FAQ

Apart from medicare and your insurance information

• A referral from your General Practitioner or family doctor
• All pertinent x-ray reports and test results from your primary care or referring physician
• A list of all medications that you are currently taking
• A list of any known drug allergies and the symptoms you may have from taking these medicines
• If you have had surgery elsewhere, please bring a copy of your operation report

You can book and come to an appointment without a referral, but Medicare will rebate the specialist services only if you have been referred by a GP.

Before seeing any medical specialist, it is always preferable to talk to your own family doctor, He or she, can help the specialist to care for you better by providing relevant information about your health. Communicating with the specialist will also enable your family doctor to care for you better during and after your specialist treatment.

Periods are a sign that your usual hormonal systems are kicking back in after you’ve given birth, but when they return varies from woman to woman. If you are not breastfeeding, you could expect your period to return by the time you have your six week check after the birth. Breastfeeding delays the return of your period because the higher levels of prolactin produced can switch off the menstrual cycle. Each woman’s response to these hormones varies though, and some who are fully breastfeeding will have a period within four weeks, while others won’t resume until after they’ve finished feeding.

Even if you haven’t had your period, or you are fully breastfeeding, you could still become pregnant because you can’t tell when you may release an egg (ovulate). Breastfeeding may delay your period and the return of your fertility, but it’s not a guarantee and you need contraception if you don’t want to fall pregnant.

Having a baby means your body has been through immense hormonal change, and sometimes things don’t return as they were, which can effect how your periods are once you’ve been pregnant.
This is good news for some women who may have had problems with irregular cycles or endometriosis before the baby and find things are better after.
But for other women their periods can become heavier and last longer. Apart from hormonal changes, there are a couple of possible reasons for this.

• Fibroids can be affected by pregnancy, with some increasing in size and others decreasing. This might affect how your periods behave
• Women may also have something called adenomyosis, where the lining of the uterus gets pushed into the muscle part of the uterus. This will increase bleeding.
• An infection of the lining of uterus, called endometritis, is also common after birth, and can cause heavier periods, along with cramps, fever and abnormal discharge.

Anything that’s worrying you about your period is worth getting checked out. This might include if you’ve finished breastfeeding, and your periods haven’t come back, or if your periods continue to be heavy or painful. Irregular periods or bleeding all the time is also definitely worth a visit to your doctor.

Women with irregularly timed periods have inconsistent menstrual cycles. Irregular periods are most common during the first few years of menses, and the year right before menopause. Some women continue to have irregular periods throughout their childbearing years, which can be common due to age, but should be evaluated by a health care professional. Oral contraception is one treatment option that can help regulate menstrual cycles.

Having regularly timed episodes of heavy or prolonged menstrual bleeding is called menorrhagia. Women with a consistent menstrual flow for 7 or more days,or blood loss exceeding a little more which shown by passing out clot or soaked your pants at night, should be evaluated by a physician. Occasionally, heavy periods can indicate other health problems, and can also cause anemia. Please consult with me, if you experienced heavy or prolonged bleeding so we can conduct tests to rule out more serious conditions. If the bleeding is not part of a more serious condition, oral contraceptives, Mirena IUD and other, are treatment options that can provide a beneficial impact on menstrual flow, general health and your life quality.

Women may accounted gynaecological diseases due to the hormone in women, which are estrogen and progesterone. There are many gynaecological cancer seen such as ovarian cancer, cervical cancer, breast cancer, endometrial cancer and vaginal cancer. Due to the developed technology, screening tests are available for cervical and breast cancer where it provides early detection. This is essential as since the discovery of these screening test, mortality and morbidity for these both cancers has reduced. The screening test for cervical cancer is known as Pap Smear test. All sexually active women between the age of 18 till 64 should undergo cervical screening once every 3 years. For breast cancer, screening mammography is used. Women of age over 40 are recommended for a mammography x-ray every 2 years.

A Pap smear (Pap test) is a test of a sample of cells taken from a woman’s uterine cervix. The test is used to look for changes in the cells of the cervix that show conditions that may develop into cancer. It is the best tool to detect precancerous conditions and hidden, small tumors that may lead to cervical cancer. If detected early, treatment will be given which this can reduce the risk of developing onto cervical cancer. Pap screen testing should begin at age 18, once sexually active. Routine screening is recommended every three years. The Pap smear is done during a pelvic exam. A doctor uses a device called a speculum to widen the opening of the vagina so that the cervix can be examined. A plastic spatula and small brush are used to collect cells from the cervix. After the cells are taken, they are placed onto a glass slide. The slide is sent to a lab for testing. This procedure is not painful, but the pelvic exam may be a little uncomfortable.

