Welcome to our latest e-newsletter!
Our latest newsletter covers a wide range of stories and topics, including information about oncoplastic breast surgery, and embryologist Tanya Harris' thoughts on fertility. We also profile gynaecologist John Short and introduce our newest member to the Oxford Women's Health's team, Anna Fenton.
Welcome to Dr Anna Fenton
Gynaecological Endocrinologist Dr Anna Fenton has joined the Oxford Women’s Health team this month. Her reputation means that many patients and medical professionals will already be aware of the high calibre of her work in Canterbury and further afield.
Anna is available to provide treatment and advice relating to gynae – endocrinology including Polycystic Ovary Syndrome (PCOS) and menopause. She does not see patients in relation to thyroid or adrenal conditions or diabetes.
She says she is excited to join the Oxford Women’s Health team. “I have been impressed by the specialist expertise, outstanding facilities and absolute dedication to patients here.
Oxford Women’s Health is considered to be at the forefront of women’s health care in New Zealand, and I am very happy to be a part of that.”
Anna completed her medical degree at the University of Auckland School of Medicine, a PhD at the University of Melbourne, and post-doctoral research in San Francisco. She was involved in establishing the New Zealand branch of the Australasian Menopause Society and has served on the board of Osteoporosis New Zealand.
Anna is currently the clinical leader of the Canterbury District Health Board Bone Density Service. She is also actively involved in postgraduate teaching and public education.
Her special interests include the management of premature ovarian insufficiency and the treatment of women after gynaecological cancer.
Dr Anna Fenton
She was co-editor-in-chief of Climacteric, the journal of the International Menopause Society until 2017, and is a Past President of the Australasian Menopause Society. She serves on the Pharmacology and Therapeutics Advisory Committee Endocrine sub-committee and the International Menopause Society Ethics Committee.
Oxford Women's Health celebrates a decade of helping Southland women
The lives of thousands of Southland women have changed for the better thanks to a decade of specialist women’s health care provided by Oxford Women’s Health.
A decade ago, the decision for Christchurch-based Oxford Women’s Health to provide specialist care at the Southern Cross hospital in Invercargill, was driven by the number of Southlanders travelling the long distance to Christchurch for treatment.
Oxford Women’s Health became the only provider of private specialist women’s health care in Southland at that time.
At first, Oxford Women’s Health specialists travelled from Christchurch monthly, but increased demand for services now sees a weekly presence in Invercargill.
Oxford Women’s Health Director and Gynaecologist Simon Jones, who regularly provides care at the Southland clinic, says the increase in demand is partly the result of Southland women realising they can receive high quality specialist care without travelling further afield.
“Rural women are particularly grateful for the fact that we work around their schedules. We also provide consistent follow up and use the latest technology in our procedures” he says. “For example, 97 per cent of the hysterectomies we perform in Southland are done laparoscopically.”
A passion for possibilities
The phrase ‘many options’ is not one women seeking breast cancer treatment might be expecting but Oncoplastic Breast Surgeon Dr Josie Todd says it often.
Josie is responsible for bringing a number of oncoplastic breast surgery techniques, used overseas, to Christchurch. Working closely with the Oxford Women’s Health Team, in the community with GPs, and as a member of the Southern Cancer Network, she has seen and led many changes.
“Not so long ago, there was much less emphasis on talking to breast cancer patients about what they would wake up with after surgery. That has changed to helping women move past the initial fear of a diagnosis, so they can make informed decisions about a number of options. Oncoplastic breast surgery includes a huge range of techniques.”
It is best described as an individualised approach to treating breast cancer and providing reconstructive surgery, she says.
“We are a long way from a mastectomy and a prosthesis as the only option.”
UK research has revealed that 30% of women who have undergone a mastectomy experience depression, and 30% of women who have had a lumpectomy experience anxiety, she says.
Oncoplastic breast surgery eliminates the need to wait for reconstructive surgery following a lumpectomy or mastectomy. “Everything is done and dusted at the same time,” Josie says.
She is passionate about her work as she describes just a few of the techniques, including nipple-spacing mastectomy, and volume displacement or replacement in relation to lumpectomies.
Dr Josie Todd
Asking her patients, “Are you happy with your breasts?”, can start a conversation on tailoring treatment to an individual.
