Women’s Health

The Cervical Screening Test replaced the Pap test in December 2017. The new test detects infection with human papillomavirus (HPV).

The Medical Services Advisory Committee (MSAC) recommended this change based on evidence that HPV causes most cervical cancers. Cervical cancer is a rare outcome of ongoing infection with certain types of HPV. It can take 10 to 15 years for an HPV infection to develop into cervical cancer.

Cervical screening can detect multiple HPV types, including the highest risk types: HPV 16 and 18. HPV 16 and 18 have been linked to 70% to 80% of the cases in Australia.

Research shows that screening for HPV every 5 years is more effective than doing Pap tests every 2 years. It’s also just as safe.

MSAC advised that people with a cervix:

• have an HPV test with partial genotyping every 5 years
• start cervical screening at age 25
• have an exit test between 70 and 74 years of age
• have an HPV test at any age if they have symptoms of cervical cancer, even if they screen regularly.

Source: Department of Health

While sometimes it seems embarrassing, it is important to discuss your sexual health with a doctor. Our doctors are professional and non judgmental.

Some important topics are:

• Sexually transmitted infections (STI)
• Painful Sex
• Sexual Performance

Human papillomavirus (HPV) is a very common virus that is spread through sexual contact. Most people do not experience any symptoms of HPV and the virus often goes away by itself. But in some people, HPV causes genital warts or cancer.

HPV can affect any male or female who is sexually active, even if they only experience sexual contact once. Nine out of 10 people have HPV at some time in their lives.

There are many different types of HPV virus some are considered ‘low risk’ while others are ‘high risk’. Low-risk HPV types can cause genital warts and do not cause cancer.

High-risk types of HPV can cause cervical cancer or other cancers, including:

• anal cancer
• vaginal cancer
• cancer of the vulva
• cancer of the penis
• oropharyngeal cancers (cancers of the back of the throat, including the base of the tongue and tonsils)

The best way to protect yourself and others against HPV is to be vaccinated. In women, the vaccine protects against 9 types of HPV that cause cervical cancer it does not protect against all types of HPV. It also helps protect against genital warts and some types of vaginal, vulval and anal cancers.

The HPV vaccine is recommended for:

• adolescents aged 9 to 18 years
• people who have weakened immune systems

The best time to be immunised is before you are sexually active. Boys and girls aged 12 to 13 receive the free HPV vaccine at school on the National Immunisation Program Schedule. It is also available for free to anyone under 20 if they were not vaccinated at school.

You can still be vaccinated if you have been infected with a type of HPV in the past.

Women who have received the HPV vaccine should still have regular cervical screening tests, since the vaccine does not cover all types of HPV. Women aged 25 to 70 need to be screened every 5 years, or 2 years after their last Pap smear.

Source: Health Direct

Vaginal thrush is a common yeast infection caused by the candida species of fungus. It is easily treated and can be prevented.

Thrush occurs in many areas of the body, but especially in the vagina, anus and mouth.

Candida is usually found in the vagina and is harmless, but when the fungus multiplies it can cause irritation and swelling both in the vagina and vulva. In most cases, the condition can be treated effectively.

Vaginal thrush can affect women of any age, although it is more common in women between the ages of 15 and 50 years old. It is unusual in girls who have not yet begun their periods and in older women after menopause.

Source: Health Direct

You can discuss with the doctor which contraception method is best for you.

Types of contraception

Condoms

Condoms are a form of barrier contraception. They prevent pregnancy by stopping sperm from reaching and fertilising an egg. Condoms also provide protection against STIs, including HIV, and stop them being passed from one sexual partner to another. Condoms are used during penetrative sex (vaginal or anal) and oral sex to protect against STIs.

Combined contraceptive pill

The combined contraceptive pill, usually just referred to as the pill, contains synthetic (man-made) versions of the female hormones oestrogen and progesterone, which women produce naturally in their ovaries. The pill is usually taken to prevent pregnancy but it can also be used to treat:

• painful periods
• heavy periods
• premenstrual syndrome
• endometriosis

Progestogen-only contraceptive pill

The progestogen-only pill doesn’t contain any oestrogen. It is an option for women who can’t use the combined contraceptive pill, such as those over 35 years old and those who smoke.

