Services and Conditions
From puberty through menopause, a woman's reproductive organs are constantly changing through the normal processes of sexual activity, pregnancy and aging, and sometimes disease and injury. Dr. Potgieter is recognized as one of the top gynaecologists in the nation and has a proven track record of fantastic outcomes. He provides individualized, specialized care aimed at maintaining health, preventing illness and treating disease. These are some of the most common gynaecological issues he assists with at his Netcare Parklane practice in Johannesburg.
- Heavy menstrual bleeding
- Menstrual pain and irregularity
- Premenstrual syndrome (PMS)
Dr. Potgieter offers a broad array of contraception options to help women select the best method for their needs, including:
- Birth control pills
- IUD's (intrauterine devices)
- Contraceptive injections
- Arm implants
- Sterilization and tubal ligation for permanent birth control
IUD fittings take just a few minutes, and they’re performed in the office during a routine pelvic exam. First, a lubricated speculum is used to gently widen the vaginal canal to make it easier to access the cervix, the opening of the uterus. Then, the IUD is inserted through the cervix into the uterus. The IUD is shaped like a “T,” with the shorter “crosspiece” serving as a sort of anchor to hold the device in place. Some IUDs are wrapped in copper, which stimulates production of a fluid that acts to kill off sperm before they reach the egg. Other IUDs use hormones for greater protection against pregnancy. IUDs can be removed at any time in a similar in-office procedure.
IUDs rarely fall out, but to be safe, prior to having intercourse it’s important to feel for the IUD’s long “tail” that extends into the vaginal canal to ensure the device is still in place.
The arm implant can be inserted in a simple procedure that takes just a few minutes. During insertion, the skin in the upper arm is numbed with a local anesthetic and a small nick is made in the skin. The implant is inserted and the nick is covered with a bandage. Once it’s in place, the implant can’t be seen, but it can be felt by pressing firmly on the skin. Arm implants need to be replaced every three years.
Pap tests are performed primarily to detect early signs of cervical cancer, abnormal pap smear results can be caused by many other reasons. In fact, most abnormal pap test results do not indicate cancer but occur as a result of another underlying issue like a yeast infection, HPV infection, hormonal changes, or other issues.
When a Pap test returns an abnormal result, one of two things usually occurs: A second Pap test is performed to see if the abnormal result occurs again (or if the initial result might have been due to hormonal fluctuations or another temporary issue), or a different type of exam called a colposcopy may be performed to evaluate the area where the abnormal cells were found.
A colposcopy is an exam that’s performed in the office in much the same way as a pelvic exam but with a special magnifying device called a colposcope that’s designed to enable Dr. Potgieter to get a clearer view of abnormal areas of tissue on or around the cervix. During the exam, the patient lies on her back and a lubricated speculum is inserted into the vagina to gently widen the vaginal canal. A solution may be applied to the cervix and walls of the vaginal canal to help highlight abnormal cells, making them easier to see. Then the colposcope is placed at the vaginal opening (outside the vagina) and a bright light is shone into the vagina and onto the cervix. Dr. Potgieter looks through the magnifying lens to examine and evaluate the cervix for any areas of abnormal tissue. If an abnormal area is identified, a small sample or biopsy of tissue may be taken for further evaluation. The tissue may be scraped away or a cutting instrument may be used to remove a layer of tissue for evaluation.
Colposcopy typically takes less than 15 minutes to perform, and women can resume their normal routines immediately afterward. There may be some mild cramping or light spotting if a biopsy is taken, but these will resolve soon afterward.
General Gynaecological issues:
- Ovarian cysts
- Pelvic pain
- Uterine fibroids
- Polycystic ovarian syndrome (PCOS)
- Acne and abnormal female hair distribution
- Genital tract infections
- Vulva and vagina skin disorders
Well Woman Exam
A well-woman exam is like a routine annual physical, but it’s focused on the unique health and medical needs of women, especially as women go through different stages of life. In addition to routine physical evaluations, well-woman exams may include birth control selection, STD prevention or testing, menopause care, and management of chronic issues like PCOS or uterine fibroids. Plus, a well-woman exam includes important health screenings aimed at helping women identify and understand their risks for specific diseases and condition so they can take steps to reduce those risks and improve their overall health and wellness.
