Obstetrics and gynaecology

Dr Linda Calabresi
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Dr Terri Foran
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In this Product Explainer, Dr Terri Foran, a Sexual Health Physician and Lecturer at the School of Women’s and Children’s Health, UNSW explains a levonorgestrel IUD; compares it and describes its potential role as another contraceptive option available in Australia. (7 mins)

Expert/s: Dr Terri Foran
Prof Rod Baber
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In this Product Explainer, Professor Rod Baber, a Clinical Professor of Obstetrics and Gynaecology at The University of Sydney discusses why estradiol gel should be used, how it is administered and when it should be prescribed and used (4 mins).

Expert/s: Prof Rod Baber
Dr Katrina Moss
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One-fifth of Australian women still don’t receive mental health checks both before and after the birth of their baby, our research has found. Although access to recommended perinatal mental health screening has more than tripled since 2000, thanks largely to government investment in perinatal mental health, our surveys show there is still some way to go before every mum gets the mental health screening needed.

Dr Karen Magraith
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It is said that nothing is certain but death and taxes. For women, provided they live long enough, another certainty is menopause. Most women have their final menstrual period between the ages of 45 and 55, though there are women with early menopause who have unique needs.

Dr Linda Calabresi
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Vaginismus is a surprisingly common condition, but women often fail to seek help because of embarrassment and sometimes shame, says sex and relationship expert Dr Rosie King, and the distress it causes should not be underestimated.

Prof Jane Tomnay
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Around one in six Australian women have had an abortion by their mid-30s. These women come from all age groups and demographics: some are mothers already, while others are child-free; some are partnered, others are single. Abortion was removed from the New South Wales Crimes Act in October and is now legal in all Australian states and territories, under certain circumstances. However, many women have difficulties accessing these services, especially in rural and regional areas. This needs to change.

Dr Linda Calabresi
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The majority of babies born prematurely will make it to adulthood without any major health issues, according to new research. In an extensive Scandinavian cohort study, researchers found there was a high prevalence of survival without any major comorbidities among those born prematurely, even though preterm births are known to be associated with cardiometabolic, respiratory and neuropsychiatric disorders in adulthood. There was an exception however. Outcomes were worse for those born extremely preterm (22-27 weeks). The study is important, say its authors, as most previous research has concentrated on the negative consequences of the baby not making it to term.

Kassia Beetham
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Expectant mothers receive an avalanche of information about potential risks to their baby. There’s a growing list of foods, toxins and environmental threats to avoid. It’s normal for this to lead to an increased level of anxiety. As a result, some women believe it’s safer to avoid any risks in pregnancy, no matter how small. Vigorous exercise may be considered one of these risks. But we’ve recently reviewed the research and found vigorous exercise is safe during pregnancy, including in the third trimester. And not only is it safe; it’s healthy, too.

Expert/s: Kassia Beetham
Dr Linda Calabresi
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Hormone replacement therapy has recently hit the headlines again and not in a good way. A research paper published in The Lancet reignited the controversy by again highlighting an association between hormone therapy and breast cancer. While the experts have been quick in their response, pointing out the numerous limitations of the study and the researchers’ conclusions, it is still more than likely GPs will again be grilled about the latest evidence with regard to this treatment. It’s an area of medicine that certainly has been heavily scrutinised over the past couple of decades and as such it is important GPs have ready access to the latest guidelines to best practice. Here is a great little resource that fits the bill perfectly.

Dr Linda Calabresi
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This is one of those resources you will wish you would have discovered earlier. Maternity Matters (https://maternity-matters.com.au/) is a website developed and largely authored by well-known Brisbane GP Dr Wendy Burton. As the name suggests it is reservoir of information related to pregnancy and is aimed chiefly at the general public but also provides a healthy serving of support materials for Australian health professionals as well. Dr Burton who is Chair of the Antenatal/Postnatal Specific Interest Group for the Royal Australian College of General Practitioners has compiled articles, interviews and links to important guidelines and similar reference materials on this site, that cover everything from pre-conception checklists to the post-natal issues such as vaccinations and return to exercise. This website is strongly based on evidence but is also very practical, addressing many of the more controversial and topical issues currently confronting the pregnant woman such as tongue-tie in infants and children’s risk of allergy. All the information is current and very Australian, with contributions from some very well-respected experts. As Dr Burton points out there is a lot of information out there on pregnancy and infant health - some of it very good, but, let’s face it, there’s a lot of dodgy stuff too – leaving women often confused and unnecessarily anxious. Asking patients not to Google is unlikely to be all that effective, but if patients can be directed to an authoritative, comprehensive site such as Maternity Matters you can feel confident that the information they receive will be reasonable and largely in keeping with what you, the qualified GP, would have said – if you were available at 3am when the patient was awake and seeking answers. Access the resource here

Dr Linda Calabresi
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Female patients who present with vulval pain or itch have usually put up with symptoms for some time before coming to the doctor. When it comes to this area of the female anatomy there is still a lot of ignorance and embarrassment in the world outside our surgeries. And while it is true you can find the answer to almost any question on the net, for these particular problems there’s a lot of dodgy information out there. So here’s an information source you can trust and recommend. Care down there (www.caredownthere.com.au) is a consumer-directed website written by respected health professionals that provides accurate, up-to-date and practical information and advice about all things vulval. From herpes to vulval sclerosis, the site covers the broad range of conditions that can affect women as well as providing some fundamental education about how to distinguish between normal anatomy and physiology and something going awry. The site was founded by Dr Gayle Fischer and Dr Jennifer Bradford who are well-known, well-respected members of the Australasian College of Dermatologists and the Royal Australian and the New Zealand College of Obstetricians and Gynaecologists. The content has been developed by a group of Australian health professionals with an interest and experience in vulval problems including dermatologists, gynaecologists, a pain management specialist, a sexual health physician, a psychologist and a pelvic floor physiotherapist. It is sponsored by Epiderm but exists as an independent resource. If you’re wanting to direct your female patients to a resource that is both comprehensive and authoritative, this really does fit the bill.   >> Access the resource here