Gynaecology

Dr Genia Rozen has limited her scope of practice in gynaecology simply to those areas relating to fertility, as well as a select few areas of general gynaecology, in order to maintain a high level of skill in a limited number of areas

Conditions Managed by Dr Rozen

Overview:

  • Reproductive endocrinology is a subspecialty of obstetrics and gynaecology focusing on hormonal functioning and its impact on reproduction.
  • Deals with infertility, menstrual disorders, polycystic ovary syndrome (PCOS), endometriosis, and hormonal imbalances.

 

Cause:

  • Genetic abnormalities affecting hormone levels or reproductive organs.
  • Lifestyle factors (stress, excessive exercise, poor diet).
  • Environmental exposures (chemicals, toxins).
  • Disorders like PCOS, thyroid disease, and pituitary gland disorders.

 

Symptoms:

  • Irregular or absent menstrual cycles.
  • Difficulty conceiving or infertility.
  • Symptoms of hormonal imbalances (eg: weight changes, hair growth, acne).
  • Pelvic pain or symptoms of conditions like endometriosis.

 

Risks:

  • Long-term health issues related to untreated hormonal imbalances (eg: osteoporosis, cardiovascular disease).
  • Increased risk of developing certain cancers (eg: ovarian, endometrial).
  • Psychological impact, including depression and anxiety, due to fertility challenges.

 

Treatment:

  • Lifestyle modifications (diet, exercise, stress management) for hormone regulation and weight management.
  • Medications to induce ovulation, manage PCOS symptoms, or regulate menstrual cycles.
  • Surgery for structural issues (eg: removal of fibroids, endometriosis treatment).
  • Assisted reproductive technologies (ART) like IVF for infertility.
  • Hormone therapy for hormonal imbalances and menopausal symptoms.
  • Counselling and support for emotional aspects of reproductive health issues.

Overview:

  • Ovulation disorders affect the release of eggs from the ovaries, including
  • Polycystic Ovary Syndrome (PCOS), a common cause.
  • Can lead to irregular menstrual cycles and impact fertility.

 

Cause:

  • PCOS: Hormonal imbalances, insulin resistance, and genetics.
  • Other ovulation disorders: hormonal imbalances, excessive exercise, extreme weight loss or gain, stress.

 

Symptoms:

  • Irregular, infrequent, or absent menstrual periods.
    Signs of high androgen levels: acne, hirsutism (excessive hair growth), and alopecia (hair loss).
  • PCOS: Multiple small cysts on the ovaries.
  • Difficulty conceiving due to irregular or absent ovulation.

 

Risks:

  • Infertility.
  • Metabolic syndrome, including type-2 diabetes, high blood pressure, and high cholesterol.
  • Increased risk of endometrial cancer.
  • Psychological issues: depression and anxiety.

 

Treatment:

  • Lifestyle modifications: Diet and exercise to manage weight and reduce insulin resistance.
  • Medications to induce ovulation (eg: Clomiphene, Letrozole).
  • Metformin to improve insulin resistance (commonly used in PCOS).
  • Birth control pills to regulate menstrual cycles and reduce androgen levels.
  • Assisted reproductive technologies (ART) like IVF for individuals facing infertility.
  • Surgical options for PCOS, like ovarian drilling, may be considered in resistant cases.

Overview:

  • Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus, causing pain and potentially fertility issues.
  • It primarily affects the pelvic area but can appear in other parts of the body.

 

Cause:

  • The exact cause is unknown, but theories include retrograde menstruation, immune system disorders, and genetic factors.
  • Hormonal factors, as endometriosis lesions are estrogen-dependent.

 

Symptoms:

  • Pelvic pain, especially during menstruation.
  • Pain during intercourse.
  • Pain with bowel movements or urination.
  • Excessive menstrual bleeding or bleeding between periods.
  • Infertility.

 

Risks:

  • Chronic pain affecting daily activities and quality of life.
  • Significant fertility challenges or infertility.
  • Ovarian cysts and scar tissue, leading to complications like bowel and urinary tract problems.

