Menopause / perimenopause
Menopause is when a woman has her last period. It happens when there is a change in the reproductive hormones and the ovaries no longer release eggs (ovulate).
Menopause may happen naturally (early 50’s), prematurely (before 40 years of age) or due to surgery/cancer treatment. Perimenopause is the stage where the ovaries are running out of eggs and may be a time when women begin to have symptoms.
Many women experience symptoms such as heavy and painful periods, vaginal dryness, mood changes, hot flushes, crawling skin and other troublesome symptoms.
Management and treatment of menopausal symptoms depends on each individual woman, their stage of life, relationships and general level of health and wellbeing. You do not need to suffer alone from peri/menopausal symptoms. There are many treatment options, including non hormonal, that can significantly improve quality of life.
This is also a good chance to take positive steps to prevent future health problems. Talk to your GP to take further steps.
Period pain (dysmenorrhoea)
Some women experience significant pain during their periods, which interferes with their normal activities. Some women have always had painful periods, but others may develop new pain. The pain can feel like cramping or pelvic heaviness, as well as low back, stomach or thigh pain. Some women also have nausea, vomiting or loose bowels.
Period pain may be caused by contractions of the uterine muscles, or pain from endometriosis and/or adenomyosis.
So what is ‘normal’ period pain? Period pain is considered normal if the pain is only there on the first 1-2 days of your period, goes away with simple pain relief, and doesn’t interfere with your normal activities. Don’t suffer with painful periods – if your pain is not normal, see your GP to discuss how we can help you with your painful periods – there are many ways we can help.
Heavy periods (menorrhagia)
Heavy periods are common, affecting one in five women, and are most common in women aged 30-50 years.
Everyone’s ‘normal’ is different, so how do you know if your periods are heavy?
- Do you bleed or flood through your pad/tampon?
- Do you need to change a pad/tampon hourly or less?
- Do you need to get up overnight to change?
- Do you pass clots bigger than a 50c coin?
- Does your period last more than a week?
- Do your periods control your life? Do they stop you from leaving the house, doing your usual activities or are they causing you anxiety?
If you have heavy periods, book in with your GP to discuss your situation. There are many ways we can help.
Medical Termination of Pregnancy (MTOP)
Women at all stages of life may find themselves faced with having to make the difficult decision to terminate a pregnancy. Doctors at Pear Tree provide a supportive, compassionate and confidential space to discuss and assess the available options to you. Your GP can help you decide the right path forwards, depending on your preferences and the stage of your pregnancy.
With recent changes in legislation, most of the doctors at Pear Tree are able to offer a medical termination of pregnancy, where appropriate. Medical termination of pregnancy is a safe and effective way of ending a pregnancy up to 9 weeks (63 days gestation), by using medication rather than surgery.
MS-2 Step process
A decision to have a termination is your own health care decision to make. The doctors at Pear Tree Family Practice provide a safe, supportive, compassionate, and confidential environment to assess and discuss all your available options. We can help you to decide the right steps for you depending on your situation. You need to be less than 9 weeks pregnant for a medical termination. If you are more than 9 weeks pregnant, please contact the Pregnancy Advisory Centre on 08 7117 8999 to discuss other options. You may also discuss this with your doctor.
A medical termination is a safe and effective method of terminating a pregnancy.
To be eligible for a medical termination you must be less than 9 weeks pregnant.
The process will involve 3 long appointments at Pear Tree Family Practice:
- The first appointment will be to discuss your history and determine if you are suitable for a medical termination. You will arrange an ultrasound to confirm the dates of the pregnancy and exclude an ectopic pregnancy.
- The second appointment is booked a week after your first appointment. If you are already close to 9 weeks, we can arrange to have this appointment earlier. Please discuss this with reception and your doctor. At this second appointment, you will be given scripts for the necessary medications. These medications will be taken at home and your doctor will advise how and when to take these.
- Your third and final appointment will be three weeks later. In this appointment your doctor will check that everything is okay and discuss contraception options with you.
These appointments will NOT be bulk-billed and will incur a Medicare-rebateable fee. These appointments will cost $186. If you are eligible for medicare your expected out-of-pocket expense will be $97.05.
There is a nursing fee of $30 non rebatable from medicare.
