Women’s Health
Dr Holland aims to give women the clearest advice around women’s health issues to help them to understand their health and the options and choices available to them in their treatment.
Services
Dr Holland treats conditions that affect the reproductive system of female patients. Providing compassionate and wholistic care, Dr Matthew has a special interest in fertility and pregnancy care. Dr Holland performs gynaecology surgery at Newcastle Private Hospital for private patients who are covered by their health fund or who choose to self-fund. Some procedures can be performed in rooms.
Screening
Dr Holland can help you take the next step in healthcare if your cervical smear returns HPV positive.
Contraception and Hormone Treatment
Giving you the ability to have the family planning and lifestyle outcome that you want.
Wellbeing
Good sexual and reproductive health is important for women’s general health and wellbeing. It is central to their ability to make choices and decisions about their lives, including when, or whether, to consider having children.
Different life stages are associated with specific women’s sexual and reproductive health issues, including menstruation, fertility, cervical screening, contraception, pregnancy, sexually transmissible infections, chronic health problems (such as endometriosis and polycystic ovary syndrome) and menopause.
Cervical Screen - In Room Procedure
The Pap smear has been replaced by a new cervical screening test to detect the human papilloma virus (HPV). The Pap smear used to look for cell changes in the cervix, but the new test looks for HPV which can lead to those changes. The test is known simply as the cervical screening test.
Colposcopy – In Room Procedure
A colposcopy is a minor procedure in which a special microscope is used to examine the surface of the cervix for abnormalities. During a colposcopy, a small amount of tissue might be removed and sent to a laboratory for testing, this is called a cervical biopsy. This is almost always done in Dr Holland’s private rooms.
Cervical Biopsy – In Room Procedure
A cervical biopsy is a diagnostic procedure used to evaluate abnormal cervical tissue found during a Pap smear, where a small amount of tissue is removed and sent to the laboratory for testing.
Pipelle Biopsy - In Room Procedure
A pipelle endometrial biopsy is a short procedure to check the lining of your uterus for endometrial abnormalities. A thin, flexible, hollow tube called a Pipelle will be slipped through your cervix and a sample is taken with gentle suction.
Hysteroscopy – Hospital Procedure
A hysteroscopy is a procedure that uses a small camera to look inside the uterus, or womb. It is used to diagnose or treat problems with the uterus. You might need a hysteroscopy to investigate problems such as heavy periods abnormal bleeding or infertility. Some conditions of the uterus can be treated during hysteroscopy.
Laparoscopy – Hospital Procedure
A laparoscopy is a type of keyhole surgery used to inspect and operate on the organs inside the abdominal (belly) and pelvic area. Laparoscopy can be used for diagnosis, by viewing the internal organs or taking a tissue sample (biopsy). It may also be used to treat a problem surgically at the same time
Endometrial Ablation – Hospital Procedure
Endometrial ablation is a procedure in which the uterine lining is destroyed either with a laser electrosurgery, or another method. Often a Novasure is used. The Novasure treatment utilises unique patented technology to deliver customised ablation to each patient. The device is inserted through the cervix to the uterus and emits precisely measured radio-frequency energy to safely remove the endometrium, the uterine lining that sheds during a period.
Endometrial Biopsy – Hospital Procedure
Endometrial biopsy is a diagnostic test performed in a doctor’s office. The test is used to acquire a small tissue sample of the endometrium (lining of the uterus) for further examination.
Polypectomy – Hospital Procedure
A polypectomy is the surgical removal of a uterine or cervical poylp, an abnormal growth of tissue in the mucus membrane.
LLETZ – Hospital OR Rooms Procedure
The LLETZ procedure is a common way of treating pre-cancerous changes to the cervix. The procedure using a small, heated wire loop to remove abnormal tissue from the cervix. This can be done in hospital under general anaesthetic or in Dr Holland’s rooms.
D&C – Hospital Procedure
Dilatation and curettage (‘D&C’) is an operation to scrape away tissue from the inside of the womb (uterus). It’s used to diagnose and treat many conditions, including abnormal bleeding, and after a miscarriage.
Diathermy of the cervix – Hospital Procedure
Diathermy treatment of the cervix involves removing the top layer of delicate cells from the cervix using a heated ball tipped probe.
