Menstrual Concerns

Menstruation or periods is the process where a woman discharges blood and other material from the uterus lining. While periods can be inconvenient, they are a sign that your body is healthy and your reproductive system is working as it should. Unless you are pregnant, breastfeeding, or have another medical condition, your periods should be regular with an average of 28- day cycle. Bleeding usually lasts around 2-7 days.

Up to 80% of women report having symptoms prior to menstruation. Common signs and symptoms include acne, abdominal bloating, tender breasts, feeling  tired, irritability, and mood changes. Period pain is extremely common among women during menstruation. However, if the pain is constant, worsening and/or unable to be resolved using over-the-counter pain medicine, it will require assessment by a Gynaecologist.

Other menstrual problems that commonly lead to intervention by a Gynaecologist include (but are not limited to):

• Irregular periods
• Heavy bleeding
• Abnormal bleeding
• Missing periods

If you or someone you know is concerned about their menstruation , Nurture Women’s Care is here to provide advice, support, and treatment when you need it most.

Ovarian Cysts

Ovarian cysts are a relatively common condition in women, and typically present very little or even no discomfort. The cysts are fluid-filled sacs in or on an ovary, that could potentially disappear without treatment within a few months. However, they can cause extreme discomfort, particularly if they rupture.

There are also other conditions that can increase the risk of developing ovarian cysts, including pregnancy and endometriosis. If you are experiencing any symptoms, it is important that you contact your GP to arrange a pelvic ultrasound to exclude any ovarian cysts.  Nurture Women’s Care are here to offer support and treatment options for all areas of gynaecology and women’s health.

Symptoms of ovarian cysts include (but are not limited to):

• Sudden & severe pelvic pain
• Worsening pain during your period
• Pain during sexual intercourse
• Abdominal bloating
• Fullness or heaviness in your abdomen

For advice and care from an experienced professional, contact the practice today and arrange an appointment with Dr Gloria Sham.

Pelvic Pain / Endometriosis

Endometriosis is a condition where tissue similar to the inner lining of the uterus is found in other areas around the body. It is most commonly found in the pelvis, and has the potential to affect reproductive organs. The cause of the condition is not yet known. However, the most prevalent theory is that during a woman’s menstrual cycle, tissue travels backwards through the fallopian tubes and into the pelvis, where it proceeds to attach and grow.

Endometriosis is one of the most commonly diagnosed gynaecological diseases, affecting more than 10% of Australian women. Symptoms generally start in teenage years, and vary greatly from person to person, making it often difficult to diagnose. The condition has the potential to affect one’s fertility, and can inhibit day to day activities due to the level of pain and discomfort experienced. Endometriosis is diagnosed by diagnostic laparoscopy ( key- hole surgery to examine the pelvic organs) While endometriosis can be well-managed, there is no known cure at this stage

The key symptom of endometriosis is pelvic pain, which is often associated with menstrual periods. For this reason, it is too often dismissed without further investigation. While a mild degree of cramping or discomfort is common, pain that is worse and potentially increasing with each period could stem from undiagnosed endometriosis.

Signs and symptoms include:

• Painful periods – beyond that of minor cramping and discomfort
• Pain in your abdomen and lower back
• Pain during or following sex
• Pain when going to the toilet
• Difficulty falling pregnant
• Heavy bleeding during or between periods

If you or someone you know is displaying any of the above symptoms, it is important that you contact Nurture Women’s Care as soon as possible.

For more information about Endometriosis, visit RANZCOG’s patient leaflet.

Contraception

Contraception, also known as birth control or family planning, is all about your individual choice. If you are engaging in sexual intercourse with a male, and do not wish to fall pregnant, you need to use contraception. There are many contraceptive methods available in Australia to suit both women and men at various stages of life. These can be divided into reversible and irreversible.

Reversible contraceptive methods include

• Condoms
• Oral contraceptive pills
• Emergency oral contraceptive pills
• Contraceptive implant
• Contraceptive injection
• Intra-uterine device (IUD)
• Vaginal ring
• Diaphragm
• Natural methods of contraception
• Withdrawal

Irreversible contraceptive methods include:

• Male sterilisation
• Female sterilisation

Long acting reversible contraception (LARC) such as contraceptive implants and intra-uterine device (IUD) gives safe, effective contraception over a number of years, depending on the type.

No matter what type of contraception you choose, using a condom is the only way to protect yourself against sexually transmitted infections (STIs).

At Nurture Women’s Care, it is our priority to educate you and recommend the best method of contraception after learning about your needs and future plans. We will help you understand the pros and cons associated with reversible and irreversible contraceptive options. If you would like to discuss your options when it comes to contraception with a specialist, contact Nurture Women’s Care today. We are always there to help! For more information about contraception and different contraceptive methods available, visit RANZCOG’s patient leaflet.

Recurrent Miscarriages

A miscarriage occurs when a pregnancy stops progressing and growing, with the tissue eventually passing out of the body. Some women will experience pain similar to that of a period, and there will often be associated vagina bleeding.

Miscarriages within the first few weeks of pregnancy are common, with studies showing that around one in five women, who are aware of their pregnancy, miscarrying before 20 weeks’ gestation. The actual rate is likely higher than this, as some women experience them before even knowing they are pregnant.

It is good to know that research had shown most women went on to have a successful and healthy pregnancy after experiencing a miscarriage.