Contraceptive implants and injections

Contraceptive implants and contraceptive injections are long-acting, effective, reversible and progestogen-only methods of contraception. Implants are over 99% reliable in preventing pregnancy. They last for 3 years. This means that fewer than 1 in 100 women who use the implant will become pregnant each year. The injection is given into a muscle every 12 weeks and is 94 to 99.8% effective.

We provide Implanon insertion and removal services.

Diaphragms and caps

Diaphragms and caps are barrier methods of contraception used by women. They fit inside the vagina and prevent sperm from passing through the entrance of the womb (cervix).

Intrauterine device (IUD)

An intrauterine device (IUD) is a small, T-shaped contraceptive device made from plastic and copper that fits inside the womb (uterus). The IUD used to be called a coil or a loop. It’s a long-acting and reversible method of contraception, which can stay in the womb for 5-10 years depending on the type.

Some IUDs contain hormones that are gradually released to prevent pregnancy. These IUDs can also be used to manage heavy periods. IUDs are more than 99% effective.

Intrauterine system (IUS)

The intrauterine system (IUS) is similar to the intrauterine device (IUD), but it works in a slightly different way. Rather than releasing copper like the IUD, the IUS releases the hormone progestogen, which prevents pregnancy. It’s a long-acting, reversible method of contraception that lasts for 5 years. It can also be used for managing heavy periods.

Emergency contraception

A woman can use emergency contraception to prevent pregnancy after having unprotected sex, or if a method of contraception has failed. There are 2 types of emergency contraception:

• The emergency contraceptive pill (sometimes called the morning-after pill) — The emergency contraceptive pill is best taken in the 24 hours after you have unprotected sex. You can take up to 5 days later, but it will be less effective.
• Copper intrauterine contraceptive device (Cu-IUD) — An intrauterine device can also be an effective form of emergency contraception if fitted by a healthcare professional within 5 days (120 hours) of having unprotected sex. It will prevent about 99% of preganancies.

Female sterilisation

Female sterilisation is an effective form of contraception that permanently prevents a woman from being able to get pregnant. Like a vasectomy, female sterilisation is a big decision that should be fully discussed with your GP and / or your specialist.

The operation usually involves cutting or blocking the fallopian tubes, which carry eggs from the ovaries to the womb (uterus). This prevents the eggs from reaching the sperm and being fertilised. It’s a fairly minor operation and many women can return home the same day.

Vaginal ring

The vaginal ring is a small, soft plastic ring that’s placed inside the vagina on the first day of a woman’s period. It is removed after 21 days. A new ring is used 7 days later. A vaginal ring is about 4mm thick and 5.5cm in diameter. It contains oestrogen and progestogen, so it’s not suitable for women who can’t take oestrogen-containing contraception.

Source: Health Direct

Antenatal care is the care you receive during pregnancy. If you have just found out you are pregnant, it’s important to see your doctor (GP) or midwife to start your antenatal care.

Antenatal appointments are important even if you are healthy and your pregnancy is going well.

They allow your midwife or GP to check your health and your baby’s health so they can find and treat any problems early on. These appointments are also a good opportunity for you to ask questions and talk about any concerns you have.

The first antenatal appointment

It’s best to make your first antenatal appointment when you are about 6 to 8 weeks pregnant. This appointment can be with a midwife, your GP or at a clinic or hospital.

At this appointment, the doctor or midwife will confirm that you are pregnant. They will do a thorough health check, including asking about your medical history and your family’s medical history. They will also give you important information about your pregnancy care.

They may also offer you tests to check for anything that may cause problems during pregnancy or labour – you can decide whether or not to have the tests.

Find out more here about the check-ups, tests and scans you will have during your antenatal visits.

You will have antenatal visits throughout your pregnancy. Most women who have uncomplicated pregnancies have 8 to 10 appointments.

