Abnormal uterine bleeding risk factors

Oxford Women’s Health Gynaecologist Michael East recently delivered a presentation to General Practitioners about abnormal uterine bleeding. Here's some of the key information that was shared.

·      Learn more about what’s normal when it comes to periods. Bleeding should occur about every 28 days and be completed within 3-8 days, and it shouldn’t be a distressing amount. If you are experiencing blood clotting and having to change protection more than two hourly, it is a sign that your periods are heavy and may require further investigation.

·     There are many possible causes of abnormal uterine bleeding that need to be considered by your General Practitioner. These include pregnancy, malignancy, endocrine conditions, infection, trauma, and anatomical issues such as fibroids and polyps. In women older than 40, it can also simply be part of hormonal changes leading up to menopause, so seek advice from your GP if you notice any changes.

·     Ninety per cent of women diagnosed with endometrial cancer will be older than 50 and will be at more risk if they weigh more than 90kg. Māori and Pasifika women with a high BMI are at significantly greater risk of uterine cancers in their late 30s and 40s.

·      Maintaining a healthy weight is important for all aspects of health. Being significantly overweight will not just contribute to a greater risk of heart disease, endometrial cancer, and joint replacements, it skews everything.
 

Gynaecologist Michael East

·     Investigations for abnormal uterine bleeding can include a vaginal examination; a smear test; checks for pregnancy, ferritin levels, and thyroid function; an ultrasound; biopsy; and a hysteroscopy, which will involve checking for polyps, fibroids, abnormal vessels, and possibly taking a tissue sample.

·      Depending on the results, the issue may be treated medically and/or surgically. Once other major gynaecological issues have been discounted, one of the best pharmacological treatments available for heavy bleeding is the Mirena device, which delivers progesterone directly to the uterus and suppresses the growth of the lining after each period.

It has been extraordinarily effective in reducing the impact of heavy periods and has revolutionised gynaecology.

Lumps, lesions and unusual conditions

Oxford Women’s Health Gynaecologist and Obstetrician Janene Brown also gave a presentation recently about vulval lumps and lesions. Below we highlight some of the takeaway points from her talk.

·      If you notice vulval or vaginal itching, burning or pain, don’t assume it is thrush, discuss your symptoms with your General Practitioner. The skin in this area can be affected by a wide range of conditions, including viral, bacterial and fungal issues, cysts, inflammation, cancers, vaginal atrophy, herpes, and ulcers.

·      It is important to remember that after menopause, women are unlikely to have thrush.

·      There are four main conditions that will cause the vulval/vaginal area to itch or burn. These include dermatitis, folliculitis and ingrown hair, Lichen sclerosus/Lichen planus and thrush.
All are highly manageable, as long as a tailored approach is taken to treating them. Lumps and bumps that are entirely normal and require no extra treatment include Fordyce spots, warts, seborrhoeic keratosis, haemangioma (often in babies), and angiokeratoma.

·      Cysts and lumps are common but can quickly become quite large, and 
 

Gynaecologist and Obstetrician Janene Brown 

very painful, so your GP may burst or lance them and take a biopsy.

·      Some cysts also recur and may require surgery to remove them.

·      Malignant vulval cancers are rare. Benign melanosis, which presents no risk of melanoma, makes up 70 per cent of all common pigmented vulval lesions in adult women.

If you would like to discuss any of the issues discussed in Mike and Janene's presentations, call the Oxford Women’s Health team on 03 379 0555.
 

The benefits of talk therapy

Working with a therapist is an active process that needs to be well structured, so people make progress from their sessions, says Oxford Women’s Health Clinical Psychologist, Inga Forman.

Trained in applying Cognitive-Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), Schema Therapy, and mindfulness-based approaches, Inga specialises in working alongside adolescents and adults experiencing pain, trauma, depression, eating issues, and anxiety.

“I aim to take a compassionate approach in my work but also make sure the work is quite structured, and it has to be, so people start to see results,” she says. “Therapy is important because it can support people to live well, have fulfilling lives, and address barriers to pursuing what they want to do in life.”