Well-woman exams begin with a personal and family medical history, followed by weight and blood pressure measurements. Patients also will be asked about any symptoms they may have or concerns they want to discuss. Next, physical evaluations are performed. Dr. Potgieter will listen to the patient’s heart and lungs, palpate the belly area to look for areas of tenderness, and perform a clinical breast exam. In most cases, a pelvic exam will also be performed, along with a Pap test or HPV (human papillomavirus) test. Depending on the patient’s specific medical history or symptoms, additional evaluations may be performed, or urine, blood, or other testing may be ordered. In some cases, diagnostic imaging studies like ultrasound may be ordered. Finally, Dr. Potgieter will review the findings and discuss any treatment or lifestyle recommendations in addition to discussing any concerns the patient may have.
Prenatal exams include different types of evaluations and services depending on the stage of the pregnancy and other factors. Typically, exams begin with a review of any symptoms the patient may be experiencing, followed by weight and blood pressure measurements.
During most exams, Dr. Potgieter will measure the belly and listen to the baby’s heartbeat, and a urine test may also be administered. Blood tests may also be performed, along with an ultrasound exam to evaluate the baby’s development and the position and size of the placenta. Other tests may also be ordered, depending on the patient’s specific needs. And of course, there will be time to ask questions and find out about what to expect during the next few weeks of pregnancy.
Most women see their obstetrician every month for the first seven months or 28 weeks, then every other week until week 36, then weekly until delivery. Women with high-risk pregnancies probably will need to be seen more frequently.
Many women who have had cesarean sections can still have vaginal deliveries for subsequent pregnancies. Patients who have had cesarean sections and want to be considered for vaginal births should discuss their desires with Dr. Potgieter so they can be evaluated to see if a vaginal birth after c-section (VBAC) is feasible.
High-risk pregnancies are pregnancies where the health of the mother or the baby is or could be compromised in some way. Some of the most common causes of high-risk pregnancies include:
> Older age
> Drug or alcohol use
> High blood pressure or diabetes that develops during pregnancy, or exists prior to pregnancy
> Multiple prior miscarriages
> Carrying more than one baby
> Certain medical treatments, including cancer treatments
> Some underlying genetic issues
Women who have high-risk pregnancies typically need to be seen more often for testing and examinations to ensure both the mother and the baby stay healthy throughout pregnancy and delivery. Genetic testing and other types of specialized testing may also be ordered for women with high-risk pregnancies, depending on their underlying condition.
- Assessment for and diagnosis of gynaecological cancers
- Treatment of pre-cancerous gynaecological lesions
Menopause begins when the body slows down its production of estrogen and progesterone, two hormones essential for reproduction but which also play important roles in other bodily functions. As hormonal production slows down, women can experience an array of symptoms, including:
> Abnormal periods - including irregular cycles, very heavy periods, or spotting between periods
> Night sweats
> Hot flashes
> Sleep problems
> Memory problems and difficulty focusing
> Weight gain
> Hair loss and facial hair growth
> Dry, itchy skin
> Sore or tender breasts or nipples
> Achy joints
> Vaginal dryness
> Painful intercourse
> Medically speaking, menopause occurs when menstruation has not occurred for 12 consecutive months. The time leading up to menopause, when most symptoms appear, is referred to as perimenopause.
Menopause treatment is focused on relieving the symptoms of menopause. Some women opt for treatments focused on specific symptoms, like using vaginal creams or lubricants for painful intercourse of vaginal dryness. Many women prefer hormone replacement therapy (HRT) to replace some of the hormones that are no longer being produced naturally by the body. Today’s bioidentical HRT uses synthetic hormones that are created to be chemically identical to the hormones produced by the body. That means the body “recognizes” these hormones in the same way it recognizes the ones produced naturally, and it uses them and eliminates them in the same ways as well. As a result, HRT is associated with far fewer side effects compared to traditional HRT, where the synthetic hormones were not as easily processed and eliminated by the body, resulting in excess accumulation of the chemicals. Women who opt for HRT will have regular testing and evaluation to ensure their dosing remains optimized for their needs.