Kāpiti Women’s Health

Hormonal changes in mid-life can upset the balance for many women. Common symptoms include mood changes, anxiety, poor sleep, insomnia, joint pains and vaginal dryness to name a few. Dr Zwart can help you make sense of these changes and talk through the range of options available to help you with this transition.

Perhaps you have other health conditions that may impact on the choices available or a family history of concern, or perhaps you are some time past menopause and want to know what the risks and benefits are for you.

Over a 45 minute consultation we look at how lifestyle choices can impact on health, the use of medications - both non-hormonal and menopause hormone therapy (MHT). We also cover other key health topics in mid-life such as heart, bone and brain health.

An imbalance of hormones or a sensitivity to hormones play a role in conditions such as Premenstrual syndrome (PMS), Premenstrual dysphoric disorder (PMDD) and Polycystic ovarian syndrome (PCOS).

Dr Zwart can talk through the range of options available- both natural and hormonal - to minimise the impact of these hormonal challenges on your day to day life.

Taking into account your preferences , age and medical history we can discuss the range of contraception options available. This includes prescription of the oral contraceptive pills, administration of Depo Provera and both insertion and removal of Jadelle implants.

Dr Zwart also offers insertion and removals of Mirena, Jaydess and Copper IUDs. This can be done with additional pain relief in the form of a cervical block where local anaesthetic is used. This can be done at patient request or if you have had a difficult insertion prior.

Dr Zwart is also trained in removal of stringless IUDs which require a cervical block.

Heavy and painful periods, irregular bleeding, bleeding after sex or after the menopause. These symptoms are important to get checked out. Not only because they can impact significantly on your quality of life, but it is also important you are examined and investigated to make sure there is nothing of concern going on. This may include updating a smear, ruling out sexually transmitted infections and ordering a pelvic scan.

Dr Zwart is also trained to take endometrial biopsies (pipelles) to aid in investigation.

Treatment options such as Mirena’s can be initiated or referral onwards to a gynaecologist if further surgical interventions are indicated.

If you are experiencing a dragging, heavy feeling in the pelvis, a lump in the vagina, leakage of urine when you cough/sneeze or can’t get to the toilet in time or trouble emptying your bowels, you may have a prolapse. 1 in 2 women experience prolapse over their lifetime but many don’t know there are successful ways to manage it.

Dr Zwart will take a full history of bowel and bladder function, perform an examination and discuss the appropriate treatment options include fitting of ring and incontinence pessaries, referrals to pelvic physiotherapists and incontinence nurses and/or urogynaecologists.

Where appropriate, ACC claims for Pelvic Mesh Treatment Injury can also be initiated.

If you’ve recently experienced pregnancy and childbirth you may be experiencing troubles with your bowel and bladder function or returning to intimacy.

An examination and advice on pelvic floor and perineal issues is available, including initiation of ACC claims for Maternal Birth Injury if applicable and referral to health providers such as physiotherapists.

Often felt but not talked about – vulval and vaginal symptoms can be distressing and difficult to manage. Common symptoms include itch, dryness, pain, discharge and skin splitting.

Dr Zwart will take a full history including previous treatments tried and perform an examination. A vulval skin biopsy can also be done to help aid diagnosis if appropriate.

Dr Zwart is confident in managing conditions such as vulval dermatitis, chronic candidiasis, lichen sclerosis, the genitourinary syndrome of menopause and recurrent bacterial vaginosis.

Referral onwards to a specialist sexual health physician can also be facilitated.

If you are considering starting a family or having trouble conceiving, we can talk about ways to boost your fertility and carry out initial investigations to help rule out underlying causes that might be impacting on your fertility.

If appropriate and desired, we can initiate a referral to public and private fertility clinics.

We offer screening and treatment for sexually transmitted infections. If you are struggling with low libido or painful intercourse, Dr Zwart offers a sensitive approach to this difficult topic and can work through with you the range of options including medication, pelvic physiotherapy and sex therapy to improve your sexual function.