Suffering in silence has long been a way of describing the many health concerns faced by women.
They are often complicated, in many cases extremely serious, and can leave women feeling incredibly isolated. From issues with infertility, pregnancy terminations, period problems, polycystic ovary syndrome, endometriosis, pelvic pain, menopause and incontinence - women's health is complicated and multi-faceted.
For the past year the Launceston Women's Health Clinic has been offering a safe and caring place for women to access care from a group of dedicated and specialised female general practitioners.
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Opening their doors during the height of the pandemic in June 2020, the clinic initially operated two days a week, with three doctors. Now, 12 months on, it's essentially doubled its services to four days a week, with six doctors.
It's something clinical director Dr Sue Mallett puts down to a demand for specialised services, offered in an environment where women can feel safe and supported.
"Women are so often invisible with their health needs and some of their health concerns are invisible ... we just don't talk about them," she said.
"To have a place where women can feel comfortable discussing symptoms and conditions that can make them feel very alone has been a very rewarding service to be able to provide.
"I think during the initial COVID lockdown, a lot of people didn't feel able to access their health needs for what might be considered routine health checks.
"It's been really encouraging to see the number of women grow for cervical screens, breast checks - all those things that are often put on the backburner until we have time."
Women's health encompasses anything to do with the female reproductive system and can mean different things for women of different ages.
Medicare Benefits Schedule data from last year showed the number of face-to-face attendances for women from March to June fell by almost 24 per cent nationally compared to the same period in 2019. In April, national trends show cervical cancer screening rates fell by 67 per cent.
In its first 12 months, the Launceston Women's Health Clinic has seen more than 3300 women, aged from 16 to 87 - the whole spread of a woman's life.
With a focus on multidisciplinary care, clinical services manager Kath Hinde said feedback from patients showed the option for longer appointments were among the features that attracted women to the clinic.
"We knew coming in from a women's health background that women really value time and to not feel pressured," she said. "We are very fortunate to have female doctors here, who are all specialised in their fields."
Among the team of female doctors is Dr Clare Cuglet, who joined the clinic in March this year. Originally from Tasmania, but having spent time working in the United Kingdom and Melbourne, she said she was pleasantly surprised to learn that a women's health clinic had been established in Launceston.
"It's really exciting. It's definitely something that was missing from Launceston," she said. "It just goes to show from all the patients that we see come in ... some of them have just been waiting for a women's health clinic to open.
"Now they have somewhere to bring their problem, or they read about us and realise this is the right place for them to come."
Dr Min Giffard, who joined the clinic in February, said many female GPs were drawn to women's health issues, but weren't often afforded the opportunity to specialise.
"I think as a younger female doctor, you naturally are going to attract women's health issues," she said.
"This clinic creates a great opportunity to be able to deliver that ... it gets delivered here better than what I was experiencing in mainstream practice. I am certainly much better supported. My job satisfaction here is much greater than what it has been for a number of years, just concentrating on one area. I am quite interested in contraception, and that stems from the fact that without the option of contraception, women's lives can take a very different path to what they maybe had wanted to. So I think that's a really important thing for any female to have access to."
The clinic is also among only a handful of services in the state's North that provides women with medical pregnancy terminations. Offered alongside pregnancy counselling, referrals for surgical abortions and assistance with applications for financial assistance, Dr Cuglet said it was vitally important for women to understand their options.
"I think it's really important to offer women choice and non-judgmental support. To be able to make their own decisions about what they want to do," she said.
"I think a lot of women have also appreciated being able to do that face-to-face, rather than via a telephone service, which we have been limited by in the past."
The clinic operates in a co-located capacity with the Launceston Health Hub on Wellington Street, with services operated independent of the Launceston Medical Centre. According to a 2019 report used to inform the federal Health Department's National Women's Health Strategy, barriers to the use and access to contraception included concerns about side effects, a lack of access to information, and negative experiences with health services.
It recommended additional training on contraceptive-specific GP consultations to improve women's health care experiences and to ensure GPs were adequately informed.
The study also found up to 10 per cent of young women aged up to 27 reported having polycystic ovary syndrome - a condition association with infertility, pregnancy complications and a range of chronic diseases including psychological distress.
Up to one in 10 women aged up to 42 years also reported having endometriosis - also associated with infertility and psychological distress.
While acknowledging significant progress had been made in women's health space in recent years, Dr Mallett said there still a long way to go.
"I think as GPs, we need to help create an environment that is safe, welcoming and supportive. To encourage women to talk about the things that are concerning them," she said.
"To be able to talk to women about that and offer them some options that may give them their freedom back, is a really rewarding thing to do."
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