility and hormonal needs of the patients together with psychological support for both the patients and their families.
Information leaflets have been written on all conditions encountered in the clinic and the service has established links with national patient support groups, some of which have held meetings in Leeds.