Gynecology Clinic

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Children, youth and families Healthcare providers

About the Gynecology Clinic

CHEO's Gynecology Clinic provides specialized gynecologic services to girls and youth presenting with:

disorders of menstruation (absent or abnormal pattern; heavy menses; painful menses; requiring menstrual suppression)
disorder of puberty (early or late)
contraception for medically complex situations
Intra-uterine system/device insertions for those <16yo or requiring anesthesia
pelvic mass (persistent benign ovarian cysts or suspected gynecologic malignancies)
vulvovaginal complaints (pain; discharge; irritation; labial fusion; mass)
abnormal genital bleeding
genital injuries
congenital anomalies of the reproductive tract
ambiguous genitalia

About our team

Our team includes 3-5 gynecologists, 1 women’s health practitioner, and 3 nurses.

Information for children, youth and families

Before your appointment

Please sign-up for a MyChart account, prior to your first visit.

Our scheduling team will contact you to schedule an appointment.

If something changes and you need to reschedule your appointment, please let us know at least 24-48 hours in advance if you are unable to make it by calling 613-737-7600 x2222. No-shows or frequent cancellations may result in discharge from the service.

What to expect during your appointment

Please plan to arrive 10-15 minutes prior to your scheduled appointment time in case there are delays with parking or finding the clinic and to complete any required paperwork that may be required in advance of your visit.

We are located in Clinic C-9 on the main floor.

Please bring a list of any medications you or your child is currently taking.

If you have ever had a menstruation/period, please bring a list of your last 6 menstruations/periods (date they started and finished, amount of flow, any pain or other associated symptoms)

After your appointment

Your Gynecologist will let you know whether any additional appointments or testing are required after your visit.

Frequently asked questions

How can I make an appointment?

All patients must be referred by a Physician or Nurse Practitioner. 

After a referral is received, we will notify the referring Physician or Nurse Practitioner whether the referral has been accepted or denied, and if accepted we will provide an estimated wait time.  This wait time can vary based on demand and urgency.  Once we have an appointment spot to offer, our Scheduling Team will reach you by phone to schedule an appointment.

Who should I contact if I am worried or have questions?

For any emergency, call 911. This includes emergencies involving your child’s gynecological problem.

For patients who are being followed by the Gynecology Clinic:  For patients who have seen a CHEO Gynecologist within the last 12 months, call your Nurse Case Manager or send a direct message to them through MyChart.  This is not for urgent calls.  Our nurses are here to give support, education and will work to coordinate your child’s /your care.  It may take 3-5 days for us to get back to you (and sometimes longer during holidays).  We will return the most serious calls first.  Please avoid leaving multiple messages for the same issue.

For patients who are waiting for their first visit with the Gynecology Clinic: Please do not call the nurses line if you have not yet been seen by a CHEO Gynecologist.  Please call your family doctor, pediatrician or visit your nearest walk-in clinic for everything else.

Sign up for MyChart to access your CHEO health record anywhere, any time.
MyChart is a secure, online patient portal that connects you to parts of your CHEO electronic health record and allows you to send two-way secure communication to your care team, complete any questionnaires your care team sends and much more.
To learn more about MyChart and sign up, visit our MyChart page and fill out the MyChart Access Request Form.

Looking for more resources or supports on gynecology?

Visit our resource and support pages to find helpful websites, local contacts, videos and more:

Vulvovaginitis – CHEO

Pediatric oncology fertility preservation – CHEO

Gynecology – CHEO

Intrauterine Devices – CHEO

Constipation - CHEO

Information for healthcare providers

Make a referral

Our clinic is now accepting e-referrals with Ocean!

If you’re already on Ocean, look us up via your account by searching "CHEO".
If you don’t yet have an Ocean account, no problem - signing up is free.

Make a referral in Ocean

All patients must be referred by a Physician. You can make an e-referral using Ocean, or mail or fax a referral form to us.

Referral criteria and eligibility

This table does not replace clinical evaluation of patients prior to referral; in many cases the referring physician will have completed additional investigations for comprehensive evaluation

