Womens Medical

At AHG Super Clinic, you will find friendly female GPs who have an interest in all areas of health that relate to women.

Menstrual concerns
Periods can cause a range of problems throughout a women’s life, with different problems more prevalent at different ages.

In the teenage years there may be concerns about the age of menarche ( periods starting) or the frequency or heaviness of periods. Whilst it is not uncommon for it to take several months for the body to establish a regular cycle, there are a range of medical conditions that can cause the period pattern to be different to normal.

If you are concerned about your periods, please come and see us. It may be a question of simple reassurance, however, when appropriate we will order investigations such as blood tests and scans to ensure further action and treatment is not needed.

During the years when contraceptives are used, many methods can cause an alteration in the period pattern. We are happy to discuss this, explain and investigate as needed.

The peri-menopausal years are frequently associated with bleeding difficulties. The periods may become longer, heavier or change their cycle. It is important to see a doctor to exclude medical conditions such as polyps, fibroids, or other abnormalities. Once appropriate investigations have been completed, there are a range of options to correct the bleeding problems. Each woman will need the management tailored to suit her own circumstances.
Finally, it is important to note that once a woman is post menopausal (no period for at least 12 months if she is over 50 yrs), she should never experience another period. Should any bleeding occur after this time it can indicate a medical problem. In this instance an appointment should be obtained as soon as possible.

Pregnancy and Fertility
Whether you are just starting to think about having a baby, have already started to try to conceive, or are already pregnant, our experienced doctors will help guide you and provide advice. Preconception advice is available for all women, but particularly important for women who have a long term medical condition or are taking regular medication.

Regular antenatal care is essential for a well managed pregnancy. Our experienced team will be able to provide invaluable care, advice and support during this time and following delivery.

At AHG Super Clinic all our female doctors can give you contraceptive advice. Our advice is tailored to the individual as not every contraceptive is suitable for every woman. We are keen to provide you with all your options and the information you need to make an informed choice that will best suit your circumstances and needs.

If you need a renewal of you oral contraceptive pill script, nursing script or would like more information about long acting contraceptive options any of our doctors would be happy to help.

We can also help if you are concerned that you may need emergency contraception or if you have recently used emergency contraception. The morning after pill or emergency contraceptive pill can be accessed at any pharmacy in Australia and in many countries overseas. It is not, however, 100% effective and we recommend follow up to discuss effectiveness and longer term contraceptive options.

Menopause is a woman’s last menstrual period. It can occur naturally at the expected age (48-52) or can occur due to treatment/surgery. It can also occur early/prematurely for some women. You can only be sure you’ve had your last menstrual period when 12 months have passed with no bleeding. Should a woman have further bleeding after this 12 months it is important to seek medical advice.

Peri-menopause is the stage before the last menstrual period occurs and can be a difficult time for some women due to hot flushes, poor sleep, itchy skin, loss of concentration and change in mood. Some of these symptoms for some women continue beyond the last period into the post menopause. For some women the changes caused by the alteration in hormone levels during the peri-menopause may prompt them to seek medical advice.

The most obvious of the changes at menopause is an alteration in period pattern, with eventual cessation of all periods. Whilst this can be a simple transition, some women experience difficulties with their periods, such as excessively heavy bleeding and more frequent bleeding. This may need medical intervention to prevent other problems such as iron deficiency anaemia.

Hot flushes and night sweats are also a key reason for women to seek medical advice during the menopause. For some women hot flushes can cause discomfort and embarrassment. We look forward to discussing with you the various options available to help control hot flushes. There are herbal and prescription medications available (including HRT). Not all options are suitable for all women and careful discussion regarding your medical and family history is very important when helping to find the best option for each individual.

Poor sleep quality is another problem that can be directly due to falling levels of oestrogen. Sleep deprivation is significant as it can lead to other problems including mood disorders, and tiredness.

Bone density also becomes very important at this time of life. Falling oestrogen levels can trigger reduction in bone strength, and factors such as calcium in our diet, vitamin D from sunshine, and adequate exercise, also play an important role in protecting our bones. A test called a bone density reading can give an accurate assessment of this, and our doctors can guide each lady as to how to maximise her bone density, thus reducing the risk of fractures in later life

Management of menopause should be tailored to the individual and our team of female doctors will gladly talk about the most appropriate management for your own circumstances.

Sexual Health
Sexual health is a topic that is relevant for all ages ranging from teens to post menopausal ladies. Our doctors will take a detailed history, perform an appropriate examination and order any pathology necessary to reassure our patients, or determine the cause of discomfort.

All care and concern is taken, with emphasis on respect for the privacy and well being of the patient.

If you have any problems with breastfeeding please contact us to discuss with either one of our doctors. We are happy to support you through any feeding problems in the postnatal period.

Breast Cancer
The breast screening programme in Western Australia targets women between the ages of 50-74. However women over the age of 40 and women over 75 are eligible to attend Breast Screen WA. Once you are registered with Breast Screen WA they will send you a reminder once every 2 years to go for repeat mammograms. At AHG Superclinic, all patient data is securely stored on ur patient management system.

There are some hereditary genes that are associated with a high incidence of breast cancer. If you have a family history of breast cancer, please come and discus this with us. In most instances, it is unlikely to be a genetic cause, but with strong family history gene testing may be indicated, and we are able to provide referrals to genetic counsellors and breast specialists for further discussion regarding this.

In a situation where you may have detected a lump or thickening, we will perform a physical examination and arrange timely investigations and appropriate referrals. Many lumps are benign (not cancer), but it is important to obtain an accurate diagnosis as soon as possible, to be sure a cancer is not missed.

