Gynecology
Empowering Women's Health
Gynaecology
"Endometriosis encompasses more than mere pelvic discomfort; it is a multifaceted condition that impacts all areas of a woman’s life including fertility. As gynaecologists, my role extends beyond medical & surgical management; I believe in empowering women with information and personalized care to help them reclaim their health and fertility."
patient information
Endometriosis
What is endometriosis?
Endometriosis is a chronic inflammatory condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often in the pelvis. This can cause pain, inflammation, and sometimes fertility issues.
How common is endometriosis in Australia?
Endometriosis affects approximately 11% of Australian women and individuals assigned female at birth, typically during their reproductive years.
What are the symptoms of endometriosis?
Symptoms vary but may include:
– Persistent pelvic pain, especially during menstruation.
– Pain during or after sexual intercourse.
– Fatigue and low energy levels.
– Painful bowel movements or urination during periods.
– Difficulty conceiving (infertility).
What causes endometriosis?
The exact cause is unknown, but factors like genetics, immune system issues, and hormonal influences may play a role.
How is endometriosis diagnosed?
Diagnosis often involves:
– A detailed medical history and symptom review.
– Imaging tests like ultrasound or MRI.
– Laparoscopy, a minimally invasive surgery, to confirm the presence of endometrial-like tissue.
What are the treatment options?
Treatment depends on the severity of symptoms and individual needs. Options include:
– Pain management with medications.
– Hormonal therapies to reduce or stop menstruation.
– Surgery to remove endometrial tissue.
– Lifestyle changes, such as diet and exercise, to manage symptoms.
Can endometriosis affect fertility?
Yes, endometriosis can impact fertility, but many individuals with the condition can conceive naturally or with medical assistance.
Where can I find support and more information?
– [Endometriosis Australia](https://endometriosisaustralia.org/): A national charity providing resources and support.
– [Jean Hailes for Women’s Health](https://www.jeanhailes.org.au/resources/endometriosis-fact-sheet): Offers fact sheets and guidance.
– Consult your healthcare provider for personalized advice.
If you have concerns about endometriosis, it’s important to seek advice from a healthcare professional. Early diagnosis and management can improve quality of life and outcomes.
"Excessive menstrual bleeding can have a profound negative impact on quality of life for a woman. I am passionate about offering personalized care and effective treatment to assist women in handling this issue and enhancing their overall health. "
Patient Information
Heavy Menstrual Bleeding (HMB)
What is heavy menstrual bleeding (HMB)?
Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman’s physical, social, or emotional quality of life. It is a common condition, affecting about one in four Australian women of reproductive age.
What are the symptoms of HMB?
Symptoms may include:
– Bleeding through clothing or needing to change pads/tampons every 1-2 hours, including overnight.
– Being unable to leave the house on the heaviest days.
– Fatigue, anxiety, or pelvic pain.
What causes HMB?
HMB can result from various factors, including hormonal imbalances, uterine fibroids, polyps, or other medical conditions. A thorough assessment by a healthcare provider is essential to determine the cause.
How is HMB diagnosed?
Diagnosis involves:
– A detailed medical history and physical examination.
– Exclusion of pregnancy, iron deficiency, and anemia.
– Additional tests, such as blood tests or imaging, based on the initial assessment.
What are the treatment options for HMB?
Treatment depends on the underlying cause and may include:
– Medical management: Medications like hormonal therapies or non-hormonal options for symptom relief.
– Minimally invasive procedures: Such as endometrial ablation.
– Surgical options: In severe cases, hysterectomy may be considered.
What does the Australian guideline recommend?
The updated Heavy Menstrual Bleeding Clinical Care Standard (2024) emphasizes:
– Offering the least invasive and most effective treatment tailored to the patient’s needs.
– Ensuring informed choice and shared decision-making between patients and clinicians.
– Addressing cultural safety and equity considerations in care.
What should I do if I think I have HMB?
If you suspect you have HMB, consult your healthcare provider. They will guide you through the assessment and help you choose the best treatment option for your situation.