Ultrasound costs will vary depending on where you have your scan. For further information please contact your radiology provider. Options include;
Benson Radiology Ph 08 8177 9500
Jones Radiology Ph 1300 435 566
If you do not have medicare there will be a fee for the hormone blood tests. This will be on the first day you start the MS-2 medication and again 1 week later. This is in addition to any previous blood tests. Further hormone levels may be required if there are signs of retained products. For more information please contact Australian Clinical Labs on 8205 5666
The cost of the MS-2 Medication is approximately $30, or the concessional PBS price if you have a concession card. If you do not have medicare the cost is $360 approximately.
The following doctors are registered MS-2 Step prescribers: Dr Brett Goodsall, Dr Ingrid Jourdan-Astier, Dr Kristy Palmer, Dr Emily Kilner, Dr Niamh Devlin and Dr Kristin McLaughlin. These doctors will be able to support you through the process of your medical termination.
For more information, please see here for more information on this process
Please book these appointments online or via the AMS connect App by choosing the Medical Termination appointment type. Please call reception on 08 7228 5818 if you are unable to book online or if you prefer to speak to our reception staff to book your appointments.
- Where possible, it is recommended you have an appointment with your GP 3-6 months before planning a pregnancy.
- Optimising your health increases your chances of a healthy pregnancy. Your GP will ensure any health issues are well managed, that any medications/supplements are pregnancy safe and check that your vaccinations are up to date.
- Smoking cigarettes, excessive alcohol and other drugs may affect fertility of both partners. Smoking and drinking alcohol and using drugs is not recommended in pregnancy. If you and/or your partner require help to quit, your GP can help you.
- Both folic acid and iodine are required for the development of your baby’s brain and nervous system. To ensure adequate levels we recommend, where possible, starting supplementation at least three months before trying to conceive. Your GP can advise the right supplements for your situation.
- Women and their partners may be carriers of serious genetic conditions, eg. Cystic Fibrosis. If both partners are carriers of the same genetic disorder, they have a 25% chance of having a child with that health condition. Couples may choose to undertake screening to find out if they both carry these genes. Your GP can discuss your situation and arrange carrier screening if you wish (fees may apply to testing).
- Once you are ready to get pregnant, it can be frustrating to not be pregnant straight away. Check in with your GP if you are aged under 35 years and you aren’t pregnant after 12 months of trying, if you are 35 years or older after 6 months, or earlier if you have concerns about your fertility.
Cervical screening (previously known as a PAP smear) can be a bit awkward, but it is an important screening test to identify those at risk of cervical cancer.
Almost all cervical cancer is caused by the HPV virus. HPV is a very common virus, with 4 in 5 Australians having had HPV at some time in their lives. HPV is spread through skin to skin contact. HPV usually has no symptoms, and for most people, will go away on its own. We now vaccinate young people against the HPV strains that are more likely to cause cervical cancer.
If you have a cervix and are aged 25 to 74 years of age, it is recommended you have a cervical screening test every five years (if your results are normal). If you can’t remember when your last test was, ask your GP to check the cervical screening register at your next appointment.
Your GP can undertake a cervical screening test, or if you prefer, you may now self-collect your test. Self collection is not recommended if you have symptoms of cervical cancer, or have unusual pain, bleeding or discharge. Have a chat with your GP to work out what is right for you.
Frequently Asked Questions
Yes! Painful periods can be common for day 1-2 of your period but this doesn’t mean there are not options to lessen/remove the pain. For some women a heat pack and anti-inflammatories can help. Other women benefit from the use of a contraceptive pill or Intra Uterine Decide which makes their periods lighter and less painful.
Endometriosis is a common conditions affecting many women that can cause pain with your periods but also at other times of your cycle. You may also have pain using your bowels or doing a wee. Women with endometriosis often have migraines and irritable bowel as well. There are a lot of strategies that can help reduce the impact that endometriosis has. Please book an appointment with a GP who has a special interest in women’s health so that they can assess your symptoms, provide a diagnosis and treatment options.
No! Unless you want to fall pregnant. There is no need to give your body a break from the contraceptive pill. If you are getting symptoms from your contraceptive pill please continue taking it and book with your GP to discuss alternative forms of contraception.