Women’s Health

St George Family Medical Centre have a special Program following the National Cervical Screening Program

Our aims to reduce morbidity and deaths from cervical cancer, in a cost-effective manner through an organised approach to cervical screening. The program encourages women in the target group to have regular Pap smears.

The program promotes routine screening with Pap smears every two years for women between the ages of 18 (or two years after first sexual intercourse, whichever is later) and 69 years.

The program seeks to integrate all elements of the cervical screening process. In particular, it aims to:

• demonstrate an increase in the percentage of eligible women who have ever been screened;
• establish more reliable and accessible services for taking, interpreting and reporting Pap tests;
• improve management of screen detected abnormalities; and
• monitor and evaluate these preventive efforts.
• The program includes: implementation and monitoring of adherence to a nationally agreed screening policy; establishment of cervical screening registers in each state and territory; and development and enhancement of other quality management strategies across the screening pathway.The screening pathway involves the following steps:
• encouraging all eligible women to enter and remain in the screening program;
• ensuring optimal quality of Pap smears by adequate training of Pap smear takers;
• ensuring optimal quality of Pap smear reading through a quality assurance program for laboratories;
• ensuring appropriate followup of abnormal Pap smears through management guidelines;
• providing an efficient system for notifying results to women by Pap smear providers;
• providing recall and reminder systems to ensure adequate followup of women with screen-detected abnormalities; and
• Maintaining women’s participation in the program by encouraging providers to set-up reminder systems, and developing cervical screening registers and national cancer data.
• A Pap smear called a Pap test, is a procedure to test for cervical cancer in women. A Pap smearinvolves collecting cells from your cervix — the lower, narrow end of your uterus that’s at the top of your vagina.
  

  The Pap smear is a simple procedure. Cells are collected from the cervix and placed (smeared) onto a slide. The slide is sent to a laboratory where the cells are tested for anything unusual. If abnormal changes are found at screening, further tests will be done to see if treatment is needed.

   

  The Pap smear is not for diagnosing cancer, but rather, for finding early changes which might become cancer.

  A Pap smear only takes a few minutes. No drugs or anaesthetics are required and it can be done by a general practitioner

During the test, the doctor or nurse gently inserts an instrument called a speculum into the vagina, so that they can clearly see the cervix. They then insert a small spatula or tiny brush to collect cells from the cervix. They smear these cells onto a glass slide and send it to a laboratory for analysis. The results are usually available within a week.

Pap tests can be uncomfortable, but should not hurt. If you feel any pain, tell your doctor, nurse or gynaecologist immediately.

Sometimes, the laboratory will report that the sample was unsatisfactory and another pap test needs to be taken. This doesn’t mean your original pap test showed abnormalities. There may have been too few cells collected, or the cells may have been hidden by blood or mucus.

The Pap smear does not check for other problems in the reproductive system. It is not a check for sexually transmitted infections. Women who are worried that they may have a sexually transmitted infection should talk to their general practitioner about the tests and treatments available.

We send you SMS or reminder letter when it is due.

In the early stages of cervical cancer, there are usually no symptoms. The only way to detect changes is if you have a Pap smear. 

If you have any abnormal vaginal bleeding (such as intermittent bleeding, bleeding after sex or after menopause), abnormal or persistent vaginal discharge (bloody or offensive), or pelvic pain, you should see your general practitioner.

Who is at risk?