Pap Smear Screening Test
A Pap smear is a simple test taken to look for changes in the cervical cells which might develop into cancer.
Up to 90% of the most common cervical cancers can be prevented by having 2 yearly pap smears.

It is recommended that all women over the age of 18 and up to the age of 70, who have ever been sexually active undergo this test every 2 years. Screening is still recommended for all women who have had vaccination against HPV (Gardasil).

In some cases it may be recommended that a pap smear is repeated earlier than 2 years. This may be to monitor very early changes, or if there has been an inadequate smear.
There are treatments available for changes in the cervical cells and if needed, your doctor will discuss and arrange referral to a gynaecologist.

The pap smear is a screening test rather than a diagnostic test. If you have symptoms of abnormal vaginal bleeding or vaginal discharge or pelvic pain it is important that you mention these to your doctor as you may require other tests as well.
The pap smear is not a test for sexually transmitted infections.

Women’s Health Vaccinations

This is a vaccine against certain strains (6,11, 16, 18) of human papillomavirus (HPV). The strains targeted are known to be key in the development of HPV-related cancers and genital warts. HPV-related cancers include cervical, anal, penile cancer. This vaccine is now part of the vaccination programme in schools for girls and boys aged 12-13. The vaccine has been available since 2007 and initially was offered to all females up to the age of 26. This programme has helped reduce the number of cases of genital warts and hopefully with time there will be a significant reduction in cervical cancer numbers.

If school vaccinations have been missed due to illness/absence on the day of injection, they can be provided free of charge during that school year. If this opportunity is missed the vaccine is available privately. The vaccine is also available privately to anyone over the age of 13. A full vaccination course consists of 3 injections at 0, 2, 6 months. Our advice currently is to continue with the pap smear screening programme even if you have had Gardasil vaccinations. For more information regarding this vaccine please see the following website or come in to discuss with one of our doctors.
www.hpv.health.gov.au – there are great factsheets on this website for students and parents.

Hepatitis Vaccine
Hepatitis is an inflammation of the liver that can be caused by numerous different viruses – hepatitis A, B, C, D, E, G – or alcohol, some chemicals, and some drugs. We are able to vaccinate against hepatitis B and in Australia this vaccination is included in the childhood vaccination programme.
Hepatitis B vaccination – hepatitis B is spread via infected body fluids – blood/vaginal fluid/semen. Vaccination should be considered by health care workers, tattooists, body piercers, men having sex with men, IV drug users, travellers to regions where hepatitis B is endemic, individuals with lowered immunity, anyone planning to adopt a child from overseas, sexual contacts and household contacts of someone with hepatitis B
A combined hep A/hep B vaccine is available.


Vaccines and pregnancy

Flu Vaccine
Vaccination against influenza is usually available in Australia from mid-March each year. All pregnant women at any stage of pregnancy are eligible for a free flu vaccine and encouraged to take this up. The reason for this is that pregnant women have been shown to be more vulnerable to complications from influenza virus and may become seriously unwell with the virus.

Whooping Cough
Our doctors will discuss current recommendations for whooping cough vaccination. These recommendations are topical at present, due to a recent increase in the incidence of the illness .

Rubella infection during pregnancy can be harmful to the developing baby. It is recommended that rubella levels are checked, and a booster provided well before pregnancy, whilst the woman is still using adequate contraception. A booster cannot be given during pregnancy.

Chronic disease
We are able to help with chronic disease care and planning. Some of the chronic diseases we encounter at AHG Super Clinic are as follows:

High blood pressure is a risk factor for heart disease including heart attacks and strokes. We frequently check blood pressures for young women who are taking the oral contraceptive pill. However from the time of menopause women should have their blood pressure checked annually.
It is important for young people with high blood pressure to be investigated to identify possible causes for their high blood pressure. As we age it is common for blood pressure to rise. In order to protect our hearts, kidneys, blood vessels from the effects of high blood pressure it may be necessary to consider dietary changes, exercise changes and medication.

Thyroid Disease
The thyroid is a gland situated in your neck. It produces hormones needed for your body to function properly. Problems with the thyroid gland are very common particularly in women. The thyroid can cause problems due to overactivity or underactivity. Sometimes these thyroid abnormalities can be triggered by pregnancy. If you are concerned that you may have thyroid problems please talk to us about your symptoms so we can discuss the tests required.

Osteoporosis is a common condition which is most likely to affect postmenopausal women. The bones become fragile and brittle making them more likely to fracture. Women with risk factors for osteoporosis (minimal trauma fractures, family history, steroid medications over a long period of time) should be investigated with a simple test for bone density.

Polycystic Ovarian Syndrome
PCOS is a condition which affects 12-18% of women. The symptoms include an irregular menstrual cycle, difficulty losing weight, acne, unwanted hair, difficulties with fertility, anxiety and depression. Each woman’s experience of PCOS may be different and you do not need to have all the symptoms listed to have a diagnosis of PCOS.
Diagnosis is made based on your discussion with your doctor plus blood tests and a pelvic ultrasound.
Once diagnosed, management will depend on age and other factors such as contraceptive needs, or the desire to conceive.
If you are concerned your period pattern is not regular, or you are having excessive difficulties with acne or weight, please see us so we can begin to investigate your situation.

Anxiety, Depression and Mood disorder
In women’s health, anxiety and depression need to be effectively managed. Some women experience quite significant mood disorders such as PMT or PMMD which fluctuate with the menstrual cycle or the introduction of hormones for contraception. Other women do not find this fluctuation, but still need effective counselling and management. Menopause is another time of increased risk for mood disturbance. Please see our doctors if you are finding problems and difficulties with mood. There are a range of management options available, including counselling, herbal medications and prescription medications.

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