"PCOS is a challenging but manageable condition. As a specialist, my priority is to offer individualized care that targets symptoms control, enhances fertility, and supports overall health, explain short term and long-term health implications, enabling women to live their lives with assurance and positivity "
Patient information
Polycystic Ovary Syndrome (PCOS)
What is PCOS?
Polycystic Ovary Syndrome (PCOS) is a common hormonal condition affecting about 1 in 10 women of reproductive age in Australia. It is more prevalent among certain groups, such as Aboriginal and Torres Strait Islander women, where it affects approximately 1 in 5 women fact sheet – Jean Hailes] (https://www.jeanhailes.org.au/resources/polycystic-ovary-syndrome-pcos).
What are the symptoms of PCOS?
Symptoms can vary but may include:
– Irregular or absent periods.
– Excessive hair growth on the face and body (hirsutism).
– Acne or oily skin.
– Hair thinning or loss on the scalp.
– Weight gain or difficulty managing weight.
– Darkened patches of skin, often on the neck or underarms.
– Fertility challenges.
What causes PCOS?
The exact cause of PCOS is unknown, but it is linked to genetic factors, insulin resistance, and hormonal imbalances. Women with PCOS often have higher levels of insulin and androgens (male-type hormones), which contribute to the symptoms fact sheet – Jean Hailes](https://www.jeanhailes.org.au/resources/polycystic-ovary-syndrome-pcos).
How is PCOS diagnosed?
Diagnosis involves:
– A review of medical history and symptoms.
– Blood tests to check hormone levels.
– An ultrasound to identify polycystic ovaries (more than 20 follicles in each ovary).
A diagnosis is typically made if two of the following are present:
1. Irregular or absent periods.
2. Signs of androgen excess (e.g., excess hair growth or acne).
3. Polycystic ovaries visible on an ultrasound fact sheet – Jean Hailes](https://www.jeanhailes.org.au/resources/polycystic-ovary-syndrome-pcos).
What are the treatment options for PCOS?
Treatment focuses on managing symptoms and may include:
– Lifestyle changes: Healthy eating and regular exercise to manage weight and improve insulin sensitivity.
– Medications: Hormonal contraceptives to regulate periods, anti-androgen medications for excess hair, and fertility treatments if pregnancy is desired.
– Specialist care: Referral to endocrinologists, dietitians, or fertility specialists for tailored management fact sheet – Jean Hailes](https://www.jeanhailes.org.au/resources/polycystic-ovary-syndrome-pcos).
What are the long-term health risks of PCOS?
If left unmanaged, PCOS can increase the risk of:
– Type 2 diabetes.
– Cardiovascular disease.
– Endometrial cancer.
– Mental health challenges, such as anxiety and depression fact sheet – Jean Hailes] (https://www.jeanhailes.org.au/resources/polycystic-ovary-syndrome-pcos).
What should I do if I think I have PCOS?
If you suspect you have PCOS, consult your doctor. Early diagnosis and management can help reduce symptoms and prevent long-term complications.
How Does PCOS Affect Fertility?
Polycystic Ovary Syndrome (PCOS) is one of the leading causes of infertility in women. Here’s how it impacts fertility:
1. Irregular Ovulation or Anovulation
PCOS often disrupts the normal ovulation process. High levels of androgens (male- type hormones) and insulin resistance can interfere with the development and release of eggs from the ovaries. This can lead to irregular ovulation or anovulation (no ovulation), making it harder to conceive.
2. Hormonal Imbalances
Women with PCOS typically have higher levels of luteinizing hormone (LH) and lower levels of follicle-stimulating hormone (FSH). This imbalance affects the maturation of eggs and their release during the menstrual cycle.
3. Insulin Resistance
Insulin resistance, common in PCOS, can lead to elevated insulin levels. This, in turn, stimulates the ovaries to produce more androgens, further disrupting ovulation and fertility.
4. Impact on Egg Quality
While PCOS does not directly affect the quality of eggs, the hormonal imbalances and irregular ovulation can reduce the chances of a healthy egg being released.
