Specialised primary care service based in Chatswood, Sydney. Consulting doctors have extensive skills & knowledge in managing women with menopausal concerns and/or symptoms. There are many different options available including lifestyle modification, pharmacotherapy for specific symptoms, hormone replacement therapy or a complementary approach.
We are proud of our patient-centred holistic approach to women who do not need a referral to seek our services.
Gynaecare was a specialised women’s medical clinic based in Artarmon for 18 years. This clinic provided services to women at all starves of their reproductive life. In September 2013 we moved to Chatswood and rebranded to accommodate a range of new and innovative services. However care of perimenopausal and post-menopausal women remains a core specialty area for us.
Women of all ages are welcome to access the clinic. Alongside menopausal treatments & advice we also look after the reproductive and sexual health and wellbeing of men and women of all ages. Most of our clients live in the greater Sydney region and Chatswood is very accessible by all forms of transport but we also offer tele-health consultations to clients in more remote areas of New South Wales and Australia who find it difficult to travel.
Many GPs are knowledgeable and have skills in management of menopause. However womens’ reproductive health is a sub-specialty area and only by providing care to a wide range of patients over many years can the necessary skills be acquired collectively to confidently and proficiently manage women at this time in their lives.
Not all GPs are interested in this clinical area but you can be sure that any doctor you see at this clinic will have extensive experience and insight into womens’ health and especially menopause and perimenopause.
Menopausal Signs & Symptoms
Around the time of menopause a woman’s ovaries slow down and cease to produce oestrogen as they are no longer ovulating. The woman is no longer in her reproductive years. This gradual decline in ovarian production is responsible for many of the symptoms of perimenopause.
Hot flushes are caused by the declining levels of oestrogen affecting the thermostat in the brain – the hypothalamus. Hot flushes (vasomotor symptoms) can be described as a burning or overheating feeling which lasts for a few minutes and can occur repeatedly during the course of the day. Factors which worsen hot flushes are probably anxiety and alcohol – and they frequently disturb sleep.
Women frequently complain of reduced libido at the time of menopause and this is likely to be multi-factorial. Life events, physical fitness, emotional wellbeing can all contribute to sex drive and desire. Menopause have frequently been in log-standing relationships and there is a tendency for couples to make love less often the longer they’ve been in a relationship. However it is thought that libido is linked with testosterone levels and these do decrease at time of menopause. There are good studies suggesting there is an increased role for testosterone replacement in menopausal women who have reduced libido.
Simple water-based lubricants can frequently assist with relieving symptoms of vaginal dryness which can make sexual intercourse painful. Hormone replacement therapy alleviates a range of menopausal symptoms including vaginal dryness but cannot be used for women with a history of breast cancer. For worn who cannot or prefer not to use hormone replacement therapy there are topical vaginal oestrogens which can be used locally inside the vagina in the form of creams or pessaries. These are particularly useful in women who need to have a pap smear and who would find a speculum examination painful.
Mental health issues and mood disorders are common in menopausal women. They frequently have other life events that affect their mental and emotional wellbeing. Eg adolescent children, ageing parents, work stress. However it may be that hormone changes at the time of menopause may contribute to irritability and depression.
A consultation will typically last between 20-40 minutes and will include history-taking and a physical examination. Blood pressure measurement is a must as menopause is a time to review your cardiovascular risk factors. If you need a pap smear we can perform this (liquid based cytology available). We would always recommend regular breast self-examination but we can provide you with a breast check as well. Using a shared decision-making approach and taking into account your health beliefs, concerns, expectations and past medicine history, we will devise a management plan for you to help you get on with your life.
A typical consultation relating to menopause usually lasts between 20-45 minutes. Cost of consultations will therefore be $120-160.00 and Medicare rebates are available for women who hold Medicare cards. Additional services such as hormonal intra-uterine devices or endometrial biopsy will incur further costs and can be performed under sedation. Eg a hormonal intra-uterine device inserted (on a weekday) under IV sedation costs $550 ($255 refundable from Medicare). Review consultations tend to be shorter and therefore cost less – e.g. a 15-minute consultation will cost $80 ($44 out of pocket). Our fees are considerably less than those charged by a specialised gynaecologist performing the same service.
Consulting GPs who specialise in womens’ health and management of menopause and perimenopause are: Dr Kate Ilbery, Dr Judi Cornell, Dr Karen Osborne, Dr Julia Menzies and Dr Emma Boulton. We also have an in-house gynaecologist Dr Sarah Choi. Consultations are available 6 days per week (Mon-Sat).
Appointments are usually available within a few days of you ringing. You can call the clinic (02) 9411 3411 to make an appointment at a time that suits you or visit our contact us page to send us an email. Tele-health consultations are also available by appointment to NSW & Australia-wide clients.
What Investigations Should I Have?
Blood tests are of limited value when managing women with menopausal symptoms. Doctors commonly measure hormone levels but in reality treatment should be guided by symptoms rather than biochemical indices.
Blood tests which may be of value are: measurement of haemoglobin if a woman has had heavy periods for a long time; thyroid function if she has heavy periods or other symptoms of thyroid malfunction; FSH which is a brain hormone which becomes elevated after menopause has occurred.
Women who use bio-identical hormones (dispensed by a compounding chemist) frequently have their oestrogen and progesterone levels measured.
Women who are at risk of osteoporosis may benefit from undertaking a bone density scan prior to menopause or treatment. Bone density scans can reliably diagnose osteoporosis either before it becomes established or after the condition develops.
We would recommend that any menopausal woman has her cardiovascular risk assessed. Blood pressure, height, weight, smoking status and fasting lipids are basic requirements.
Breast cancer is on the rise and is more common in post-menopausal women. We would recommend all women undertake self-breast-examination every month or so. Partners are usually happy to help! A woman is the best person to detect changes in her own breasts and any new lump or other breast symptom should be checked by a doctor.