Women’s Health and Pregnancy

Women of all ages are welcome to our appointments. We have a suitable specialist for every concern or question. 

When should you book a gynecologist appointment?

You should come to a gynecologist appointment:

• in case of menstrual cycle disorders or gynecological symptoms;
• if there is a suspicion of a gynecological condition or for screening for sexually transmitted infections;
• for questions related to conception, infertility, or contraception;
• in case of menopause, hormonal imbalance issues, or urinary incontinence;
• for personalized cancer prevention, examinations, or day surgery procedures.

Sexual counseling provides support and helps find answers to questions related to sexual life and intimate relationships.

When should you see a sexologist? 

You can seek sexual counseling:

• in case of difficulties with erection, ejaculation, or orgasm;
• in case of changes in sexual desire or differences between partners;
• in case of pain during sexual intercourse;
• for questions related to sexual identity or orientation;
• for topics related to different relationship structures, specific sexual interests, or the use of pornography;
• in case of changes in sexual life related to pregnancy, the postpartum period, or parenthood.

You can come to counseling either alone or with a partner.

When should you see a gynecologist to confirm pregnancy?

• You should come for pregnancy confirmation after a positive home test, at 6–8 weeks of pregnancy.
• Please ask the reception for an urgent appointment with a gynecologist for pregnancy confirmation.

Why is it necessary to confirm a pregnancy?

At the gynecologist’s appointment we:

• determine the number of embryos and their location;
• assess early fetal development and viability;

• evaluate cervical length and the ovaries;
• refer you for further examinations if needed;
• initiate pregnancy monitoring or discuss termination of an unwanted pregnancy.

Important information:

• Take a home pregnancy test before the appointment
• Do not come for the appointment before the 6th week of pregnancy
• Pregnancy weeks are counted from the first day of your last menstrual period, not from the date of conception

A midwife provides support and guidance before pregnancy, throughout pregnancy, during childbirth, and in the postpartum period. A midwife helps you with breastfeeding, prepares you for parenthood, offers family planning counselling, and supports the prevention of women’s health conditions.

Book an appointment with a midwife if you need to:

• receive antenatal care throughout your pregnancy;
• attend check-ups before and after childbirth;
• get advice and support on breastfeeding;
• choose the contraceptive method that is right for you; 
• receive guidance on family planning; or
• take part in cervical cancer screening.

The OSCAR test is performed early in pregnancy, between the 12th and 13th weeks of gestation. It is a combined first-trimester screening test used to assess the risk of chromosomal conditions in the fetus, such as Down syndrome, Edwards syndrome, and Patau syndrome. The risk assessment is based on ultrasound measurements of the fetus, the mother’s blood test results, and the mother’s age.

What does the OSCAR test assess?

• The fetus’s heartbeat, limbs, and movements.
• The anatomy of the fetal heart and the integrity of the spine.
• The fetal nuchal translucency.
• The risk of chromosomal conditions.
• The risk of pre-eclampsia and preterm birth.

The test is safe for both the mother and the fetus. If the screening indicates an increased risk, we will recommend additional testing, such as a non-invasive prenatal test (NIPT) or invasive diagnostic procedures.

What should you know about the OSCAR test?

• The OSCAR test is performed between the 12th and 13th weeks of pregnancy.
• A referral is required if the test is covered by the Estonian Health Insurance Fund.
• No referral is needed if you are paying for the test yourself. 
• NIPT does not replace the OSCAR test; it is used as a complementary screening method.

The second-trimester fetal anatomy scan is one of the most important ultrasound examinations during pregnancy.It assesses fetal development to detect possible abnormalities at a stage when the organs are clearly visible.

What is assessed in the fetal anatomy scan?

• The development of the fetus’s heart, brain, spine, face, and other organs, to detect developmental abnormalities early.
• The fetus’s growth and measurements.
• The position of the placenta and the amount of amniotic fluid.
• The structure of the umbilical cord and blood vessels.
• The overall well-being of the fetus.

The examination is safe for both the mother and the fetus.

What should you know about the fetal anatomy scan?

• A referral is required if the examination is covered by the Estonian Health Insurance Fund.
• With a referral, the scan is performed between the 18th and 21st weeks of pregnancy.
• No referral is needed if you are paying for the examination yourself.
• Upon personal request, the scan can be repeated throughout the second trimester.