5. Increased Risk of Miscarriage
Women with PCOS may have a slightly higher risk of miscarriage due to hormonal imbalances and other associated factors, such as obesity or insulin resistance.
6. Endometrial Health
Irregular periods can lead to a thickened uterine lining (endometrium), which may not be optimal for implantation of a fertilized egg.
Improving Fertility with PCOS
The good news is that many women with PCOS can conceive with the right interventions:
– Lifestyle Changes: Weight loss (even 5-10% of body weight) can improve ovulation and increase the chances of conception.
– Medications: Ovulation-inducing medications like clomiphene citrate or letrozole are often prescribed.
– Assisted Reproductive Technologies (ART): In vitro fertilization (IVF) may be an option for women who do not respond to other treatments.
If you’re planning to conceive and have PCOS, it’s essential to work closely with a healthcare provider or fertility specialist to develop a tailored plan. Early intervention and management can significantly improve your chances of a successful pregnancy.
"Fibroids can significantly impact a woman's health and fertility, yet they do not have to dictate her future. As a gynaecologist, my emphasis is on offering customized patient centred, research-supported treatments to alleviate her symptoms and enhance quality of life, enabling women to proceed with assurance and hope."
PATIENT INFORMATION
Uterine Fibroids
What are uterine fibroids?
Uterine fibroids are non-cancerous growths that develop in the muscle layer of the uterus (womb). They are also known as leiomyomas or myomas. Fibroids are common, affecting up to 70% of women under 50 in Australia, although many women may not experience symptoms.
What are the symptoms of fibroids?
Symptoms can vary depending on the size, number, and location of the fibroids.
Common symptoms include:
– Heavy or prolonged menstrual bleeding.
– Pelvic pain or pressure.
– Painful periods.
– Frequent urination or difficulty emptying the bladder.
– Constipation.
– Pain during intercourse.
– A feeling of fullness or swelling in the lower abdomen.
What causes fibroids?
The exact cause of fibroids is unknown, but they are linked to hormonal factors, particularly oestrogen and progesterone, which stimulate their growth. Risk factors include:
– Family history of fibroids.
– Early onset of menstruation.
– Obesity.
– High blood pressure.
– Being of African descent.
How are fibroids diagnosed?
Diagnosis typically involves:
– A review of symptoms and medical history.
– A pelvic examination.
– Imaging tests such as an ultrasound or MRI.
– In some cases, procedures like hysteroscopy or laparoscopy may be used to examine the uterus.
How do fibroids affect fertility?
Fibroids can sometimes impact fertility by:
– Distorting the shape of the uterus.
– Blocking the fallopian tubes.
– Interfering with implantation of a fertilized egg.
However, most women with fibroids can conceive and have a normal pregnancy.
What are the treatment options for fibroids?
Treatment depends on the severity of symptoms, the size and location of the fibroids, and whether you wish to have children in the future. Options include:
– Medications: To manage symptoms like heavy bleeding or pain.
– Minimally invasive procedures: Such as uterine artery embolization or endometrial ablation.
– Surgical options: Myomectomy (removal of fibroids) or hysterectomy (removal of the uterus) for severe cases.
– Lifestyle changes: Maintaining a healthy weight and managing stress may help reduce symptoms.
When should I see a doctor?
You should consult a doctor if you experience:
– Heavy or prolonged menstrual bleeding.
– Severe pelvic pain or pressure.
– Difficulty getting pregnant.
– Symptoms that interfere with your daily life.
For more detailed information, you can refer to resources like the [Royal Women’s Hospital] (https://www.thewomens.org.au/images/uploads/fact-sheets/Fibroids-2018.pdf) or [Jean Hailes](https://www.jeanhailes.org.au/health-a-z/ovaries-uterus/fibroids).
"Ovarian cysts may present difficulties, yet they can be effectively managed with appropriate care. My approach as a specialist is focussed on accurate diagnostics, personalized treatments, and empathetic support to tackle issues, maintain fertility, and enable women to take charge of their health."
PATIENT INFORMATION
Ovarian Cysts
What are ovarian cysts?
