WOMEN'S HEALTH
At Bondi Road Doctors we are committed to providing a full range of women’s health care. This includes sexual health checks, PAP smears, breast checks, menopause management, contraceptive advice and help with fertility concerns, pregnancy and antenatal care. Women also benefit from preventative health strategies to achieve healthy weight and exercise, lower risks of heart disease, cancer and diabetes.
Many of our doctors have additional training in women’s health and can help you with a range of conditions including
endometriosis
fibroids
preventative screening (pap tests, sexual health, breast checks, skin checks, bowel cancer screening)
menopause
period problems
fertility advice
pregnancy care
contraception
IUD insertion and removal
unwanted pregnancy
implanon insertion
incontinence
breast health
sexual health and sexual problems
Mental health matters including depression, anxiety, post natal depression, relationship issues
IUDS (INTRAUTERINE DEVICE)
Intrauterine devices have been used since Egyptian times for contraception. Currently they come in the form of hormonal or non hormonal devices that are effective, well tolerated and reversible.
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Hormonal IUDs also suppress the thickening of the endometrium and lead to light periods or no periods in the majority of women. This has revolutionized the management of women with heavy or long periods and is licensed as a contraceptive for 5 years from insertion. It is useful for avoiding pregnancy and particularly during the peri-menopausal period when it can help with menopausal symptoms and protect the endometrium if HRT is required. Some women find it helps with PMS symptoms and migraines.
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Non hormonal IUDs are also popular with women who choose to avoid hormones because of sensitivity and intolerance to the associated side effects of the pill. It can cause periods to be heavier and longer although this cannot be predicted for an individual and so requires a trial period. Copper IUDs received a reputation for pelvic infection in the 1950-80s. This was related to the lack of screening for sexually transmitted infection at the time of insertion and the lower use of condoms for casual liaisons. These IUDs last 5-10 years for contraception.
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IUDs (both hormonal and non hormonal) are best inserted during or just after a period and are checked by ultrasound after insertion to confirm correct positioning.
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Long acting reversible contraception is also available as a subcutaneous implant in the inner upper arm providing security of effective contraception for 3 years without the need to take the pill. Condoms however are the most effective way to avoid infection.
COLPOSCOPY
Screening for cervical cancer is currently by pap smear on a 2 yearly basis. In 2016 there will be a gradual change to the screening guidelines. In essence women will only need screening 3-5 yearly and will be screened by a HPV test sample taken from the cervix. Yes, a speculum will still be needed.
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If pap smears (and later HPV tests) are reported as abnormal by the laboratory then the next stage of investigation is often a colposcopy. This involves looking at the surface of the cervix in more depth with a powerful focused light and a microscope. The cervix is then swabbed with a dilute ascetic acid (like white vinegar) and iodine. These two liquids stain the cervix and help to highlight areas likely to be affected by the HPV virus. We now know that abnormal pap smears, CIN, and cancer of the cervix are caused by HPV (the wart virus that affects the genital region).
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A diagnosis at the time of colposcopy is subjective and if there are any affected areas these should be biopsied and sent to a laboratory for a definitive diagnosis and reporting. This report directs the level of surveillance or treatment that is required for each individual. Biopsy is performed under local anaesthetic and typically has little or no down time. Results are usually available 7 days later and require a follow up visit to the doctor for results and a management plan.