Required investigations for triage
Reason for referral	Criteria	Mandatory information to include on referral
Menstrual
Heavy menstrual bleeding	CBC, ferritin, TSH and prolactin. If personal and/or family history of a bleeding disorder, add: PTT, INR, von Willebrand antigen and activity factor and factor VIII	Start patient on iron therapy. Patient must complete a menstrual calendar (paper or phone app) and bring it to their appointment.
Secondary Amenorrhea/ Oligomenorrhea/ Irregular menses	CBC, Bhcg, FSH, LH, E2, prolactin, TSH If inflammatory acne or a Ferriman-Gallwey score over 4 or a family history of PCOS, add: DHEAS, androstenedione, testosterone profile (total and free testosterone, SHBG), androstenedione and 17-OHP	Provide age of menarche. If the patient has not menstruated in 3 months (and pregnancy has been ruled out), consider providing them with medroxyprogesterone acetate 10mg qhs x 10 doses to take (diagnostic and therapeutic). Patient must complete a menstrual calendar (paper or phone app) and bring it to their appointment.
Primary amenorrhea	As for secondary amenorrhea, but add an abdo-pelvic ultrasound (report must comment on kidneys, uterus, and ovaries)	Must provide growth charts and indicate Tanner staging (breast and pubic hair). Indicate if cyclic abdominal pain.
Menstrual suppression	No investigations needed to triage.	Must indicate if patient is pre- or post-menarchal. If the patient is pre-menarchal, must indicate their Tanner stage (for breast and pubic hair) Provide the patient/family with the following resource.
Dysmenorrhea	Pelvic ultrasound	Ensure patient is taking NSAIDs and acetaminophen pre-emptively (1-2 days prior to menses), regularly and at correct doses throughout menses. Constipation is often associated with this condition. Please ensure stools are Bristol type 4: Constipation - CHEO
Vulvovaginal issues
Vulvovaginitis	Vaginal culture and sensitivity (for pre-menarchal patients: only if abnormal discharge or very erythematous introitus) If sexually active, NAAT for Chlamydia and gonorrhea (first void urine, vaginal or cervical)	Please provide the patient/family with the following handout and review vulvar hygiene with them. Constipation is often associated with this condition. Please ensure stools are Bristol type 4: Constipation - CHEO
Labial adhesions	No investigations needed to triage.	Please provide the patient/family with the following handouts and review vulvar hygiene with them: Vulvovaginitis - CHEO Labial adhesions Indicate if patient is having culture-proven recurrent urinary tract infections. Constipation is often associated with this condition. Please ensure stools are Bristol type 4: Constipation - CHEO
Prepubertal vaginal bleeding	No investigations needed to triage.	Must provide growth charts and indicate Tanner staging (breast and pubic hair).
Labial hypertrophy	No investigations needed.	Please note that only under exceptional circumstances do we accept referrals for this condition. Labioplasty is not a procedure covered by OHIP. Labia minora growth continues throughout puberty and up to age 18. Often the growth is asymmetrical but eventually catches up. Reassurance is needed and normalizing examination is important. Please review the following handout with your patient: Labial hypertrophy And provide them with the following websites: LabiaLibrary.org.au Scarleteen YoungWomensHealth.org TheGreatWallofVulva.com OurBodiesOurSelves.org
Vulvodynia / Inability to insert tampons	No investigations needed to triage.	Recommend referral to Pelvic Floor Physiotherapy while awaiting consultation.
Contraception Please note that we do not accept referrals for routine contraception
Insertion of Nexplanon or intra-uterine device in patients 16yo or older	No investigations needed to triage.	N/A
Insertion of intra-uterine device in patients less than 16yo	No investigations needed to triage.
Complex contraception	No investigations needed to triage.	Please indicate the medical condition/medication that is contra-indicated. Please indicate any contraception that has been tried thus far and why it was discontinued.
Ovarian cysts
Simple cyst of less < 5cm or hemorrhagic cyst of <3cm	No investigations needed	No referral is needed. Repeat US in 6-8 weeks.
Simple cyst >5cm or hemorrhagic cyst >3cm	Pelvic ultrasound	Repeat pelvic ultrasound 6-8 weeks after the first one. Cysts are often physiological and resolve on their own. Only if the cyst is persistent on the 2nd ultrasound should a referral to Gynecology be sent. Please include growth charts or at minimum the patient’s BMI.
Complex cyst	Pelvic ultrasound LDH, serum hcg, AFP and CA-125
Any other type of cyst	Pelvic ultrasound
Mullerian anomalies
Incidental finding of mullerian anomaly in pre-pubertal patient	Abdo-pelvic ultrasound	Please provide patient’s Tanner stage (breast and pubic hair).
Non-obstructive mullerian anomaly	Abdo-pelvic ultrasound
Obstructive mullerian anomaly	Abdo-pelvic ultrasound	This is an urgent referral. Suggest calling the gynecologist on-call during the day to discuss whether menstrual suppression or other imaging is appropriate.

Contact us

Gynecology Clinic (C-9), CHEO
401 Smyth Road
Ottawa, ON K1H 8L1

Fax: 613-738-4298