What are the opening hours?

Monday 09:00 - 17:00 Tuesday 09:00 - 17:00 Wednesday 09:00 - 17:00 Thursday 09:00 - 17:00 Friday 09:00 - 17:00 Saturday 09:00 - 13:00

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Ephraim Medical Clinic

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Antigua
Saint John's
Ephraim Medical Clinic

Gynecology and General Women's Health clinic in Antigua and Barbuda.

30/03/2026

WHEN MEDICAL ABORTION FAILS

Medical abortion refers to termination of pregnancy using medications like misoprostol. It is usually done before 11 weeks of pregnancy. It is not always successful, with success rates of 92% before 7 weeks and only 80% at 9 to 11 weeks.

Signs that medical abortion has failed include heavy or prolonged va**nal bleeding, va**nal bleeding that stops and restarts in a few days, severe lower abdominal pain, foul-smelling va**nal blood or discharge, fever and continuation of pregnancy symptoms like nausea and breast tenderness.

If you suspect medical abortion has failed, you must seek medical attention immediately. A pelvic ultrasound should be performed which will show retained products of conception in the uterus. These products must be surgically removed from the uterus as soon as possible using vacuum aspiration or dilation and curettage (D&C). Delay in evacuating products can result in severe complications like infection, hemorrhage, infertility and need to remove the uterus (hysterectomy).

15/03/2026

UTERINE FIBROID TREATMEMT OPTIONS

Uterine fibroids are non-cancerous tumors that grow in the uterus or womb. They may not cause any symptoms. Sometimes, fibroids cause heavy va**nal bleeding, abdominal pain, abdominal swelling and fertility problems. Treatment options include medications, minimally invasive procedures and major surgery.

Medications do not permanently shrink fibroids or cause fibroids to go away. They are used to control heavy bleeding and pain. Common medications include hormonal pills or patches, hormonal IUDs and GNRH agonists.

Uterine fibroid embolization is a minimally invasive procedure that cuts off blood supply to fibroids stopping their growth. Recovery is 1-2 weeks. Myomectomy is surgical removal of fibroids, leaving the uterus intact for fertility. Recovery is usually 2 weeks (laparoscopic) or 6 weeks (open). Hysterectomy is removal of the uterus which contains the fibroids, eliminating the risk of future fibroids. Recovery takes about 6 weeks.

18/02/2026

FAB FOUR STDs: VAGINAL DISCHARGE

Bacterial Vaginosis (BV)
Imbalance of va**nal pH, causing overgrowth of a bacteria, Gardnerella va**nalis. While not strictly an STD, s*xual activity can introduce Gardnerella va**nalis into the va**na. The bacteria can also be transmitted to males during s*x. BV causes a thin whitish grey, fishy-smelling discharge. Diagnosis is usually clinical. Treatment is antibiotics. Recent evidence suggests that both partners should be treated. BV is particularly dangerous during pregnancy as it can cause early rupture of the "water bag" and loss of the pregnancy.

Vulvova**nal Candidiasis (Yeast Infection):
Overgrowth of the fungus Candida. While not strictly an STD, it can be passed to a partner during s*xual activity (oral, a**l, or va**nal). It causes a thick, white, cottage cheese-like discharge, accompanied by intense itching, burning, and pain during in*******se. Diagnosis is usually clinical. Treatment involves antifungal medications.

Trichomoniasis:
Most common STD worldwide. It is caused by the parasite Trichomonas va**nales. It often causes no symptoms, especially in men. When present, symptoms include a greenish-yellow, frothy, foul-smelling va**nal discharge, ge***al itching and pain. There may also be pain on urination. Diagnosis is usually clinical supported by urine and/or va**nal swab tests. Treatment is with antibiotics. Both partners must be treated simultaneously to avoid re-infection.

Chlamydia and Gonorrhoea:
Most serious of the STDs that cause discharge. Caused by the bacteria Chlamydia trachomatis and Neisseria gonorrhoeae which are almost always isolated together. Symptoms include a very thick, yellow or cloudy, foul-smelling discharge with severe pelvic pain and painful urination. It is the most common cause of pelvic inflammatory disease or PID. Early detection and treatment is important to prevent complications like ectopic pregnancy and infertility. Diagnosis is with urine and swab tests. All s*xual partners must be treated with antibiotics.

08/02/2026

FAB FOUR STDs: BUMPS ON THE V***A

Ge***al Warts (HPV): fleshy, skin-colored, or grayish bumps, often appearing in clusters. They are caused by the Human Papilloma Virus (HPV) 6 and 11. Warts do not cause pain and may go unnoticed while small. They may disappear for a while, but re-emerge in situations where the immune system response decreases eg. pregnancy. Diagnosis is clinical but can be confirmed with a swab (HPV test). There is no cure for HPV, but warts can be removed.

Ge***al Herpes (HSV): clusters of painful small blisters that break down to form red painful sores. They are caused by the Herpes Simplex Virus (HSV) 1 and 2. Sores disappear within 5 to 7 days but recur frequently in outbreaks. Diagnosis is usually clinical but can be confirmed with a blood test. There is no cure, but outbreaks are controlled with antiviral drugs like Acyclovir.

Molluscum contagiosum (MCV): small, raised, white or skin-colored bumps with a dimple in the center. They are caused by the Molluscum Contagiosum Virus (MCV) which is a poxvirus. Bumps are painless but may be itchy or inflamed. The infection usually clears on its own without scarring. However, bumps may persist for 6 months to 2 years unless removed.

