Dr Richard Murphy

Top 10 reasons to see your gynaecologist

My patients in Perth come to see me as their gynaecologist for a variety of reasons. This is a succinct overview of common reasons to book a consultation or to ask your GP for a referral. In gynaecology, it is often not only about managing discomfort and symptoms, but also about seeing the bigger picture. Especially when symptoms can help us diagnose underlying conditions or provide information about your fertility.
Obstetrics and gynaecology consultations at my private practice in Subiaco.
Fertility consultations at Fertility Specialists of Western Australia in Applecross
Delivering at the Labour Ward of SJOG Subiaco Hospital

Perth gynaecologist

Reason 1: Heavy periods

The main reason why patients come to see me is heavy periods. Heavy menstrual bleeding can be debilitating physically, socially and psychologically. Large blood clots, flooding and needing to change pads or tampons overnight are all signs your periods are too heavy.

"There used to be a time when discussing this burden was not common and complaints were brushed off by many doctors. But as a woman, you deserve to be heard and helped, also because heavy periods can cause other health problems. Low iron levels and anaemia can result, causing a further reduction in your quality of life. "

Dr Richard Murphy, Gynaecologist Perth
The good news is that a wide range of medical, both hormonal and non-hormonal, and surgical treatments such as endometrial ablation and hysterectomy, are available. When you come and see me as your gynaecologist, we assess your symptoms and find the right treatment for you.

Perth gynaecologist

Reason 2: Painful periods

Heavy and painful periods can be one and the same problem but some women only experience the pain and the discomfort without excessive bleeding. If you dread the pain associated with your periods, missing work, study, social activities or other normal day-to-day activities due to period pain there are very effective treatments available to help. Life should not just be about managing the pain.

Endometriosis and adenomyosis are common underlying conditions of painful periods. The management of these conditions means that your gynaecologist helps you reduce the symptoms and looks at the underlying causes that need attention. My role as your gynaecologist is to create clarity and to help you reduce the pain with the most suitable treatment or management plan.

Perth gynaecologist

Reason 3: Irregular periods

A common reason to speak to your gynaecologist is the irregularity of your cycle. A “normal” period cycle is regular and usually 28-30 days long. This can vary between 26-35 days. The average cycle length decreases with age from 25 until you reach menopause.

An irregular period can be associated with fertility problems, being a sign of infrequent or disordered ovulation. An irregular or very long cycle will also increase the risk of pre-malignant change in the endometrium and endometrial cancer.

Common causes of an irregular cycle include polycystic ovarian syndrome, thyroid problems, high prolactin and central disorders of the hypothalamus in the brain. I can help you diagnose why your periods are irregular and provide treatment so serious complications do not develop.

Perth gynaecologist

Reason 4: Pain during intercourse

If you experience pain during intercourse, the medical term for that is “Dyspareunia”.
It is common and there are a number of causes. “Superficial” pain occurs when there is pain with vaginal penetration. This can be with intercourse but also tampons. It is often caused by an overactive pelvic floor, where pelvic muscle contraction causes pain or discomfort.

A Women’s Health Physiotherapist has specialist training in the treatment of this condition. “Deep” pain is felt further inside the pelvis and can be a symptom of endometriosis, adhesions or other pelvic pathology. We may find clues to the cause with a good quality specialist gynecological ultrasound. Laparoscopic surgery is commonly used to diagnose and treat deep pelvic pain associated with intercourse.

Perth gynaecologist

Reason 5: Cervical screening test abnormalities

It’s important to note that since 2017 we no longer do the “Pap” test. Australia has moved to the Cervical Screening Test (CST) which screens for the presence of “high risk” Human Papillomavirus (HPV). We have known that certain viruses, when they persist in the body for a number of years, can cause the development of cancers. HPV causes almost all cervical, vaginal, vulval and anal cancers as well as a significant number of throat cancers.

"From the patient point of view, the CST and a Pap are the same, involving a speculum examination of the cervix and using a brush to collect cells from the cervix. The CST will tell whether you have a high-risk HPV strain and if so automatically look for cellular (“cytological”) abnormalities using the same sample."

Dr Richard MurphyGynaecologist Perth
Perth gynaecologist Dr Murphy

If you have an abnormal CST your General Practitioner may recommend a Colposcopy. This involves a detailed examination of the cervix using a colposcope, a type of microscope. HPV related changes will be visible, allowing us to biopsy any abnormal areas, helping to guide treatment.

If a high-grade abnormality is found then a surgical procedure is usually recommended such as a Large Loop Excision of the Transformation Zone (LLETZ) or Loop Electrosurgical Excision (LEEP). Sometimes a more extensive Cone Biopsy may be needed. Treatment for premalignant cervical disease will always consider any future plans you may have for pregnancy.

Perth gynaecologist

Reason 6: Contraception

There is a huge range of options for contraception available, non-hormonal, hormonal and surgical. If you have complicated medical issues or have experienced side effects from contraception in the past we should still be able to find the right method for you and your partner. Non-hormonal options include condoms and the copper IUD. Hormonal contraceptives include the minipill, the combined (standard) pill, NuvaRing, Kyleena, Mirena, Depo-Provera and Implanon. Surgical options include vasectomy and tubal ligation.

Perth gynaecologist

Reason 7: Infertility

If you have been trying to fall pregnant for over 12 months, if you are 35 or over and not pregnant after 6 months, or if there is some specific reason you believe you may have difficulty conceiving, then please come and see me. We can explore your history, perform the appropriate investigations and discuss the options available to help you complete your desired family size.

Perth gynaecologist

Reason 8: Miscarriage

The loss of a wanted pregnancy can be devastating. The most common cause for first-trimester miscarriage is a chromosomal problem in the pregnancy which occurs shortly after fertilisation of the egg. I can help guide you through what is often a very difficult, confusing and stressful time.
Often a surgical curettage, “D+C”, is recommended to treat miscarriage. I often use medical treatment to treat miscarriage, helping to avoid hospitalisation, anaesthetic and surgery. If any treatment is needed to complete your miscarriage we can decide the best option for you.

Perth gynaecologist

Reason 9: Preconception counselling

If you have ongoing, chronic medical conditions or a history of major illness or disease in your past or in your family it is often helpful and reassuring to plan around these issues before pregnancy occurs. Optimising your general health, taking folic acid supplements for 3 months before you start trying, stopping smoking or any drug use are important.

Recently the option of screening for hundreds of rare genetic diseases which can seemingly occur at random in the community has become available. These X-linked and recessive diseases are almost never associated with a family history and while each of them is individually rare, collectively 3% of couples are at risk and about 1 in 200 babies will be affected.

If you and your partner are found to be at risk, the option of using IVF to screen embryos for these diseases is available, using Preimplantation Genetic Testing, PGT.

Perth gynaecologist

Reason 10: Menopause management

The end of your periods can come as a relief. Often though the loss of estrogen can leave you feeling dreadful. Hot flushes, night sweats and vaginal dryness can cause a lot of discomforts. Other symptoms such as a loss of focus, tiredness, memory loss, low libido, anxiety, depression or mood swings can occur. There is also the silent loss of bone density which can cause osteoporosis.
People are complicated and menopause often occurs just when life is at its most demanding, with children, parents, work, mortgages and relationships all demanding attention and time. There is no one size fits all cure to help everyone get through menopause. We can work together to find what will work best for you.