Source: Health Direct

Mothers’ bodies will go through major adjustments after giving birth. It’s important to look after yourself during this time and see a GP if you have any difficulties with:

• Bleeding
• Pains
• Healing from a caesarean section
• Breastfeeding
• Care for pelvic floor muscles

Shared care is an arrangement between a hospital (or other birth setting) and a local GP where your pregnancy care is divided between the local provider and the hospital. You will have some of your antenatal appointments with your local provider and others with the hospital, depending on the reason for the visit. Most tests and scans, for example, would take place at the hospital.

Most hospitals that offer shared care do so only for women with low-risk pregnancies.

In Australia, GPs who provide shared care will often have extra obstetric training and qualifications and a special arrangement with the maternity hospital where you want to give birth to your baby.

The benefits of a shared care pregnancy

Some women like shared care because it means they can receive most of their maternity care from a GP who they are familiar with and who works close to their home or workplace. It also means that the same GP who has cared for you during the pregnancy can continue to care for you and your baby in the weeks and months after birth.  If English is your second language, your GP might speak your first language and be more aware of your cultural needs. GPs are also trained to deal with other relevant issues such as monitoring your mental health during the pregnancy and in the postnatal period and the provision of contraception.

You should see your doctor as soon as possible if you notice any changes in your breasts or the areas around them, as well as attending screening mammograms every 2 years if you are between 50 and 74 years old. Everyone’s breasts change as they get older, especially during puberty, pregnancy, breastfeeding and menopause, so sometimes it can be hard to know if a change is normal or if it is a sign of cancer. By discussing all changes with your doctor, you can be sure you are keeping yourself as safe as possible from breast cancer.

If members of you family have recently been diagnosed with the disease, you should speak to your doctor about your personal risk of developing the disease. Your doctor will help you decide if you should attend a screening mammogram more often, and may recommend additional ways to reduce your breast cancer risk.

Source: Health Direct

Perimenopause

Perimenopause means around menopause. It relates to the time leading up menopause, where you are getting some of the symptoms of menopause. For some women, that starts a year or 2 before menopause. But for others, changes start 10 years earlier, or even more.

Perimenopause takes place because most women’s ovaries don’t just stop working overnight. They gradually slow down over a period of years, producing fewer eggs and releasing less of the hormones than usual.

One of the common features of perimenopause is irregular periods. Your periods may come less often, or sometimes even more often. There may be less bleeding than usual, or there may be more. It can change from month to month.

Other features of menopause can appear, although usually in a mild way. So there might be some problems sleeping, some hot flushes, a slow decline in your sex drive, headaches, mood swing, disturbed sleep, sore breasts, weight gain and some vaginal dryness.

Natural menopause

Menopause is the time in life when you stop having monthly periods. This marks the natural end of the reproductive stage of your life, when your ovaries no longer have eggs to release. Most Australian women experience menopause between 45 and 60 years of age. The average age of menopause is 51 years. You have reached menopause when you have gone 12 months without having your period.

Symptoms of menopause are caused by a drop in the levels of the hormone oestrogen.

Early menopause

Early (or premature) menopause can occur due to:

• medical treatments that stop ovaries from functioning, such as chemotherapy or radiotherapy for cancer
• surgery to remove a woman’s ovaries (oophorectomy) — for example, to prevent or treat ovarian-cancer or breast cancer
• surgery to remove the uterus (hysterectomy) in some cases
• primary ovarian insufficiency — for example, due to certain genetic, autoimmune or metabolic conditions
• some unknown cause — for 6 in 10 women with early menopause, the cause is unknown

How is menopause diagnosed?

There isn’t a specific test for menopause. Your doctor will help you determine if you are menopausal based on how frequent your periods are and what symptoms you are experiencing. Menopause is confirmed 12 months after your last period. Blood tests are unlikely to accurately predict menopause.

Seek medical advice if you are concerned about irregular cycles, heavy or abnormal bleeding, or symptoms that interfere with your daily life. Your doctor may also suggest other health checks such as a mammogram, pelvic examination or cervical screening.

How is menopause treated?

Most women can manage mild menopause symptoms without any medication. If you feel you need treatment for menopausal symptoms seek medical advice to find the best treatment for your individual circumstances.

