Gynaecology

What is Endometriosis?

Endometriosis is a common condition whereby the lining of the uterus is found growing in places outside of the womb. Most commonly it exists within the pelvis overlying the bladder, around the ovaries, or between the bowel and cervix. On rare occasions however, it can be found in locations quite distant to the pelvis such as the diaphragm and even in caesarean section scars! It is known to affect a little over 1 in 10 women or those assigned female at birth and is associated with pelvic pain, heavy periods, pain with intercourse, pain with opening the bladder or bowels, and infertility.

How is it treated?

Whilst endometriosis can only be reliably diagnosed with surgery, management strategies for potential endometriosis can include medical and non-surgical therapies. Similarly, whilst it can be associated with infertility, pleasingly most women with endometriosis fall pregnant without medical assistance, or with the aid of surgery alone.

Dr Chris Arthur has extensive experience in laparoscopic surgery including the advanced laparoscopic procedures sometimes required to manage widespread and invasive disease. For many women however, surgery is not a preferred investigative and management option and Dr Arthur is similarly experienced in helping them to improve their pain with lifestyle and dietary modification, activity based therapies, hormone modulation and medical therapies.

What causes Pelvic Pain?

There are myriad causes for pelvic pain and in some instances we never figure out exactly what it is that is causing the pain. What we can do in every case though is exclude particular conditions and identify effective management strategies. Dr Arthur is experienced in the investigation and management of gynaecological causes for pelvic pain, surgically and medically.

What can I do about Heavy Menstrual Bleeding?

Heavy periods (menorrhagia) can greatly affect quality of life with significant emotional and social consequences in addition to the physical pain and loss of energy. It can result in physical embarrassment, avoidance of social events, avoidance of physical intimacy, tiredness and avoidance of exercise, and low iron. There are many lifestyle, medical and surgical management strategies for heavy menstrual bleeding and Dr Arthur will discuss these with you in order to figure out the best strategy for you and your particular circumstance.

Are Fibroids common?

Fibroids are benign growths within the uterus. They are exceptionally common and up to 50% of 40-year-old women and 70% of 50 year old women will have fibroids able to be demonstrated on ultrasound. These are very, very commonly completely asymptomatic, causing no concern whatsoever. However, for some they can be associated with infertility, heavy periods or mass effect on other organs, such as a need to pass urine frequently because of a compressed bladder.

How is it managed?

In addition to the surgical management of fibroids which can include removal either hysteroscopically (via instruments passed through the cervix) or laparoscopically (keyhole surgery) or as part of a hysterectomy (usually keyhole surgery), there are radiological and medical treatments available and Dr Arthur will work with you to determine what the best option is for you.

What if I have an Abnormal Cervical Screening?

Having an abnormal cervical screening test (what we used to call a pap smear) can be stressful for many women. Dr Chris is skilled in colposcopy and the management of pre-cancerous changes of the cervix and is a member of the Australian Society for Colposcopy and Cervical Pathology. He is able to take you through the investigation and management process using clear language and ensures you understand what your likely journey will look like.