Gynaecologist and Women’s Health Specialist | Dr Simon Nothman

Gynaecology

Gynaecology is a specialised area of medicine focusing on women’s health, including women’s reproductive health. Dr Simon Nothman is an accomplished fertility specialist offering expert care for women’s health in his Bondi Junction and Sydney CBD practices.

As a women’s health specialist in the eastern suburbs of Sydney, Dr Nothman is experienced in managing a wide range of women’s health concerns, including menstrual disorders, endometriosis, fibroids, pelvic pain, and the symptoms of perimenopause and menopause.

Menstrual disorders

Menstruation, or a period, is the regular shedding of the lining of the uterus in a woman of child-bearing age. For most women, this occurs as monthly vaginal bleeding, which may be associated with mild to moderate discomfort. However, with changes in lifestyle and diet over the decades, abnormal menstruation symptoms are now quite common, affecting over 6 in 10 women.

Menstrual disturbances can include:

  • Unusually heavy or prolonged bleeding
  • Irregular periods
  • A lack of periods
  • Infrequent periods
  • Unusually light periods
  • Severe pain and cramping during menstruation

Numerous factors can contribute to menstrual disorders, and may have the potential to affect your fertility. Menstrual disorders can also be associated with significant emotional distress and quality of life. Read more about menstrual disorders and its impact on fertility here.

Endometriosis and Adenomyosis

Endometriosis is a common but often underdiagnosed chronic condition. The endometrium lines the inside of a healthy uterus. In endometriosis, tissue similar to this lining develops outside the uterus, resulting in pain and inflammation. A related condition, adenomyosis, is where such abnormal endometrial tissue is found in the muscle layer of the uterus. These conditions can exist independently of each other, and can also coexist together.

In Australia, 1 in 9 women are affected by endometriosis.

Symptoms of endometriosis and adenomyosis include:

  • Pain in the abdomen or pelvis during menstruation, sexual intercourse, or toileting
  • Heavy or irregular periods
  • Changes in bowel or bladder movements
  • Bloating
  • Fatigue and lethargy leading up to and during your period.
  • Endometriosis is a leading cause of infertility

There is currently no cure for endometriosis but your symptoms can be managed, typically through hormone-based therapies, such as the contraceptive pill or an intrauterine device (IUD). Surgery can improve symptoms, and potentially also fertility (depending on an individual’s situation) but does carry some risks, including possible ovarian damage. While spontaneous pregnancy may be possible for many women with endometriosis, IVF is often required. Further, given the risk of ovarian damage in such an operation, fertility preservation should be considered prior to endometriosis.

Fibroids

Fibroids of the uterus are common benign (non-cancerous) growths that develop in the layer of muscles of the uterus wall. In most cases, they don’t cause any issues, however, some women experience bothersome symptoms such as:

  • Menstrual disturbances such as heavy or painful periods
  • Lower back or pelvic pain
  • Pain during sexual intercourse
  • Constipation

Most women with uterine fibroids are able to conceive normally and carry through a healthy pregnancy. But in some situations, fibroids can increase the risk of infertility, miscarriage, and pregnancy complications.

If your symptoms are severe or causing concerns, your gynaecologist can offer effective treatments such as medications, hormone therapy, surgery, or other medical procedures.

Pelvic pain

The pelvis is the area of your body between your abdomen (belly) and your upper thighs. Around this area you can find your hips, tailbone, reproductive organs, vagina, bladder, and bowels.

Pain in the pelvic area can be due to a wide array of causes, ranging from harmless to life-threatening. Among other reasons, pelvic pain can be associated with:

  • Normal menstrual periods
  • Urinary tract infections
  • Sexually transmitted infections
  • Infection of the uterus and pelvic inflammatory disease
  • Endometriosis
  • Ectopic pregnancy
  • Uterine fibroids

The most appropriate treatment for your pelvic pain will depend on the underlying cause.

Perimenopause and menopause

Menopause refers to a woman’s last menstrual period and signifies the conclusion of your reproductive years. Perimenopause is the time leading up to menopause. In Australia, the average age of normal menopause is between 51 and 52, but it can happen any time between 45 and 55 years old and occasionally at younger ages. When menopause occurs at younger ages, it is particularly important to undergo proper evaluation – both to assess the possibility of an underlying condition that has resulted in premature ovarian insufficiency, and also due to increased risk of complications of menopause and thus the need to discuss therapeutic options.

Though menopause is a natural part of every woman’s life, it can be associated with some bothersome symptoms due to shifting hormones. These symptoms can differ between individuals, and some may not experience any symptoms at all.

Some common menopausal symptoms can include:

  • Hot flushes
  • Headaches
  • Joint and muscle pain
  • Tender breasts
  • Mood changes
  • Fatigue
  • Difficulty with memory and concentration

Menopause is not an illness that needs to be cured, but the right gynaecologist can help you to effectively manage its symptoms.

Contraceptive options for women

Though condoms and the contraceptive pill are the most well-known forms of contraception, there are other solutions that may work better for your lifestyle and stage of life.

During your initial consultation with your gynaecologist, you can discuss contraceptive options such as:

  • An intrauterine device (IUD) placed inside the uterus during a minor in-office procedure, which prevents fertilisation of an egg with sperm
  • A contraceptive injection, which is a long-acting synthetic hormone injected every 12 weeks
  • A contraceptive skin implant inserted in the upper arm, which slowly releases synthetic progesterone hormone to prevent ovulation
  • Tubal ligation, a permanent method of contraception which involves clipping your fallopian tubes to prevent fertilisation

Dr Simon Nothman is an experienced fertility specialist and women’s health doctor in Bondi Junction and Sydney CBD, offering comprehensive treatment and management of a wide range of women’s health concerns, including their effects on your fertility.

© 2024 All rights reserved. Dr Simon Nothman. ABN 54 572 986 907