Oophorectomy – Hospital Procedure
An oophorectomy is an operation to remove one of or both of your ovaries. The fallopian tube connected to your ovary is usually removed at the same time.
Hysterectomy – Hospital Procedure
There are different types of hysterectomy. In a total hysterectomy, the cervix (the lower part of the uterus near the vagina) is also removed. In a subtotal hysterectomy, the uterus is removed without the cervix.
Prolapsed uterus repair – Hospital Procedure
Prolapsed uterus (also called uterine prolapse or pelvic organ prolapse) is when the uterus drops down towards the vaginal opening. It may protrude outside of the vagina.
The treatment suggested will depend on the type and extent of the prolapse. Whatever the course of action, it is important that you do something about the prolapse or your symptoms are likely to get worse.
In some women, strengthening the pelvic floor muscles and changing their daily activities may be all that is needed. You may be recommended to see a pelvic floor physiotherapist or a continence nurse to help with this.
Some women may be offered a ring pessary, which is a small disc put high in the vagina as a support.
In severe cases, women will be advised to have surgery to repair weakened tissues, insert synthetic mesh to replace damaged tissues, or remove the uterus entirely (hysterectomy).
There are many different forms of contraception and many things to consider when choosing which method of birth control is right for you. Talking to your partner and your GP about family planning, general health and consideration of future pregnancies are the best place to start. Dr Holland is an experienced gynaecologist who offers implanted and surgical contraceptive options to align with your reproductive and lifestyle goals.
Mirena – Inserted during a consult or in hospital
The Mirena is a hormonal, progestogen-only IUD, reversible contraceptive device that is effective for up to 5 years. The Mirena can also be used as a treatment for heavy bleeding during your period. The device is placed in your uterus by Dr Holland during your appointment.
Kyleena – Inserted during a consult or in hospital
Like the Mirena, the Kyleena is a hormonal, progestogen-only IUD, reversible contraceptive device that is effective for up to 5 years. The device is placed in your uterus by Dr Holland during your appointment.
Implanon – Inserted during your consult
An Implanon is a hormonal, reversible contraceptive that is inserted under the skin inside your arm. The implant is 4cm long, made of plastic and is effective for up to 3 years. Implanon continuously releases small amounts of a hormone, etonogestrel, that prevents pregnancy. Etonogestrel is a progestogen hormone. The device is inserted into your arm by Dr Holland during your appointment.
Copper IUD – Inserted during a consult or in hospital
The copper IUD is a reversible contraceptive, it is made of copper and plastic, and does not release a hormone. There are 2 copper IUDs available in Australia. Multiload lasts for up to 5 years and the Copper T (or TT380R) lasts for up to 10 years. The device is placed in your uterus by Dr Holland during your appointment.
Tubal Ligation – Hospital procedure
Tubal ligation is a procedure to block or cut the fallopian tubes. It is a permanent form of female contraception. If you have a tubal ligation, your fallopian tubes will be clipped, cut and tied, or sealed shut. This will prevent any eggs from travelling from your ovaries into your uterus where they can become fertilised. Dr Holland performs this procedure at Newcastle Private Hospital.
Contraception after a baby
It’s possible to become pregnant again very soon after the birth of a baby, even if you’re breastfeeding and even if your periods haven’t returned. You ovulate (release an egg) about two weeks before your period arrives, so your fertility may have returned before you realise it.
It’s important to sort out contraception from the start. If you had your baby in hospital, you should discuss contraception with your doctor or midwife before going home. You’ll also be asked about contraception at your six-week postnatal check, but you can discuss it at any time with your midwife, doctor or local family planning/sexual health clinic.
You can use male and female condoms as soon as you feel ready to have sex. The combined pill, progestogen-only pill and contraceptive implants can be used from 21 days after the birth. However, the combined pill is not recommended if you are breastfeeding, as it can affect your milk supply.
You can usually have a contraceptive injection or start using a diaphragm or cap around six weeks after giving birth. If you used a diaphragm or cap before becoming pregnant, see your doctor or family planning/sexual health clinic after the birth to ensure that it still fits correctly, as childbirth and other factors such as weight loss/gain can have a significant effect. An IUD or IUS can usually be fitted 6-8 weeks after giving birth.