Risk factors for developing cervical cancer include:

• the presence of some types of the human papillomavirus (HPV) on the cervix
• smoking
• the presence of sexually transmitted infections such as chlamydia
• early age of first intercourse
• early age of first childbirth
• number of sexual partners
• long-term use of the contraceptive pill.
• The risk of developing cervical cancer increases with age. All women with a cervix who have ever had sex at some time in their life are at risk of cervical cancer. About half the new cases of cervical cancer diagnosed each year are in women over 50 years of age. Women in this age group are less likely than younger women to have regular Pap smears. More women over 50 years of age die from cervical cancer because their cancer is diagnosed later when treatment is more difficult.What is the cause of cervical cancer?Human Papilloma Virus (HPV), a sexually transmitted infection which in most cases (80%) is cleared by the body’s immune system in 8-14 months. The presence of HPV may be detected by the Pap smear. Some women who have persistent infections may develop abnormalities of the cervix. This is why it is important to have a regular Pap smears.How effective is the Pap smear?Regular Pap smears every two years can help prevent up to 90 per cent of the most common type of cervical cancer.Like all screening procedures, the Pap smear has limitations. Sometimes it will not detect early cell changes because the smear did not contain enough abnormal cells. Sometimes samples are difficult to interpret due to blood or mucus on the slide. If this occurs, the general practitioner or nurse may need

  Who should have a Pap smear?

  All women over 18 who have ever had sex are advised to have a Pap smear every two years, even if they no longer have sex. If a woman starts sexual activity at a younger age, screening should start within two years of first sexual intercourse.

  Your general practitioner may recommend more frequent Pap smears if a previous smear showed significant cell changes or you experience problems, such as bleeding or pain after sex.

  I’ve been through menopause; do I still need to have a Pap smear?

  Yes, the risk of getting cervical cancer increases with age so it is important to keep having Pap smears every two years, even after menopause.

  Should I have a Pap smear if I have had a hysterectomy?

  If your hysterectomy was only partial, and your cervix was not removed, you will still need to have a Pap smear every two years. If you have had a total hysterectomy, that is, your uterus and cervix have been removed, you may still need to have a Pap smear. Check with your doctor to be absolutely sure.

  Should women with a disability have Pap smears?

  Yes, all women with a cervix who have ever had sex are at risk of cervical cancer. One of the key objectives of the Glenrock Country practice Cervical Screening Program is that its services are accessible to all women. We ensure that women with disabilities can be directed to a practitioner who is best able to meet their individual needs. other strategies have been put in place to address the needs of women with disabilities who wish to have a Pap smear, including:

• purchase of adjustable examination couches;
• referral to Pap smear providers who can meet women’s special needs in terms of physical and intellectual disabilities.
• When should I stop having Pap smears?If you are 70 years or over and have had two normal Pap smears in the last five years, you do not have to keep having Pap smears, unless you wish to do so. Women who are over 70 years who have never had a Pap smear, or those who request a Pap smear, can make an appointment to be screened.How much does it cost?There are two costs involved in having a Pap smear the Doctor consultation fee and the Pap smear pathology test. The normal fee in St George Family Medical Centre is a long consultation for your doctor while pathology provider (laboratory) fees are bulk billed. In most of the cases you may be asked to pay the full doctors fee and then claim a rebate from Medicare.If you can’t afford the full fee ask your doctor to be ‘bulk bill’ which case there is no cost for the Pap smear or the consultation.Ask for information about the cost when you make an appointment.

  Useful Links

  NSW Cervical Screening Program 

  Tel: (02) 8374 5757 Fax: (02) 8374 5700

  What is the Menopause?

  Menopause is the final menstrual period of a woman’s life. It’s also known as the ‘change of life’, as it represents the end of a woman’s ability to reproduce.

  Menopause occurs when the production of hormones by the ovaries begins to slow down. As this change occurs, the hormone levels in a woman’s body will tend to fluctuate, which will most likely have an effect on the woman’s menstrual cycle.

  Eventually, hormone production levels fall to a point where menstruation stops altogether – this point is the menopause.

  Menopause normally affects women between the ages of 45 and 55, with the average age falling around 50 years old. In some instances, medical intervention for other conditions can cause early-onset of menopause, such as radiation treatment for cancer.

  Menopause causes a range of different symptoms, but the most likely to occur include hot flushes, night sweats, aches and pains, irritability, tiredness and headaches. Less common symptoms include forgetfulness, reduced libido or sex-drive, vaginal dryness and increased urinary frequency.