Ovarian cysts are fluid-filled sacs that develop in or on the ovaries. They are common and often harmless, with many resolving on their own. However, some cysts can cause symptoms or complications, requiring medical attention.
What are the symptoms of ovarian cysts?
Symptoms may include:
– Pelvic pain or pressure.
– Bloating or swelling in the abdomen.
– Pain during intercourse.
– Changes in menstrual cycles, such as irregular or heavy periods.
– Difficulty emptying the bladder or bowel.
In rare cases, cysts can rupture or twist (ovarian torsion), causing severe pain and requiring emergency care.
What causes ovarian cysts?
Most ovarian cysts form during the menstrual cycle and are called functional cysts.
Other causes include:
– Endometriosis (growth of uterine tissue outside the uterus).
– Hormonal imbalances.
– Pelvic infections.
– Pregnancy.
How are ovarian cysts diagnosed?
Diagnosis typically involves:
– A pelvic ultrasound to visualize the cyst.
– Blood tests to check hormone levels or markers like CA-125 (used to assess cancer risk in postmenopausal women).
– In some cases, laparoscopy (a minimally invasive surgical procedure) may be used.
What are the treatment options for ovarian cysts?
Treatment depends on the size, type, and symptoms of the cyst:
– Watchful waiting: Many cysts resolve on their own within a few months.
– Medications: Hormonal contraceptives may prevent the formation of new cysts but do not shrink existing ones.
– Surgical options:
– Laparoscopy: Removal of small cysts through keyhole surgery.
– Ovarian cystectomy: Removal of the cyst while preserving the ovary.
– Oophorectomy: Removal of the affected ovary in severe cases.
– Hysterectomy: Removal of the uterus and ovaries if the cyst is cancerous.
What are the complications of ovarian cysts?
Complications may include:
– Rupture, causing internal bleeding and severe pain.
– Ovarian torsion, which can cut off blood supply to the ovary.
– Rarely, an increased risk of ovarian cancer.
What do Australian guidelines recommend?
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) advises:
– Regular pelvic examinations for early detection.
– Individualized care based on the patient’s age, symptoms, and risk factors.
– Referral to a specialist if malignancy is suspected.
When should I see a doctor?
You should seek medical advice if you experience:
– Sudden, severe pelvic pain.
– Persistent bloating or abdominal discomfort.
– Unusual changes in your menstrual cycle.
For more information, you can refer to resources like [Healthdirect Australia](https://www.healthdirect.gov.au/ovarian-cysts) or the [RACGP guidelines](https://www.racgp.org.au/afp/2015/january-february/investigation-and-management-of-an-ovarian-mass).
"Recurrent miscarriage affects 1-2% of women in Australia, often bringing emotional and physical challenges. As a specialist, I am dedicated to providing compassionate care, thorough investigations, and tailored treatments to address underlying causes. My focus is on empowering women with knowledge and support, helping them navigate their journey toward successful pregnancies with confidence and hope."
PATIENT INFORMATION
Recurrent Miscarriage
What is Recurrent Miscarriage?
Recurrent miscarriage is defined as the loss of three or more consecutive pregnancies. In Australia, it affects approximately 1-2% of women and can be a deeply emotional and challenging experience.
Causes
While many cases of recurrent miscarriage remain unexplained, some common
causes include:
– Chromosomal abnormalities in the embryo.
– Uterine abnormalities, such as fibroids or a septum.
– Hormonal imbalances, including thyroid disorders or polycystic ovary syndrome (PCOS).
– Blood clotting disorders, such as antiphospholipid syndrome.
– Lifestyle factors, including smoking, excessive alcohol consumption, or high caffeine intake.
Diagnosis
In Australia, investigations typically begin after three consecutive miscarriages.
These may include:
– Blood tests to check for hormonal or clotting issues.
– Ultrasound to assess the uterus.
– Genetic testing for both partners to identify chromosomal abnormalities.
Treatment Options
Treatment depends on the underlying cause and may include:
– Lifestyle changes: Quitting smoking, reducing alcohol and caffeine intake, and maintaining a healthy weight.