Reproductive health is an important part of a person’s overall physical, mental and emotional health and wellbeing, as well as quality of life. Good reproductive health enables people to have children if and when they choose to. Dr Holland provides health care aimed towards a healthy and satisfying experience, giving you advise and treatment to enable you to have a safe and satisfying sex life, the ability and freedom to have children, if, when and how often you choose and following on with healthy pregnancy, safe delivery and happy, healthy baby.
Menstruation
Your menstrual bleeding, or ‘period’ usually comes between 21 and 35 days apart and is controlled by hormones that prepare your body to fall pregnant.
Menstruation is different for each person, most women bleed for 3 to 7 days. Bleeding can be light or heavy and the blood can range from bright red to dark brown, you might also see some clots.
Problems with periods that Dr Holland can assist you with include heavy bleeding, severe period pain, irregular periods, not getting your period and bleeding between periods.
Ovarian Cysts
An ovarian cyst is a fluid-filled sac that forms in your ovary. They are common, and almost every female will have one at some stage. Most are not cancerous. There are several types of cysts; endometrioma, dermoid cyst, cystadenoma, hydrosalpinx and ovarian cancers are just a few. Cysts can be very painful and are most often detected via a pelvic ultrasound.
Bartholin’s Cyst
A Bartholin’s cyst can develop if the ducts of glands at the entrance of the vagina become blocked.
Bartholin’s glands are found on each side of the vaginal opening and produce the fluid that helps lubricate the vagina. Sometimes the glands become blocked, and the fluid builds up to cause a cyst. If the fluid becomes infected, it will form pus and become a Bartholin’s abscess.
The cyst or abscess usually forms on one side of the vaginal opening.
Uterine Fibroids
A uterine fibroid is a non-cancerous tumour that grows in and around the womb (uterus). It is also known as a myoma.
Uterine fibroids develop from the muscle tissue of the uterus. They may also grow in the fallopian tubes, cervix, or tissues near the uterus.
Uterine fibroids are usually found during a gynaecological examination, pelvic ultrasound or during surgery for other conditions.
Sexual Health
If you are sexually active, it is important that you maintain your sexual and cervical health. Regular check-ups and cervical screening will help you stay healthy.
Occasionally, medical conditions can cause difficulty in achieving a satisfying sex life. The following summaries contain information on causes of sexual dysfunction and other issues that can affect your sexual enjoyment.
Atrophic Vaginitis: Is an inflammation or irritation of the vagina caused by the thinning of the vaginal lining and by a decrease in lubricating secretions of the vagina.
Inhibited Sexual Desire: Also called hypoactive sexual desire, sexual apathy, and sexual aversion. A lack of interest or aversion to sex that may have either physical or emotional causes.
Painful Intercourse: Is also known as dyspareunia. Causes of painful intercourse range from simple problems that are easy to treat, to more complex problems that may require extensive testing and treatment.
General sexual Dysfunction: Causes of sexual dysfunction involve emotions that inhibit appropriate responses, and often involve both physical and psychological issues.
Vaginal Dryness: A decrease in female hormone levels, or estrogen, brought about by a variety of reasons, is the primary cause of vaginal dryness. Vaginal dryness affects more than 25 million women at one time or another.
Early Menopause
Menopause before the age of 45 is called ‘early menopause’ and before the age of 40 is called ‘premature menopause’. Some medical conditions such as autoimmune diseases and genetic conditions can cause premature and early menopause, sometimes when a women is in her 20s or even during childhood. This is known as ‘premature ovarian failure’.
Menopause
Menopause is a natural occurrence in women where their body ceases to produce the female hormones oestrogen and progesterone, this marks the end of a women’s fertility and reproductive years. As you approach menopause the production of hormones from your ovaries begins to slow down, this may cause you periods to become irregular, your cycle to become irregular and your periods lighter or even heavier. Once a woman has not had a period for 12 months, they have completed menopause. The average age a women experiences menopause is 51, most women reach menopause between 45 and 55 years of age.
Although fertility after 45 years is very low it is still possible to fall pregnant during menopause, if you do not wish to fall pregnant during this time it is advisable to use contraception.
Dr Matthew Holland, Fertility Specialist, Obstetrician and Gynaecologist