  What happens to my body at menopause? The experience of menopause varies widely from woman to woman and from culture to culture. All women, however, undergo the same basic hormonal changes during menopause. A woman’s ovaries produce three types of hormones – oestrogen, progesterone and testosterone. These hormones play a vital role in menstruation, ovulation and pregnancy. During the peri-menopause, the ovaries’ production of these hormones diminishes. This process is usually gradual, taking a number of years (unless the ovaries are surgically removed or affected by radiation or chemotherapy). The degree to which each woman’s body responds to these normal hormonal changes varies 25% of women do not have any problems with menopaus 50% of women experience some menopausal symptoms, varying from mild to moderate. 25% of women have more severe problems. It is important to recognise that not all symptoms that women experience at this stage in life are related to menopause. Some are just part of the normal ageing process. Common menopausal symptoms include:

  Menopause symptoms

  Changes in hormone levels can produce different symptoms. It is estimated that around two-thirds of women experience the most common symptoms of

  A)Hot flushes and night sweats. Hot flushes are characterised by feelings of heat that spread to the chest, neck, face or even the whole body and may be accompanied by sweating, nausea, heart palpitations, and flushed skin . When hot flushes occur at night they are referred to as night sweats. They can last anywhere from 30 seconds to five minutes or occasionally longer. Some women may only experience them infrequently but others may have many each day. Hot flushes and night sweats can be aggravated by stress, anxiety, alcohol, hot food and drinks, spicy foods, overdressing and a hot environment. Hot flushes and night sweats are thought to be caused by hormonal changes occurring at menopause.

  B)  Tiredness, lack of energy, a reduced interest in sex and psychological symptoms, including depression.

  C) Urinary problems – Changes in the vagina, urethra and bladder at menopause can make women more susceptible to urinary tract infections. Symptoms of a urinary tract infection include painful and frequent urination, feeling a need to urinate when the bladder is empty and a strong or unpleasant odour to the urine. The drop in oestrogen levels can aggravate existing pelvic floor muscle weakness resulting in incontinence problems. D) Joint/muscle aches and pain – Peri-menopausal women may have morning stiffness and joint pains in the hands, knees, hips, lower back and shoulders. This symptom is commonly reported in menopausal women in Asia. The drop in oestrogen may be a contributing factor but the reasons for why this increases joint/muscle aches and pain are unclear.

  E) Menstrual irregularities – Irregular periods are often one of the first signs that a woman is approaching menopause. Though the exact symptoms of irregular periods vary depending on a woman’s unique cycle, most women will experience irregular periods for three to ten years before periods stop completely. In fact, only 10% of women reach menopause without any irregular periods.

  As menopause approaches, women’s hormones become imbalanced, and because the menstrual cycle is entirely dependent upon hormones, irregular periods often occur. Keep reading to learn more about irregular periods and their symptoms, common causes, and treatment options.

  F) Sleep disturbances – Studies show that lack of sleep leads to decreased function in the daytime, including lack of concentration, irritability, and a weaker immune system. For women undergoing menopause, this can be even more devastating as they are dealing with shifting hormone levels – which are often the root of their sleep problems – as well as all the stresses of adult life.

  Fortunately, sleep disorders can be managed and even treated.

  More information

  http://www.34-menopause-symptoms.com/treatments.htm

  Long-term effects of the menopause include increased risk of osteoporosis and cardiovascular disease.

  Menopause relief

  Hormone replacement therapy (HRT) can help protect women from osteoporosis, replacing the oestrogen lost during the menopause and, therefore, protecting bones.

  HRT is also good at controlling menopausal symptoms, but it can slightly increase the risk of developing conditions such as breast cancer and deep vein thrombosis.

  Changing your diet and doing more exercise can also help with symptoms of the menopause.

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