– Medications: Hormonal treatments or blood-thinning medications like aspirin or heparin.
– Surgical interventions: Correcting uterine abnormalities.
– Supportive care: Close monitoring and emotional support during subsequent pregnancies.
Emotional Support
Recurrent miscarriage can take a toll on mental health. Support is available through:
– Counselling services.
– Support groups, such as those offered by [Miscarriage Australia]
(https://miscarriageaustralia.com.au/understanding-miscarriage/fact-sheets/).
– Speaking with your healthcare provider about coping strategies.
Where to Seek Help
If you have experienced recurrent miscarriage, consult your GP or a specialist clinic.
They can provide comprehensive care, including investigations, treatment, and emotional support.
Key Takeaways
– Recurrent miscarriage is a medical condition that can often be managed with the right care.
– Early diagnosis and tailored treatments improve the chances of a successful pregnancy.
– Emotional support is vital—don’t hesitate to reach out for help.
"Menopause indicates a significant change in a woman's life, requiring a compassionate and personalized care. As a specialist, my mission is to acknowledge, understand and support women by offering an expert insights and individualised strategies to tackle both physical and emotional issues, ranging from hormonal fluctuations to enduring health matters such as bone health & emotional wellbeing. By equipping women with appropriate resources and up to date knowledge, I aspire to assist them in navigating this new phase with strength, assurance, and vigor."
Patient Information Leaflet
Menopause and Its Management
What is menopause?
Menopause is a natural stage in a woman’s life, marking the end of menstrual cycles. It is diagnosed after 12 consecutive months without a period and typically occurs between the ages of 45 and 55. In Australia, the average age of menopause is 51.
What are the symptoms of menopause?
Symptoms vary but may include:
– Hot flushes and night sweats.
– Vaginal dryness and discomfort during intercourse.
– Mood swings, irritability, or anxiety.
– Sleep disturbances.
– Fatigue and difficulty concentrating.
– Joint and muscle pain.
– Weight gain and changes in body shape.
What causes menopause?
Menopause occurs due to a decline in the production of reproductive hormones, such as estrogen and progesterone, by the ovaries. It can also result from surgical removal of the ovaries, chemotherapy, or radiation therapy.
How is menopause managed?
Management focuses on relieving symptoms and improving quality of life. Options include:
1. Lifestyle Changes:
– Regular exercise to improve mood, sleep, and bone health.
– A balanced diet rich in calcium and vitamin D to support bone health.
– Stress management techniques, such as mindfulness or yoga.
2. Menopausal Hormone Therapy (MHT):
– MHT, previously known as Hormone Replacement Therapy (HRT), is the most effective treatment for menopausal symptoms like hot flushes and night sweats.
– It also helps prevent bone loss and reduces the risk of osteoporosis.
– MHT is tailored to individual needs and should be discussed with a healthcare provider.
3. Non-Hormonal Treatments:
– Certain antidepressants, gabapentin, or clonidine may help manage hot flushes and night sweats.
– Vaginal moisturizers and lubricants can alleviate vaginal dryness.
4. Complementary Therapies:
– Acupuncture, herbal remedies, and cognitive behavioral therapy (CBT) may provide symptom relief for some women.
What are the risks and benefits of MHT?
The Australasian Menopause Society highlights that MHT is generally safe for most women when started within 10 years of menopause or before the age of 60. However, it may slightly increase the risk of breast cancer, blood clots, and stroke in some women. A healthcare provider can help weigh the risks and benefits based on individual health factors.
When should I seek medical advice?
Consult a healthcare provider if:
– Symptoms significantly affect your quality of life.
– You experience unusual bleeding or pain.
– You have concerns about your bone health or cardiovascular risk.
Where can I find more information?
For detailed guidance, visit the [Australasian Menopause Society] (https://www.menopause.org.au/hp/information-sheets/ams-guide-to-mht-hrt-doses) or the [Royal Women’s Hospital](https://www.thewomens.org.au/health-information/menopause-information/managing-menopause).