Human papillomaviruses (HPVs) are a group of more than 100 related viruses. They are called papillomaviruses because certain types may cause warts, or papillomas, which are benign (noncancerous) tumors. Some types of HPV are associated with certain types of cancer. These are called high-risk HPVs. Genital HPV infections are very common and are sexually transmitted. Most HPV infections occur without any symptoms and go away without any treatment over the course of a few years. However, HPV infection sometimes persists for many years, with or without causing cell abnormalities. This can increase a woman’s risk of developing cervical cancer. HPV vaccination is a safe, effective vaccine which is available to protect females and males against some of the most common types of HPV and the health problems that the virus can cause. The HPV vaccine works by preventing the most common types of HPV that cause cervical cancer and genital warts. It is given as a 3-dose vaccine. To be most effective, one of the HPV vaccines should be given before a female has any type of sexual contact with another person. Both are given in a series of 3 doses within 6 months. People who have already had sexual contact before getting all 3 doses of an HPV vaccine might still benefit if they were not infected before vaccination with the HPV types included in the vaccine they received. The best way to be sure that a person gets the most benefit from HPV vaccination is to complete all three doses before sexual activity begins.

Laparoscopy is a technique to operate intra abdominal organs, using very small skin incisions. This procedure typically involves 3 or 4 very small incisions being made inyour tummy, allowing the use of specialised instruments and a tiny camera. The entire abdomen, pelvis, uterus and ovaries can be seen on a high definition screen. A laparoscope is a fiber-optic telescope designed to allow the surgeon to visualize and examine the organs lying within the pelvic and abdominal cavities.

This technique allows all manner of procedures to be performed without the need for a large skin incision and minimal handling of tissues.

This typically results in:

• less pain
• faster recovery
• minimal scarring
• early return to normal activity
• reduced risk of infection

Typically the operation is performed under general anaesthesia. A very small cut is made just below the navel through which the operating telescope (laparoscope) is inserted. When necessary, separate small incisions are made low down and at the sides of the abdomen to allow insertion of other fine instruments, e.g. grasping forceps, scissors, etc., and these will enable organs and tissue to be grasped, moved or cut as is required for your surgery. The incisions are closed and small dressings are often applied to cover these wounds.

This procedure can be used to investigate pelvic pain, potential causes of infertility, examination of cysts and tumours, to obtain biopsy samples and to investigate suspected ectopic pregnancy – amongst other things.

From an operating perspective, common procedures include:

• To achieve female sterilization
• For treatment of ectopic pregnancy
• To release/remove pelvic or abdominal adhesions
• To surgically treat endometriosis
• To excise or drain ovarian cysts
• To remove fibroid (benign) tumours from the uterus
• To enhance fertility eg: assisted reproductive techniques
• To facilitate hysterectomy
• To reconstruct the pelvic floor, treat prolapse and incontinence

No surgical procedure is entirely without risk, but this type of surgery attempts to minimise such risks. Anaesthesia itself has some slight risks and these are made worse by severe obesity or cigarette smoking. There is always a small chance that unforeseen circumstances may dictate that your procedure requires an open / traditional surgery approach but this is very uncommon and occurs in < 1% of cases that are planned to proceed laparoscopically.

This is obviously entirely dependent on your individual recovery – however whilst traditional surgery patients are encouraged to refrain from driving for a minimum of 4 weeks, you may be able to drive in as little as a few days depending on your surgery and your rate of recovery.

If in doubt, always consult me for further advice.

In Australia, the average age of menopause is 50 to 51 years of age, but in some women it could happen earlier or later. If it happens before the age of 40, it is called “premature menopause”. Menopause is a natural process that results from normal ageing of the ovaries.

This refers to the transition time that leads to menopause. During this time, the normal function of the ovaries slows down, producing less hormones (oestrogen and progesterone) until ovulation no longer occurs and periods stop altogether. This phase may last for 6 months to 10 years. A woman is considered postmenopausal when she has not had a period for 12 months.

Symptoms vary from woman to woman. Some have no symptoms at all, others may experience symptoms and not be bothered by them, whilst some women find them irritating and troubling. These symptoms include hot flushes (often accompanied by sweats, day or night), disturbed sleep, aches and pains, vaginal dryness (making sex uncomfortable), reduced sex drive, urinary frequency, headaches and or migraines, forgetfulness and or irritability, mood swings, and dry skin or a crawling or itching sensation.

The long-term risks associated with menopause are a thinning of the bones known as osteoporosis together with an increased risk of cardiovascular (heart) disease. A healthy lifestyle with a good diet and regular exercise is an important part of managing menopause.

Regular Pap smears and breast checks including mammography are recommended for menopausal and post menopausal women. It is also recommended that you discuss with a doctor the need for bone density testing to check for any signs of osteoporosis together with the need for any calcium supplementation. Your cholesterol, blood glucose and blood pressure should also be monitored.

The aim of this therapy is to replace the hormone or hormones that were made by the ovaries prior to menopause. It can reduce many of the unpleasant effects of the symptoms of menopause and may be appropriate in women with moderate to severe menopausal symptoms. HRT must be prescribed by a doctor and is not available over the counter. HRT comes in various forms and combinations of hormones (oestrogen and progesterone). Anyone considering this treatment should discuss the benefits, risks and side effects with a doctor and have their treatment well monitored.