 

Treatment:

  • Pain management with NSAIDs.
  • Hormonal therapies to reduce estrogen levels and menstrual flow, such as birth control pills, GnRH agonists, and progestins.
  • Surgical options for diagnosis, removal of endometriosis implants, and relief of obstructions, including laparoscopy and, in severe cases, hysterectomy.
  • Assisted reproductive technologies (ART) for women facing infertility.
  • Lifestyle changes and complementary therapies (diet, exercise, acupuncture) for symptom management.

Overview:

  • Adenomyosis is a condition where the endometrial tissue, which normally lines the uterus, grows into the muscular wall of the uterus.
  • This can cause an enlarged uterus and painful, heavy periods.

 

Cause:

  • The exact cause is unknown, but it is linked to estrogen levels and may be related to previous uterine surgery, childbirth, or other uterine trauma.

 

Symptoms:

  • Heavy and prolonged menstrual bleeding.
  • Severe menstrual cramps or pelvic pain.
  • Pain during intercourse.
  • Chronic pelvic pain.
  • An enlarged uterus palpable during a physical exam.

 

Risks:

  • Chronic anaemia due to heavy bleeding.
  • Impact on quality of life due to chronic pain and heavy menstrual bleeding.
  • Potential infertility or complications during pregnancy, although less common.

 

Treatment:

  • Anti-inflammatory drugs to reduce pain and decrease menstrual blood loss.
  • Hormonal treatments like birth control pills, progesterone IUDs, or GnRH agonists to manage symptoms.
  • Uterine artery embolisation to shrink the adenomyotic areas by cutting off their blood supply.
  • Endometrial ablation, though less effective if adenomyosis is deep in the uterine muscle.
  • Hysterectomy (removal of the uterus) is the only definitive cure and is considered when other treatments fail and if childbearing is not desired.

Overview:

  • Menstrual disorders encompass a variety of issues related to the menstrual cycle, including heavy bleeding (menorrhagia), irregular periods, and absent periods (amenorrhea).
  • Can affect quality of life and signal underlying health conditions.

 

Cause:

  • Hormonal imbalances (eg: thyroid problems, PCOS).
  • Uterine abnormalities (fibroids, polyps, adenomyosis).
  • Blood clotting disorders.
  • Medications and contraceptives.
  • Pregnancy-related issues.

 

Symptoms:

  • Heavy menstrual bleeding (soaking through one or more pads/tampons every hour).
  • Menstrual bleeding lasting more than 7-days.
  • Irregular or unpredictable menstrual cycles.
  • Painful cramping (dysmenorrhea).
  • Absence of menstruation.

 

Risks:

  • Anaemia due to heavy blood loss.
  • Severe pain impacting daily activities.
  • Potential infertility or complications with pregnancy.
  • Increased risk of endometrial cancer with prolonged untreated issues.

 

Treatment:

  • Hormonal therapies (birth control pills, IUDs with progesterone) to regulate or lighten periods.
  • NSAIDs for pain relief and to reduce menstrual flow.
    Iron supplements for anaemia.
  • Surgical options for uterine abnormalities (eg: removal of fibroids, endometrial ablation).
  • Lifestyle changes and weight management, particularly for disorders like PCOS.
  • Assisted reproductive technologies for fertility issues related to menstrual disorders.

Overview:

  • Gynaecological pelvic pain refers to discomfort in the lower abdomen and pelvic area, often linked to the reproductive system.
  • Can be chronic (lasting more than 6-months) or acute, affecting women’s health and quality of life.

 

Cause:

  • Endometriosis: Tissue similar to the uterus lining grows outside the uterus.
  • Ovarian cysts: Fluid-filled sacs on the ovary.
  • Pelvic inflammatory disease (PID): Infection of the reproductive organs.
  • Uterine fibroids: Noncancerous growths in the uterus.
  • Adenomyosis: Uterine lining grows into the muscular wall of the uterus.

 

Symptoms:

  • Persistent or intermittent pelvic pain.
  • Pain during intercourse.
  • Pain during menstruation or ovulation.
  • Heavy or irregular menstrual bleeding.
  • Painful urination or bowel movements.

