In this episode of The Good GP, Karin Sekhon speaks with Professor Jayashri Kulkarni, a renowned psychiatrist, about premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

Professor Kulkarni explains the distinctions between PMS and PMDD, emphasising that PMS is more prevalent and generally involves physical symptoms like bloating and headaches, while PMDD affects a smaller percentage of women and includes severe psychological symptoms such as major depression, anxiety, and brain fog. She talks about the genetic and environmental factors contributing to PMDD, highlighting a specific gene complex that may be activated by trauma.

Discussing the primary pharmacological treatments for PMDD, Professor Kulkarni advises starting with hormonal treatments like the combined oral contraceptive pill; she recommends the pill "Zoely" for its balanced hormone levels. She also elaborates on the use of SSRIs like sertraline for additional support and gives a stepped approach to treatment, including the possible need for hormone replacement therapy (HRT) or menstrual suppression in complex cases.

They also touched on the potential role of complementary therapies and the importance of holistic care, involving psychological support and lifestyle modifications. Professor Kulkarni provides guidance on when GPs should consider referring patients to specialists and emphasises the collaborative role of GPs in managing PMDD effectively.

If you want to learn more about this topic, consider the HER Centre Australia's online short course on Women's Mental Health: https://www.monash.edu/medicine/translational/psychiatry/short-courses/womens-mental-health

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com

Join The Good GP host Dr Krystyna de Lange in an episode with Dr Rebecca Starkie as they discuss the topic of cervical screening and the self-collection method in Australia.

Dr Starkie, a GP, practice owner, academic, medical educator, and researcher with a specific interest in women's health, shares her expertise on the success of self-collection for cervical screening. With the uptake of self-collection, especially among older women and those in remote areas, we have seen a reduction in barriers to cervical screening and improved access

They delve into the eligibility criteria for self-collection, discussing those who can opt for this method and those who still require clinician-collected samples. Expected changes in guidelines for the cervical screening program are also touched upon, emphasising the upcoming recommendations for test-of-cure processes.

Sharing insights for GPs on how to effectively explain and guide patients through the self-collection process, including the use of instructional resources and addressing possible patient concerns. Dr Starkie offers practical tips for handling abnormal test results and troubleshooting sampling challenges.

Dr Starkie recommended adopting a whole-of-team approach in general practice to support cervical screening efforts, underscoring the importance of involving practice managers, nurses, and reception staff in creating a positive patient experience.

Links & Resources:

• https://acpcc.org.au/practitioners/resource-hub/

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com

In this episode of The Good GP, host Dr Karin Sekhon is joined by Dr Jana Combrinck, an experienced women's health GP working in Perth and the current GP lead of Oasis Fertility Centre. They delve into the GP's role in fertility management.

Dr Combrinck discusses the prevalence of fertility issues, noting that one in six couples of reproductive age in Australia are affected by subfertility. Identifying advanced maternal age as a common cause, along with conditions such as polycystic ovarian syndrome (PCOS), ovulation disorders, and endometriosis. She emphasises the importance of considering male factors, which are responsible in at least 50% of cases.

Giving insights on the process for couples experiencing infertility. Dr Combrinck outlines a systematic approach, which includes taking a thorough history, conducting necessary blood tests, and performing imaging investigations. For male patients, a semen analysis is recommended as the first step.

Dr Combrinck also discusses the medications and supplements that GPs can prescribe to aid in fertility. For PCOS patients, metformin and myoinositol are suggested as first-line treatments. She provides a comprehensive guide on the use of letrozole for ovulation induction, emphasising the need for close monitoring. Supplements like CoQ10 and melatonin are recommended for women with reduced ovarian reserve, and Menivit is suggested for male patients with suboptimal semen analysis.

They also touched on when to refer patients to a fertility specialist. Referral timelines vary based on the age of the female partner and any known fertility-impacting conditions.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network.

If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com.