Optimising quality of life and future fertility
I diagnose and treat the full range of gynaecological conditions that may affect women from adolescence through adulthood. My aim is to relieve symptoms that may be affecting your quality of life, while minimising the potential impact of your condition on your current or future fertility.
You may be referred to me for one or more of the following reasons:
Abnormal periods (heavy, painful, irregular)
Abnormal menstruation refers to periods that are particularly painful, heavy, unusual in duration and/or irregular. There are many potential causes of abnormal periods, ranging from stress and lifestyle factors to more serious underlying conditions, such as abnormalities of the uterus or endometriosis in the case of painful periods.
If you are experiencing problems with your periods, I can help you manage your symptoms while investigating the cause. Depending on the specific diagnosis, treatment may involve medication (like the oral contraceptive pill or hormone releasing IUD), or I may recommend surgery, e.g. to remove polyps or endometrial growths.
‘Pelvic pain’ is felt in the area below your belly button and between your hips. It’s an important symptom to discuss with your doctor because it may indicate a more serious problem, such as pelvic inflammatory disease, endometriosis or an ovarian cyst.
Treatment for pelvic pain depends on its cause and tests will be performed to help identify the specific cause of your pain. These tests may include blood and urine tests, or imaging studies, such as an ultrasound.
Once I have diagnosed the problem, I will be able to advise what kind of treatment will help relieve your symptoms and correct the underlying cause of your pain.
Abnormal cervical screening test
The Cervical Screening Test is a procedure that aims to detect pre-cancerous changes of the cervix in women. It’s a quick and simple test that involves collecting a small sample of cells from your cervix (neck of the womb) to look for human papillomavirus (HPV) infection.
Women aged between 25 and 74 are advised to have a Cervical Screening (or HPV) test every five years. If your Cervical Screening Test is positive, this means that HPV is present. Typically, this virus clears up naturally within one to two years without any intervention. However, in some women, it can take longer for the virus to clear, increasing the risk of cervical cancer.
Because of this risk, if your Cervical Screening Test is positive, additional laboratory tests will automatically be done on the cells taken from your cervix. Depending on the results of these tests, you may need to have a repeat Cervical Screening Test in 12 months' time (to check that the HPV infection has cleared), or a follow-up procedure called a colposcopy. In this case, your GP will refer you to a specialist like myself.
A colposcopy is a minor procedure used to examine the cervix, using a special microscope called a colposcope. If I see an unusual area of cells during the colposcopy, I may perform a biopsy (take a sample) while you are awake. Alternatively, these cells may be removed under an anaesthetic using cautery and a thin wire loop (‘LLETZ’ or loop excision).
Contraception, including placement of Mirena®
There are now many different forms of contraception available, some of which have benefits beyond contraception. My aim is to provide you with sufficient information, so you can weigh up the pros and cons of each method, and choose an approach that’s right for you.
The contraceptive method you decide on will depend on a variety of factors, including how important it is for you to avoid falling pregnant, your likelihood of getting a STI, your general health, lifestyle and relationships. In some cases, contraception may also be used as a way of managing other problems, e.g. a hormone releasing IUD may be recommended if you have heavy periods but also require contraception.
Some contraceptive methods will require more involvement from you than others. The oral contraceptive pill, for example, requires you to remember to take a pill every day, whereas a contraceptive implant can last for up to three years. The hormonal IUD available in Australia is called the Mirena®. It is a small t-shaped device which is fitted inside your uterus (womb) and releases progestogen, thereby preventing pregnancy.
What works well for you will depend on your personal circumstances and preferences. I'll walk you through all the different options, so you can decide which method is the best fit for your lifestyle and stage of life.
Minimally invasive (keyhole) surgery
Minimally invasive (or keyhole) surgery is often used to treat physical problems that are affecting your reproductive organs or surrounding structures, e.g. endometriosis affecting the ovaries, fallopian tubes, uterus, bladder and/or bowel. It involves making one to four small incisions (‘key holes’) within your belly-button and/or bikini line.
This is quite different from open surgery, which involves a much larger incision to ‘open’ your pelvis. Due to its minimalist approach, keyhole surgery is typically associated with less pain, fewer complications and a shorter hospital stay than open surgery.
Certain conditions, such as polycystic ovary syndrome or endometriosis, can be diagnosed and treated with minimally invasive surgical techniques. In some cases, this surgery may avoid the need for IVF or ART to help a woman conceive, or help improve the outcome of these fertility treatments.
I am an accomplished surgeon and highly experienced in using minimally invasive surgical techniques, including laparoscopes and hysteroscopes. Where suitable, I will employ keyhole techniques to avoid the need for open surgery.