When should I see a gynaecologist?
While there isn’t a clear-cut answer to this question, as every person is different, there are a few key recommendations to help guide you, which we will outline in this article.
In Australia, your first port of call should always be your General Practitioner (GP). We have an amazing network of skilled and knowledgeable GPs in our community, so our recommendation is always to see your GP first. If your regular GP is not particularly comfortable with gynaecological concerns, you can see one of Maven Centre’s Women’s Health GPs to manage your gynaecological issue, in conjunction with your regular GP.
After seeing your GP, they may decide that you require a referral to a gynaecologist for specialist advice. You will need to obtain a referral letter from your GP, so that you can access the Medicare rebate for your specialist visit. You can then book an appointment with the specialist of your choice.
Our team of specialists are always happy to see you, and discuss your concerns.
Below is a list of common gynaecological concerns, with advice around who to see and when to see them.
Understanding Common Gynaecological Conditions
How do I know if my periods are heavy? This question is commonly asked and the answer is: when your period is too heavy for you! Is the heaviness of your period impacting on your quality of life? Are you avoiding going out on certain days? Are you changing your sanitary wear frequently, for fear of an accident? Are you low in iron as a result of losing too much blood every month? Your period may have always been heavy, or your flow may have recently changed. If you feel your menstrual flow is impacting on your quality of life and keeping you from doing things that you would like to do, this is worth discussing with your care provider.
“Periods are meant to be painful!” is what we were all told for decades. Not so! Is the pain from your periods impacting your day-to-day life? Do you have to call in sick to work every month when you have your period?
Not all painful periods are endometriosis, and not all endometriosis is painful. But there is certainly more to this story. It’s important for your health care provider to know what you use for pain relief, if you get pain on days other than the days you bleed and if you get pain during sex or when opening your bowels.
Your answers to the questions above will help your clinician to determine if endometriosis is a possible cause of your pelvic pain. Endometriosis is a disease where cells that line the uterus are actually located outside the uterus. These cells are stimulated by our cyclical hormones to thicken and bleed. So these deposits also thicken and bleed, causing irritation and pain in the first instance, and scarring and adhesions of pelvic organs. This can impact on bowel function and fertility.
Not all painful periods are endometriosis, and not all endometriosis is painful. Endometriosis is complex, and different for all sufferers. If you have concerns that you may have endometriosis, seek the care of a gynaecologist to discuss your concerns further.
Too many or too few? How do you know? One or two periods a year, compared to two ‘periods’ every month. Opposite ends of the spectrum, but both can be concerning and may well impact on your life.
Polycystic ovarian syndrome (PCOS)
If you have irregular periods, this may be caused by PCOS – a metabolic and reproductive endocrine disorder. Your clinician can discuss this with you as a possible diagnosis.
Human Papilloma Virus (HPV) and cervical cancer
Abnormal cervical screening test results can cause a lot of worry. The cervical screening test involves testing for particular important strains of the HPV virus, that have been linked to cervical cellular changes in the first instance, and cancer if left untreated. There are very clear guidelines around management of cervical screening test abnormalities, and if you meet the criteria, you may require further investigation with a colposcopy (closer examination of the cervix by a gynaecologist), to guide ongoing management.
Using one form of contraception, but experiencing side-effects? Or just wanting to try something different? There are a number of long acting reversible contraceptive (LARC) options available which you can discuss with your care provider.
If your GP has found a cyst on your ovary on ultrasound, they may recommend you see a gynaecologist for advice. You may require blood tests or other imaging, and the cyst may need to be removed.
Fibroids are generally benign muscle overgrowths of the uterine muscle. Depending on their size and location, they can cause secondary issues such as heavy bleeding, subfertility, and / or pressure symptoms. Some fibroids can be managed medically (with tablets), while others require surgical removal. Consulting with a gynaecologist can help you to explore your options, and to choose between them.
Troublesome menopause symptoms
Not all people experience difficulty with the transition that is menopause, but some experience debilitating symptoms that warrant further discussion and a nuanced approach to care.
You may decide you are ready to conceive and wish to discuss this with a clinician to ensure your health – both general and reproductive – is optimal prior to trying. Our Womens Health GPs can help discuss what you should be aware of, and if you have complex medical issues that require more specialised care our gynaecologists can assist you.
If you’re younger than 35yo, and haven’t conceived naturally after one year of trying or if you’re 35 years of age of older, and haven’t conceived naturally after six months of trying you may need some investigations to figure out why. A general gynaecologist can be the first port of call here, and if any issues arise they can involve a fertility specialist.
Sexual health and wellness: STI screening and prevention, sexual dysfunction
Let’s talk about sex! We are happy to talk about all things sex without shame. Sexual function is an important part of gynaecological health. If you have concerns, don’t feel ashamed to voice them – we may be able to help.
When should I see a fertility specialist?
You should seek the advice of a fertility specialist if you and your GP or gynaecologist have concerns or more specialised questions about your fertility.
If you’re younger than 35yo, and haven’t conceived naturally after one year of trying or if you’re 35 years of age of older, and haven’t conceived naturally after six months of trying then a fertility specialist may need to be involved in your care.
If you have struggled with recurrent miscarriages (i.e. three miscarriages in a row), then further investigations need to be performed to find out if there is a reason why.
If you have a desire to pursue assisted reproductive techniques (e.g. in the setting of being single, or in a same-sex relationship) then a fertility specialist will help outline your options and facilitate the process.
When should I see a urogynaecologist?
Do you have a vaginal prolapse (i.e. bulging of pelvic organs such as the bladder and bowel down into the vagina)?
Not all vaginal prolapses require treatment. If you are troubled by symptoms such as a bulge in the vagina, trouble emptying your bowels or bladder due to prolapse, then you may need to seek further care. Conservative management (e.g. pelvic floor muscle exercises and / or a vaginal pessary) can be right for some women, while others may need a surgical approach.
If you have urinary incontinence (i.e. unintentional leakage of urine) a urogynaecologist can help. As with prolapse, there are both conservative, medical, and surgical management approaches for pelvic organ prolapse. Consulting with a urogynaecologist will guide which approach(es) are most appropriate for you.
What to expect when you see a Maven Centre clinician
All Maven Centre clinicians have a patient-centred approach. They will present you with your options, and allow you to make an informed decision about your body and your care. They may recommend that you see one of the other clinicians within the team, and occasionally even another specialist outside the team, to help you find the best care for you.
You may need to be examined as part of your consultation. You can request that the clinician stops at any time. We do not wish for the experience to be traumatic, and can certainly discuss obtaining the information that we would have gained from an examination, in other ways.
There is absolutely no need to wax or shave before your visit. Please do not feel the need to apologise for however you have maintained your garden (so to speak).
You can be assured that everything you discuss with your clinician will be confidential. Your referring GP will be provided with a summary of the consultation and details of the plan moving forward.
It’s natural to feel nervous about your appointment. You are welcome to bring a support person with you, to help you feel more comfortable.