Inga has recently moved to Christchurch from Tauranga with her family. Following her clinical training, she provided individual and group treatment sessions in prisons and in the community. She also established her own private practice.

Inga is delighted to be based at Oxford Women’s Health on Tuesdays and Thursdays. In her current work, Inga is noticing the mental health effects of
 

Clinical Psychologist Inga Forman

the pandemic.

“Some people have been really struggling with all the changes it has brought,” she says. “Many young people are feeling like they have the weight of the world on their shoulders and are accessing support.”

“The way I practise is very open, supportive, and non-judgemental. I have plenty of experience working with adolescents and adults and enjoy providing therapy to help them navigate through a difficult time.”

To make an appointment to see Inga, please call the friendly Oxford Women’s Health team on 03 379 0555.
 

Meet our new physiotherapist, Rowan

We are thrilled to welcome Physiotherapist Rowan Parsons to the Oxford Women’s Health team.

Rowan is a physiotherapist with a special interest in supporting women of all ages living with pelvic health conditions.

She has worked in private practice, at a Reformer Pilates-based clinic, at a multidisciplinary sports clinic, and with the Tactix netball team and its development squad.

After she developed a special interest in women’s and pelvic health physiotherapy, she did further study to receive a Post-Graduate Certificate in Clinical Physiotherapy – Continence and Pelvic Health, at Perth’s Curtin University. She is passionate about working with women
 

Physiotherapist Rowan Parsons

with all types of pelvic health conditions, to empower them with information and the tools to help them return to activity, improve function, and boost their overall quality of life.

Centre of Medical Excellence opens in Queenstown

We officially “opened” our new consulting rooms at the Queenstown Centre of Medical Excellence in Kawarau Park with a GP event on Monday 28 November. 

Gynaecologists Janene Brown, Ben Sharp and Olivia Smart are available for appointments at our new Queenstown location.

You will find the Oxford Women’s Health clinic in unit G, opposite the new Southern Cross Hospital on the Frankton side of Queenstown.
 

The official opening was a great opportunity for presenters Dr Janene Brown (OWH) and Dr Sharon English (Urology Associates) to meet local GP colleagues and discuss commonly presented gynaecological and urological conditions.

Pelvic Pain Multidisciplinary Team

This year, Oxford Women’s Health was delighted to introduce a Pelvic Pain Multidisciplinary Team (MDT) to further enhance our services for New Zealand women.

This means we are one of very few private clinics in the country with the expertise and capacity to support people with complex health issues.

The MDT includes Oxford Women’s Health gynaecologists, physiotherapists, dietitians, psychologists, and nurses who meet once a month to consider patients who have consented for their cases to be discussed.
 

General Manager Catherine France says multidisciplinary teams deliver a cohesive model of care by looking at all aspects of the person and developing a treatment plan.

"We know our General Practitioner and specialist colleagues value our patient care model and I’m delighted that we have taken it a step further with the creation of a formal, dedicated team with clinicians from such a wide range of disciplines,” she says.

"We are also responding to the Ministry of Health Guidelines for Endometriosis, where a regular multi-disciplinary meeting is the recommended best practice approach for patients with complex health needs.”

The New Zealand Menopause Survey

Bay of Plenty General Practitioner, Dr Linda Dear, has developed a survey to learn more about New Zealand women living with perimenopause and menopause.

She is aiming to raise awareness and improve support for women in Aotearoa, saying: “I have seen so many people struggling…it’s time to give those people a voice”.

We encourage you to take part in the
 

New Zealand Menopause Survey by visiting www.menosurvey.com

Responses will be anonymised. Overall results will be shared with the public via the media, and the health, employment, and education sectors.

Merry Christmas, from Oxford Women's Health

The Oxford Women’s Health team wish you a very happy Christmas and New Year.

We hope you and your families have a wonderful holiday, and we look forward to seeing you again in 2023.

Oxford Women’s Health will close for
 

the Christmas break at 12.30pm on Friday 23 December. We will be back to start the New Year at 8am on Monday 9 January.