 

Risks:

  • Chronic pain can lead to reduced mobility and quality of life.
  • Infertility or complications during pregnancy.
  • Psychological impacts, including depression and anxiety.

 

Treatment:

  • Pain management: NSAIDs, hormone therapy (eg: birth control pills, GnRH agonists).
  • Antibiotics for PID.
  • Surgical options for endometriosis, fibroids, and ovarian cysts (eg: laparoscopy, hysterectomy).
  • Lifestyle modifications: Diet, exercise, and stress management.
  • Physical therapy to strengthen pelvic floor muscles and relieve pain.
  • Counselling or support groups for emotional support.

Overview:

  • Menopause marks the end of a woman’s menstrual cycles, diagnosed after 12-months without a period.
  • Typically occurs between ages 45 and 55 but can vary.

 

Cause:

  • Natural decline in reproductive hormones (estrogen and progesterone) as women age.
  • Can be induced prematurely by surgery (eg: hysterectomy), chemotherapy, or radiation.

 

Symptoms:

  • Hot flashes and night sweats.
  • Vaginal dryness and discomfort during intercourse.
  • Sleep disturbances.
  • Mood changes.
  • Thinning hair and dry skin.
  • Decreased metabolism and weight gain.

 

Risks:

  • Increased risk of osteoporosis and bone fractures.
  • Higher risk of cardiovascular disease due to changes in lipid profiles and arterial health.
  • Potential impact on mental health, including increased risk of depression and anxiety.

 

Treatment:

  • Hormone replacement therapy (HRT) for symptom relief and protection against osteoporosis.
  • Non-hormonal treatments (eg: SSRIs, gabapentin) for hot flashes and mood swings.
  • Lifestyle modifications including regular exercise, a healthy diet, and quitting smoking to manage symptoms and reduce health risks.
  • Vaginal estrogen creams, tablets, or rings to alleviate vaginal dryness and discomfort.
  • Calcium and vitamin D supplements to support bone health.

Overview:

  • Premature Ovarian Insufficiency (POI) occurs when the ovaries stop functioning normally before age 40, leading to reduced estrogen production and fewer eggs.
  • It affects fertility and can bring on menopause-like symptoms earlier than usual.

 

Cause:

  • Genetic factors like Turner syndrome or Fragile X syndrome.
  • Autoimmune diseases where the body attacks ovarian tissues.
  • Medical treatments such as chemotherapy and radiation.
  • Surgical removal of the ovaries.
  • In many cases, the cause is unknown.

 

Symptoms:

  • Irregular or missed periods.
    Hot flashes and night sweats.
  • Vaginal dryness, leading to discomfort during sex.
  • Difficulty getting pregnant.
  • Emotional symptoms such as mood swings or depression.

 

Risks:

  • Increased risk of osteoporosis due to lower estrogen levels.
  • Possible increased risk of heart disease.
  • Emotional and psychological impact, including anxiety and depression.

 

Treatment:

  • Hormone replacement therapy (HRT) to manage menopausal symptoms and reduce the risk of osteoporosis.
  • Calcium and vitamin D supplements to support bone health.
  • Assisted reproductive techniques for those wishing to conceive, including the use of donor eggs.
  • Psychological support and counselling to address emotional well-being.
  • Regular monitoring for associated health risks such as heart disease and osteoporosis.

Dr Rozen’s Approach to Gynaecology

Dr Genia Rozen understands that gynaecological health is deeply personal and often sensitive, and can impact your quality of life in various significant ways.

She offers a warm and welcoming, professional environment where you can feel comfortable discussing any concerns or questions you may have, and will offer solutions. Her approach is centred on respect, empathy and personalised care.

Get in touch with our friendly team.

Dr Genia Rozen is a Melbourne gynaecologist and fertility specialist with 10+ years of experience dedicated to fertility medicine.

She holds a PhD in fertility after cancer treatment, and a Masters of Reproductive Medicine (MRMED) degree. She undertook three years of sub-specialising training in Fertility and Reproductive Medicine at the Royal Women’s Hospital in Melbourne as is affiliated with Genea Fertility, who are recognised leaders in advanced reproductive laboratory services.

Please get in touch if you have a question or wish to book an appointment.