Miscarriages can understandably be extremely distressing for everyone involved, so when they reoccur, can take a major toll on one’s mental and physical health. Around 2% of women will experience three or more consecutive miscarriages. When this is the case, they are known as recurrent miscarriages. It is recommended that the cause of recurrent miscarriages should be thoroughly investigated.

Some medical conditions increase a woman’s risk of having a miscarriage. This includes uncontrolled diabetes, fibroids and thyroid problems.

Sooner we investigate and  find out the underlying cause, the better chance we can intervene and prevent a miscarriage.

Many women who experience one miscarriage will go on to fall pregnant and have a healthy baby. Staying positive and reducing stress is extremely important.

If you or someone you know has suffered from recurrent miscarriages, contact Nurture Women’s Care today. We are here to provide pre-conception support, and walk through the journey with you long after your little one has arrived.

For more information about miscarriages, visit The Royal Women’s Hospital fact sheet.

Menopause

Menopause is defined as the cessation of menstruation. It occurs because the ovaries stop producing eggs which lead to  reduction in hormone production. Menopause is a normal life event and generally occurs naturally for women at around the age of 50. Menopause occurs in women under the age of 40 is called ‘premature menopause’; whereas menopause occurs in women under 45 is called ‘early menopause’

Some factors may lead to early onset of menopause, such as surgery, radiation or chemotherapy treatment.

Menopause itself is made up of 3 main stages, including:

Perimenopause (The menopause transition) 

This stage includes the years leading up to your final menstrual cycle, and extends until a year after your final period. Drastic hormonal changes can lead to a range of symptoms, with the most common during this stage of transition including:

• Hot flushes
• Irregular menstrual cycles
• Restless sleep
• Irritability and lack of concentration
• Fatigue
• Decreased sex drive

The most common misconception is that women cannot fall pregnant during this time. If you do not wish to fall pregnant, it is vital that you continue to use contraception until at least 12 months after your final period.

Menopause

At this stage, a permanent end to menstrual periods can be confirmed if there is no menstrual bleeding after 12 consecutive months. You are no longer at risk of becoming pregnant.

Postmenopause

The years following menopause are called postmenopause. During this time, many of the symptoms of menopause ease for most women; you may regain your energy and feel emotionally normal once again. But, as a result of a lower level of estrogen, postmenopausal women have an increased risk for a number of health conditions, such as osteoporosis, heart disease, and changes in the vagina and bladder. While everyone’s experience with menopause is different, some symptoms may be difficult to cope with. Symptoms can be managed in a variety of ways, from simple changes to lifestyle and diet, to medical intervention and psychological treatment.

If you would like to learn about how to manage menopause, or what you can expect at the onset to help with transition, see RANZCOG’s patient leaflet. Alternatively, contact Nurture Women’s Care today.

Abnormal Cervical Screening

A cervical screening test provides protection against cervical cancer, which is widely recognised as one of the most preventable types of cancers. In December 2017, the Cervical Screening Test replaced the Pap test in Australia. Where the Pap test only detected cell changes in the cervix, the Cervical Screening Test can detect the human papillomavirus (HPV). HPV is a common infection that is spread by genital skin-to-skin contact. It is so common in fact, that many people will have it at some point in their lives without even realising as there typically are no symptoms.

HPV infections that are not naturally removed by the body can cause abnormal cervical cell changes. This process can take months or years to develop. Generally, persistent high risk HPV infection can lead to cervical cancer

Lifestyle and medical conditions that lower women’s immune system will increase their chances of developing HPV- related cervical cell abnormality; this includes smoking, hepatitis B and C, HIV/AIDS, recent glandular fever and immunosuppressive drugs.

Cervical screening test is extremely straight forward. For women aged 25 to 74, the test is due two years after your first Pap test, then every 5 years ongoing. Once you have completed the Cervical Screening Test, you will either be:

• Asked to return for a screen in 5 years time
• Asked to repeat the test in 12 months time
• Referred to a specialist if further investigation required

If your test returns an abnormal result, you will be referred to a specialist gynaecologist who will perform a colposcopy. This does not mean that you have developed cancer.  Dr Gloria Sham at Nurture Women’s Care will provide specialist care following an abnormal cervical screen, and will educate you on what to do moving forward to safeguard your health.

Pelvic Organ Prolapse

Pelvic organ prolapse is a common condition, where the bladder, bowel and/or uterus protrude into the vagina.

Factors that can increase your risk of pelvic organ prolapse include:

• One or more pregnancies and vaginal births
• Giving birth to a large baby
• Increasing age
• Obesity
• Prior pelvic surgery
• Chronic constipation or frequent straining during bowel movements
• Family history of weakness in connective tissue
• Being Hispanic or white

Pelvic organ prolapse can lead to a range of symptoms including:

• Sensation of vaginal heaviness
• Difficulty emptying the bowel
• Urinary problems such as urinary incontinence or retention
• A vaginal lump
• Issues with sexual intercourse

Treatment of  pelvic organ prolapse can be recommended when you experience any symptoms of prolapse.. There are non-surgical and surgical treatment options available to manage pelvic organ prolapse depending on symptom severity and the type of prolapse you experience.

Dr Gloria Sham at Nurture Women’s Care is here to diagnose your Pelvic Organ Prolapse and to tailor your management according to your needs and concerns.

For more information about pelvic organ prolapse and subsequent surgical intervention, visit RANZCOG’s patient leaflet.