Syphilis: single, firm, painless sore (chancre). It is caused by a bacteria Treponema pallidum. The disease progresses in stages: painless sore (primary), non-itchy rash on palms and soles (secondary), no symptoms (latent), severe and irreversible damage to eyes, heart, brain (tertiary). Diagnosis is usually clinical and is always confirmed by a blood test. Treatment is with antibiotics.

25/01/2026

GE***AL WARTS AND HPV

Ge***al warts are small, skin-colored bumps on the ge***als that resemble cauliflower. They are caused by the human papillomavirus (HPV). HPV is one of the most common s*xually transmitted infections. Ge***al warts do not cause cancer. However, some types of HPV cause cancers of the cervix, p***s, a**s, and throat. So all women with ge***al warts need to have regular pap smears and HPV tests.

Treatment of ge***al warts may be for cosmetic reasons or because they cause itching, burning and pain. Treatment involves medications or surgery. Medications include skin creams and ointments like Imiquimod, Podophyllin and Trichloroacetic acid. They are not 100% effective in removing warts and may have side effects like skin color changes, itching, burning, and pain.

Surgery is used when warts are large or extensive. Warts are always surgically removed during pregnancy to avoid contact with the baby during delivery. Surgery includes cryotherapy (freezing with liquid nitrogen), electrocautery (burning with an electric tool), laser (burning with a light beam) and excision (cutting with a scalpel under general anesthesia).

18/01/2026

ENDOMETRIOSIS
Endometriosis is a painful condition in which tissue from the inner lining of the uterus backflows through the fallopian tubes and becomes stuck outside the uterus, especially on the ovaries and the skin covering the pelvis.
Endometriosis tissue breaks down and bleeds with each menstrual cycle. However, unlike the lining of the uterus, it is not flushed out of the body during the cycle. It continues to grow in areas where is does not belong. In the ovaries it causes cysts called endometriomas to form. It also causes bands of scar tissue called adhesions to form that cause pelvic organs to stick to each other.
Common symptoms of endometriosis include heavy painful periods, lower back or stomach pain, pain during or after s*x, pain with bowel movements or urination and infertility.
The diagnosis is made with a pelvic exam, ultrasound scans and an MRI. In some cases, laparoscopy may be performed. Treatment involves different medications and in some cases surgery.

11/01/2026

POSTMENOPAUSAL BLEEDING

Postmenopausal bleeding (PMB) is any va**nal bleeding or spotting that occurs after menopause. Any va**nal bleeding or spotting after menopause is not normal and should not be ignored, even if it is painless and not heavy. PMB should always be investigated, because it may be an early warning sign for serious medical conditions like uterine hyperplasia and uterine cancer.

All cases of PMB should be evaluated with a transva**nal ultrasound. This helps to determine if the lining inside the uterus is thickened. If the uterine lining is thickened, an endometrial biopsy should be done as quickly as possible. This is a minor surgical procedure used to collect cells from the uterine lining, to determine if any cancerous cells are present.

Being evaluated by a doctor at the first sign of PMB can be the key factor in detecting uterine cancer early, when it can still be treated effectively.

04/01/2026

RETAINED PRODUCTS OF CONCEPTION

Retained products of conception or RPOC refers to pregnancy tissue remaining in the uterus after the end of pregnancy; that is, after childbirth, miscarriage, or abortion. The tissue remaining may be pieces of placenta, membranes or fetus. Symptoms include heavy va**nal bleeding and fever. RPOC must be evacuated to prevent complications like severe hemorrhage, infection of the uterus and infertility. Diagnosis is confirmed by transva**nal ultrasound.

Treatment options may be expectant, medical or surgical. Expectant management means waiting for your body to pass the tissue on its own. Success rates are low (30-40%) so this method is generally not recommended. Medical management with medications like Misoprostol carry much higher safety profiles and success rates (70-80%). In many cases surgical intervention with dilatation and curettage or D&C is necessary for complete evacuation, with success rates (97-100%).

16/03/2025

Asherman's Syndrome is a cause of female infertility. It is the formation of scar tissue in the uterus. It is usually caused by surgery (dilation and curettage for abortions) or by infections (pelvic inflammatory disease).

Asherman's Syndrome may be the cause of infertility in women who have regular normal periods and whose fallopian tubes are not blocked.

A basic pelvic ultrasound will not detect Asherman's Syndrome. Diagnosis is usually by a special x ray (hysterosalpingogram) or by a special ultrasound (sonosalpingogram) or by a minor surgical procedure (hysteroscopy).

09/03/2025

Ovarian cysts are small sacs on the o***y that are filled with fluid. Cysts can be non-cancerous or cancerous. One type of non-cancerous cyst is called a Cystadenoma. Cystadenomas usually do not cause symptoms. Sometimes they may become large and cause bloating, belly pain or back pain. These cysts are often diagnosed by accident when women do ultrasound scans for other reasons. Treatment is surgical removal of the cyst, which is then sent for testing to confirm that it is not cancerous. If you notice your belly is getting big and/or if you have bloating, abdominal pain or back pain check your doctor and get an ultrasound. It may be the first step in avoiding a major problem.

01/03/2025

WE HONOUR THE MOTHER OF GYNECOLOGY!

Address

American Road
Saint John's

Opening Hours

Monday	09:00 - 17:00
Tuesday	09:00 - 17:00
Wednesday	09:00 - 17:00
Thursday	09:00 - 17:00
Friday	09:00 - 17:00
Saturday	09:00 - 13:00

Website

facebook.com

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