Prescribed treatments

Menopausal hormone therapy (MHT), or hormone replacement therapy, involves replacing your hormones (oestrogen and progesterone, and sometimes testosterone) to relieve menopausal symptoms. It is an effective treatment for hot flushes, sweats, mood swings, irritability, insomnia, joint aches and vaginal dryness.

The most recent and comprehensive reviews of MHT show that many healthy women can safely use it for years to manage menopausal symptoms, but it’s important to first check with your doctor to see if MHT is right for you. If you opt to start MHT, take the lowest effective dose for only as long as you need to, and review with your doctor regularly whether to continue treatment.

MHT is not appropriate if you have a history of oestrogen-dependent cancer, such as breast or uterine cancer.

Other conditions that rule out MHT include:

• undiagnosed vaginal bleeding
• untreated thickening of the uterine lining
• unmanaged high blood pressure
• current thrombosis (such as deep vein thrombosis, or DVT), or conditions that increase your risk of blood clots
• coronary heart disease, stroke or dementia

Your doctor might also suggest some non-hormonal prescription medicines to manage menopausal symptoms. These include certain antidepressants and other medicines.

Complementary treatments

Many women try non-hormonal options to manage menopause symptoms such as hot flushes and night sweats. These options include:

• herbal remedies such as black cohosh and red clover and plant-based oestrogens (phytoestrogens), found, for example, in soy
• hypnotherapy
• cognitive behaviour treatment
• mindfulness therapy
• acupuncture and traditional Chinese medicine

For a dry vagina, drug-free treatments include the use of lubricants, oils, vaginal moisturisers, or black cohosh.

It’s important to seek medical advice before trying any treatment — including herbal therapies. Some remedies may be expensive and unproven, or they may interact with other treatments.

Source: Health Direct

Iron deficiency is when there is not enough iron in the body.

Iron is an essential mineral that is needed to produce red blood cells, which are important for a healthy immune system, mental function, muscle strength and energy. Its main role is in red blood cells, where it helps make a protein called haemoglobin. Haemoglobin carries oxygen in the blood from the lungs to all the cells in the body so they can work properly.

The body can’t make iron, so you need to get it from food. If you do not eat as much iron as you use each day, you develop iron deficiency.

It is important to have the correct amount of iron in the body. If you have low iron, you can develop anaemia. If you have too much iron, it can be toxic. Iron deficiency is the most common nutritional disorder in the world.

What causes iron deficiency?

There are 3 main causes of iron deficiency.

1. Not eating enough iron-rich foods. Your body can store iron but it cannot make it. Iron must come from food. Some people need more iron than others. The people who need most iron are children, teenagers (especially girls), females who have periods, pregnant women and breastfeeding women. Babies need breast milk or iron-fortified formula for the first year. Babies who have cow’s milk instead are more likely to get iron deficiency. People who follow vegetarian or vegan diets are also more at risk.
2. Trouble absorbing iron. Iron in food is absorbed through the stomach and bowel. Some health conditions affect how much iron is absorbed, such as coeliac disease. If you’ve had stomach surgery, that can also affect how much iron you can absorb.
3. Blood loss. If you lose blood through any sort of bleeding, this means you lose iron too. The main causes of excess blood loss are having heavy menstrual periods and bleeding in the stomach or bowel, which may be associated with taking medicines such as aspirin or other anti-inflammatory medicines, ulcers, bowel polyps or cancer. Other causes can include giving blood too regularly, losing blood due to surgery, some gut conditions such as inflammatory bowel disease, and infection with parasites such as hookworms.

When should I see my doctor?

If you think you might have low iron levels, see your doctor. It’s important to find out why you have iron deficiency and what you can do about it.

Make sure you see your doctor before taking any iron supplements, to get their advice on the right type of iron and dose for your needs.

See your doctor if you have any of the symptoms of anaemia, which include:

• being extremely tired and weak
• being short of breath
• your heart beating fast and irregularly, or both
• being dizzy and light-headed
• headache
• cold hands and feet
• sore or inflamed tongue
• brittle nails
• poor appetite
• being irritable
• having cravings for unusual things like ice, dirt or starch

Source: Health Direct