This is a more detailed ultrasound examination that assesses the fetus’s condition, growth, and well-being using various indicators. The scan provides an overview of both fetal development and factors that may influence the course of pregnancy.

When is a fetal well-being scan recommended?

• When you want to assess the fetal position, the amount of amniotic fluid, and the location and structure of the placenta.
• When an evaluation of fetal growth is needed, including estimated fetal weight and comparison with gestational age.
• When blood flow needs to be assessed in the umbilical artery, middle cerebral artery, and, if necessary, other blood vessels.
• When additional information about fetal condition is required, including activity and breathing movements.

If desired, it is possible to receive an ultrasound image of the fetus. The availability of images depends on the fetal position during the examination and is subject to an additional fee.

After the examination, the results are explained and, if necessary, recommendations are given for further pregnancy monitoring.

We perform a detailed assessment of the fetal heart, evaluating its structural development across five different planes. We also examine blood flow patterns and velocities in the fetal heart’s vessels and valves. After the examination, we explain the results and, if necessary, provide further recommendations for pregnancy monitoring

When should a fetal heart examination be performed?

A fetal heart scan should be performed if:

• there is suspicion of a heart defect during the fetal anatomy scan;
• there is an increased risk of congenital heart defects in the baby;
• the pregnant person has a heart condition;
• medication use requires monitoring of the fetal heart;
• the pregnant person has a chronic condition, such as type 1 diabetes.

What should you know about the fetal heart examination?

• A referral is required if the examination is covered by the Estonian Health Insurance Fund.
• With a referral, the scan is performed at the indicated stage of pregnancy.
• No referral is needed if you are paying for the examination yourself.
• Upon personal request, the examination can be performed throughout the third trimester.

• A pregnancy 3D/4D ultrasound allows you to see your baby in three dimensions and in real time — including facial expressions, movements, and even smiling.
• In addition to medical information, the scan offers an emotional experience as you see your baby before birth.

We use the latest-generation high-resolution ultrasound machines and matrix transducers to obtain the most realistic possible image of the baby’s appearance.

When should a 3D/4D fetal ultrasound be done?

Come for the scan if you:

• want to see the fetus and their movements;
• want to check fetal development and anatomy;
• want to capture images or videos of your baby’s movements.

What should you know about the 3D/4D fetal ultrasound?

• The best time for the scan is between 24 and 32 weeks of pregnancy, when the baby’s face and movements are clearly visible.

• No referral is required, as this is a private (self-paid) service only. 
• During the scan, we assess and measure fetal well-being.
• Please note that in some cases, the fetal position may not allow all desired images to be obtained. In such cases, the fee is non-refundable.
• After the scan, you will receive photos and, if desired, a video clip.

This examination assesses precancerous changes in the cervix. The screening programme is funded by the Estonian Health Insurance Fund and is free of charge for all women in the invited age group.

Who is invited for screening in 2026?

You can attend the screening free of charge even if you do not have Estonian Health Insurance coverage. Women born in the following years are invited: 1961, 1966, 1971, 1976, 1981, 1986, 1991, 1996. 

What should you know about the screening?

• You do not need to wait for an invitation — if you belong to the target group, you can attend even without one.
• The test is quick and painless, and results are sent digitally via the patient portal.
• If necessary, you will be invited for further examination or a colposcopy (an examination of the vagina and cervix).

What is colposcopy?

Colposcopy is an examination of the cervix and vaginal mucosa using a microscope-like device to detect precancerous changes. In our clinic, colposcopies are performed by gynecologists with specific expertise in this procedure.

What should you know about colposcopy?

• The procedure cannot be performed during menstruation.
• It is usually painless or may cause mild discomfort.
• If necessary, a small tissue sample (biopsy) is taken.
• You will receive the results within 3–4 weeks.
• We will contact you if it is necessary to perform this examination.
• If you already have a referral, you can book an appointment yourself.

Vulvoscopy is an examination of the external genitalia using a microscope-like device (colposcope) to assess changes and detect precancerous conditions.

What should you know about vulvoscopy?