She could, for instance, recommend a lumpectomy and breast reduction which, as well as producing a better aesthetic outcome for a patient, might result in less radiotherapy.
Women are becoming increasingly aware that they can ask questions and seek a second opinion, she says.
One of the best jobs in the world
Dr Tanya Harris, the director of Genea Oxford Fertility’s Embryology Laboratory, says she has one of the best jobs in the world - helping dreams come true for people wanting a baby.
"It is also hugely varied as we look for solutions for such a wide variety of problems. With access to world-leading technology in the laboratory, I feel it is a unique privilege to watch embryos develop in the knowledge that some of them will become little people. At Genea Oxford Fertility our success rates are in the top quartile of all Australasian clinics.”
While Tanya and her team never tire of the excitement of a successful pregnancy from an implanted embryo, they also understand the mental and physical struggles faced by people with fertility issues.
In February this year, Statistics New Zealand reported that New Zealand’s total fertility rate in 2017 was down to 1.81 births per woman, its lowest recorded level. Couples experiencing infertility are not alone. About one in six women will experience fertility issues. The rates are similar for men, whose fertility typically drops with age.
Tanya encourages those wanting a family to try and conceive sooner rather than later.
Dr Tanya Harris
By age 36, the chance of a woman becoming pregnant each month has dropped by almost half, from the time that she was at her most fertile in her early 20s. This downward trend continues and by age 45, the average chance of getting pregnant each month is just 1%.
“These statistics can feel scary for people, but it is important to be aware of the reality,” Tanya says. “If people are struggling with fertility issues, they need to seek help and become as informed as possible. Anyone wanting us to assist them should first connect with one of our fertility nurses and start learning about the options that are available. What many people don’t realise is that there is every possibility they won’t need IVF. However, if it is needed, we will do everything we can, using the latest reproductive technology, to help them achieve a successful pregnancy.”
A conversation with John Short
Gynaecologist John Short’s expertise covers the spectrum of women’s health issues from menstrual pain and endometriosis to ovarian cysts and prolapse. His special interest is urogynaecology and he has recently been appointed chair of the UroGynaecological Society of Australasia (UGSA). In this month’s conversation he talks about when women with urinary incontinence should see a specialist and some of the most topical issues in urinary incontinence management.
What has been the impact of the mesh debate on urinary incontinence management?
Hospitals are now required to specifically credential all surgeons who wish to perform mid-urethral (mesh) slings to treat stress urinary incontinence. This requires surgeons to submit data about the numbers of surgeries they have performed, together with the outcomes and complications. They are also required to provide proof of robust consenting processes and participation in ongoing educational activities. A minimum number of 10 procedures annually is required. In theory, this should provide women with the confidence that their surgeon has the appropriate experience and expertise to perform the procedure, which is a very positive thing.
Mid-urethral slings remain the best evidence-based procedure for treating stress urinary incontinence and most of the alternative procedures have not been performed in high volumes for many years. In the last 15 years, 90 – 95 per cent of procedures have been mid-urethral slings and the vast majority of patients have had a good experience with them.
Have women been deterred from seeking help with urinary incontinence because of concerns about mesh?
I have noticed a dramatic decline in the number of women being seen and having surgery for stress urinary incontinence in the public system. Colleagues elsewhere in NZ and Australia report the same issue, so it is definitely possible that women have been scared-off by media reports. This is a great concern, as it means there are many women suffering unnecessarily. Incontinence affects one in three women who have had a baby and one in four people in the general population. If it is having a major impact on a woman’s lifestyle, such as not being able to exercise or participate in family or social activities, they should ask their GP to refer them to a specialist.
What can women do to avoid urinary incontinence?
Dr John Short
Pelvic floor exercises, maintaining a healthy weight and a generally healthy lifestyle can all help but urinary incontinence is not always a straight forward problem. It can be influenced by chronic conditions, medications and sometimes what people are eating and drinking. Often, women don’t know how to do pelvic floor exercises properly, so it can be really helpful for them to talk to a physiotherapist.
What do you do to maintain a healthy lifestyle in amongst your busy working life?
I love skiing and always get excited about the prospect of a new ski season. I am also looking forward to going to the Rugby World Cup in Japan later this year.
John Short works in Christchurch and Invercargill for Oxford Women’s Health and is also a consultant at Christchurch Women’s Hospital.