• The procedure cannot be performed during menstruation.
• It is usually painless or may cause mild discomfort.
• If necessary, a small tissue sample (biopsy) is taken.
• You will receive the results within two weeks.
• A gynecological consultation is required before the procedure.
• If you already have a referral for vulvoscopy, you can book an appointment directly.

nvasive prenatal diagnostic tests are performed to confirm a diagnosis following an abnormal screening test or a high-risk NIPT result. The procedure is carried out under ultrasound guidance at the stage of pregnancy determined by your treating physician. Your physician will also decide which procedure is appropriate: chorionic villus sampling (CVS) or amniocentesis.

Chorionic villus sampling (CVS) is performed between 10 and 14 weeks of pregnancy by taking a small sample of placental tissue.

Important information

• A referral from your physician and pre-test genetic counselling are required.
• Results are usually available within 2–3 weeks.
• These procedures are performed only when there is a medical indication.

A fallopian tube patency test (HyCoSy or HSSG) is performed to determine whether difficulty conceiving or infertility is caused by a blockage or obstruction of the fallopian tubes.

During the procedure, a contrast medium is introduced into the uterine cavity, and ultrasound is used to observe whether the fluid passes freely through the fallopian tubes. This allows the doctor to determine whether the tubes are open and functioning normally.

When should a fallopian tube patency test be performed?

• you have been trying to conceive for at least one year without success;
• you have had pelvic inflammatory disease or previous pelvic surgery that may have affected the fallopian tubes;
• your doctor recommends further evaluation to determine the cause of infertility.

What should you know about a fallopian tube patency test?

• The procedure is performed under ultrasound guidance and does not require general anesthesia.
• It usually takes about 20–30 minutes.
• You may experience mild discomfort during the examination, although the procedure is generally well tolerated and usually painless.
• After the procedure, you may have mild lower abdominal cramping or light spotting, which usually resolves within a few hours.
• A consultation with a gynecologist is required beforehand to determine whether the examination is appropriate for you.

You can choose to terminate a pregnancy on your own request and without a medical indication up to 12 weeks of pregnancy.

How does a medical abortion take place?

To terminate a pregnancy:

• you must sign your consent for the termination of pregnancy;
• you will attend two doctor visits — at the first visit we provide counselling, take tests, and administer the medication; at the second visit we carry out a follow-up examination;
• two ultrasound examinations are performed — the first to assess the gestational age and the second to confirm completion of the termination.

What should you know about medical abortion?

• Termination of pregnancy on request is possible up to 11 weeks and 6 days of pregnancy.
• The procedure can be done as a self-paid service or with partial coverage if you have Estonian Health Insurance.
• After taking the medication, you will be allowed to go home. The process of miscarriage usually takes place at home.
• n some cases, medical abortion can also be carried out in a day surgery unit; in this case, an additional day surgery bed fee applies.

An intrauterine device (IUD) provides effective contraception for 3 to 8 years, depending on the type of IUD chosen. The IUD is inserted into the uterine cavity and is suitable for both women who have given birth and those who have not.

When should you consider an IUD?

An IUD may be a good option if you:

• want a reliable, long-term method of contraception;
• prefer not to take contraceptive pills every day;
• have heavy or painful menstrual periods.

Your gynecologist will help you choose the most suitable type of IUD during your consultation.

What should you know about IUD insertion?

• IUD insertion and removal are available both as a publicly funded service (where eligible) and as a self-paid service.
• The cost of the IUD itself is not covered by the Estonian Health Insurance Fund. The procedure fee does not include the cost of the IUD.
• If you choose a hormonal IUD, you will need to purchase it from a pharmacy using a prescription before your appointment.
• A non-hormonal (copper) IUD can be purchased from a pharmacy without a prescription.
• The procedure is performed under local anesthesia.

When is a hysteroscopy needed?

A hysteroscopy is performed:

• to identify the cause of abnormal uterine bleeding and, in many cases, to treat the underlying cause at the same time;
• to remove fibroids and polyps located within the lining of the uterus;
• to completely remove the lining of the uterus (endometrium).

In cases of infertility, hysteroscopy is used to detect and, where possible, remove intrauterine adhesions (scar tissue) or a uterine septum.

The best time to perform a hysteroscopy is shortly after your menstrual period has ended.

What do you need to know about hysteroscopy?

• Do not eat for 6 hours before the procedure and do not drink anything (including water) for 2 hours beforehand.
• The procedure is short, and you can usually go home the same day.
• After general anaesthesia, you must not drive a vehicle.
• If you have a referral, you can book your procedure immediately.
• It is normal to have light vaginal bleeding or spotting for 2–3 weeks after the procedure.

Mid-urethral sling surgery is one of the most effective long-term treatments for stress urinary incontinence. During the procedure, a thin supportive mesh sling is placed beneath the urethra to provide support and help prevent urine leakage during physical activity.

When should you consider sling surgery?

You should consult us if:

• you experience urine leakage during exercise, coughing, sneezing, or other physical activities;
• urinary incontinence is affecting your work, daily activities, or social life;
• you are looking for a long-term solution to stress urinary incontinence.

What should you know about the procedure?

• The procedure usually takes 30–40 minutes.
• t is performed under local anesthesia or short general anesthesia, depending on your individual situation.
• You can usually go home on the same day.
• Most women notice an improvement in bladder control immediately after the procedure.
• A consultation with a gynecologist and a comprehensive evaluation of your urinary incontinence are required before surgery.

It is used to refine a diagnosis or also for treatment. In most cases, curettage is not necessary, and an examination of the uterine cavity (hysteroscopy) is sufficient.

When is uterine curettage performed?

• Curettage is needed when heavy bleeding must be stopped and a tissue sample from the uterine cavity needs to be taken.

What should you know about uterine curettage?

• The procedure is performed under general anesthesia. After anesthesia, you are not allowed to drive a vehicle yourself.
• You can go home on the same day after the operation. Recovery is usually quick.

When are surgeries on the external genitalia performed?

• Surgery on the external genitalia is performed when it is necessary to remove benign tumors, cysts, or inflammatory masses.
• In the case of a Bartholin gland cyst, we use a newer method called a Word catheter, which restores the gland’s natural drainage and reduces the risk of recurrence.

When should you consult a doctor?

• You should come for a consultation if there is a painful, swollen, or otherwise bothersome lump in the external genital area.

What should you know about surgery on the external genitalia?

• The procedure usually takes up to 30 minutes.
• It is performed under general anesthesia.
• You can go home on the same day after the procedure, but you are not allowed to drive yourself.
• The Word catheter is placed under local anesthesia and is a short procedure lasting 10–15 minutes.
• Recovery after surgery is usually quick.
• A preoperative consultation with a gynecologist is required.

Come to our appointment if you are experiencing a sensation of pelvic organ prolapse and a more detailed examination is needed.

What should you know about cervical surgery?

• The procedure is performed under general anesthesia.
• You can go home on the same day after the operation, but you are not allowed to drive yourself.
• Recovery takes 4–6 weeks.
• A preoperative consultation with a gynecologist is required.

The goal of urinary incontinence treatment is to restore bladder control and reduce involuntary urine leakage.

Bulkamid® injections are a simple and effective minimally invasive treatment. During the procedure, a soft hydrogel is injected into the tissue surrounding the urethra, helping it close more effectively and improving urinary continence.

When are Bulkamid® injections recommended?

You should consult us if:

• you experience urine leakage when coughing, sneezing, or during physical activity;
• urinary incontinence is affecting your daily life or limiting your activities;
• you are looking for a treatment option that does not require surgery;
• you have tried pelvic floor muscle exercises, but they have not provided sufficient improvement.

What should you know about the procedure?

• The procedure usually takes 15–30 minutes and is performed under local anesthesia.
• In most cases, you can go home on the same day.
• Bulkamid® provides an immediate effect, and the results typically last for several years.
• A consultation with a gynecologist and a comprehensive evaluation of your urinary incontinence are required before treatment.

Intimate plastic surgery is a form of aesthetic gynecological surgery performed with your individual needs and expectations in mind. Depending on your goals, the procedure may include labiaplasty, perineoplasty, or vaginoplasty.

When is intimate plastic surgery performed?

• improve the shape or size of the labia minora or labia majora;
• correct scars resulting from childbirth or trauma;
• improve vaginal laxity and restore pelvic floor support.

What should you know about intimate plastic surgery?

• During your consultation, your gynecologist will discuss whether surgery is appropriate and what results can realistically be expected.
• The procedure is performed under general anesthesia.
• You can usually go home on the same day, but you should not drive yourself after the procedure.
• Depending on the type of surgery, recovery typically takes 3–8 weeks.