A women’s health journey can certainly be complex and taking care of your health should be a priority. It should however also be an enjoyable one. Through expert guidance and compassionate care, we strive to find that perfect balance to make your journey as easy and stress-free as possible.

Breast Health

What kinds of changes occur in breast tissue throughout life?

Your breasts respond to changes in levels of the hormones estrogen and progesterone during your menstrual cycle, pregnancy, breastfeeding, and menopause. Hormones cause a change in the amount of fluid in the breasts. This may make the breasts feel more sensitive or painful. You may notice changes in your breasts if you use hormonal contraception such as birth control pills or hormone therapy.

What should I do if I find a lump in my breast?

If you find a lump or suspicious area in your breast, contact your health care provider. Your health care provider will probably do a physical exam of your breasts. This is called a clinical breast exam. Based on the results of this exam, more tests may be recommended.

What is mammography?

Mammography can be used as a screening test for breast cancer (screening mammography) or to help diagnose a suspicious area or problem (diagnostic mammography). An annual screening mammogram is recommended for women aged 40–75 years. Women older than 75 years should talk to their health care providers about the need to continue having this test.


Menopause is the time in your life when you naturally stop having menstrual periods. Menopause happens when the ovaries stop making estrogen. Estrogen is a hormone that helps control the menstrual cycle. Menopause marks the end of the reproductive years. The average age that women go through menopause is 51 years.

What is perimenopause?

The years leading up to menopause are called perimenopause. Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries begins to fluctuate. A common sign of perimenopause is a change in your menstrual cycle. Cycles may become longer than usual for you or become shorter. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal during perimenopause, you still should report them to your health care provider. Abnormal bleeding may be a sign of a problem.

Besides menstrual cycle changes, what other signs and symptoms can occur during perimenopause?

Some women do not have any symptoms of perimenopause or have only a few mild symptoms. Others have many symptoms that can be severe. Common signs and symptoms include the following:

  • Hot flashes—A hot flash is a sudden feeling of heat that rushes to the upper body and face. A hot flash may last from a few seconds to several minutes or longer. Some women have hot flashes a few times a month. Others have them several times a day. Hot flashes that happen at night (night sweats) may wake you up and cause you to feel tired and sluggish during the day.
  • Sleep problems—You may have insomnia (trouble falling asleep), or you may wake up long before your usual time. Night sweats may disrupt your sleep.
  • Vaginal and urinary tract changes—As estrogen levels decrease, the lining of the vagina may become thinner, dryer, and less elastic. Vaginal dryness may cause pain during sex. Vaginal infections also may occur more often. The urethra can become dry, inflamed, or irritated. This can cause more frequent urination and increase the risk of urinary tract infections.

Pelvic Organ Prolapse

What is pelvic organ prolapse?

This condition refers to the bulging or herniation of one or more pelvic organs into or out of the vagina. The pelvic organs consist of the uterus, vagina, bowel and bladder. Pelvic organ prolapse occurs when the muscles, ligaments and fascia (a network of supporting tissue) that hold these organs in their correct positions become weakened.

Symptoms include:

  • a heavy dragging feeling in the vagina or lower back
  • feeling of a lump in the vagina or outside the vagina
  • urinary symptoms such as slow urinary stream, a feeling of incomplete bladder emptying, urinary frequency or urgent desire to pass urine, and urinary stress incontinence
  • bowel symptoms, such as difficulty moving the bowel or a feeling of not emptying properly, or needing to press on the vaginal wall to empty the bowel
  • discomfort during sexual intercourse

What causes pelvic organs to prolapse?

The main cause is damage to the nerves, ligaments and muscles which support the pelvic organs and may result from
the following:

  • Pregnancy and childbirth are considered to be major factors leading to weakening of the vagina and its supports. Prolapse affects about one in three women who have had one or more children. A prolapse may occur during or shortly after a pregnancy or may take many years to develop. However, it is important to emphasize that only 1 out of 9 women (11%) will ever need surgery for prolapse in their lifetime
  • Aging and menopause may cause further weakening of the pelvic floor structures
  • Conditions that cause excessive pressure on the pelvic floor like obesity, chronic cough, chronic constipation,
    heavy lifting and straining
  • Some women may have an inherited risk for prolapse, while some diseases affect the strength of connective tissue e.g. Marfan syndrome and Ehlers-Danlos syndrome

Stress Urinary Incontinence

Stress Urinary Incontinence (SUI) is the involuntary leakage of urine during activities such as coughing, sneezing, lifting, laughing or exercising. SUI affects at least 10-20% of women, many of whom do not realize that there are simple, effective treatment options available. SUI affects the quality of women’s lives in many ways. Incontinence may limit women’s social and personal relationships, as well as limiting physical activity.

Causes of Stress Urinary Incontinence

  • Pregnancy and vaginal birth.
  • Obesity, chronic cough, chronic heavy lifting and constipation.
    These can cause an increase in abdominal pressure and aggravate stress incontinence.
  • Genetically inherited factors

What are my treatment options?

Dr Groenewald will advise you on the best options for you, but initially you may be recommended conservative treatment.

Reducing Your Risk of Cancer

What causes cancer?

Cancer occurs when old cells do not die when they should or are damaged. Normally, the body repairs or destroys such cells. Sometimes, these cells may grow out of control. This causes growths or tumors to form. Tumors can be benign (not cancer) or malignant (cancer).

Benign tumors do not spread to other parts of the body. Malignant tumors can invade and destroy healthy tissues and organs. Cancer cells also can spread to other parts of the body and form new tumors. The risk of cancer can be inherited in a person’s genes. In some cases, cancer can be caused by being exposed to a harmful substance such as a virus, certain chemicals, or radiation. Sometimes more than one cause is involved.

What are the warning signs of cancer?

Most types of cancer have early warning signs that something is wrong. If you notice any of these signs, contact your health care provider right away:

  • A change in bowel or bladder habits
  • A sore that does not heal
  • Unusual bleeding or discharge
  • Thickening or a lump in the breast or other parts of the body
  • Indigestion or difficulty swallowing
  • A change in a wart or mole
  • A nagging cough or hoarseness

None of these signs is a sure sign of cancer. They are clues that something could be wrong. If you notice any of these signs, see your doctor right away. Getting treatment early increases your chances of successful treatment, whether you have cancer or some other problem.

It’s time to stop smoking

With each puff of a cigarette, your body is exposed to more than 7,000 chemicals. Hundreds of these chemicals are toxic. About 70 are carcinogens. The chemicals in cigarette smoke move from your lungs to your blood. The blood in your arteries carries these chemicals to every organ in your body. When you smoke, it damages your body right away. Smoking even one cigarette is not safe.

What are some reasons to quit smoking?

Quitting smoking is one of the best things you can do for your health and your family’s health. Additional reasons to quit include the following:

  • You will look better and have more energy.
  • Tobacco stains will fade from your teeth, nails, and hands.
  • You will have more money in your pocket.
  • You will be free from having to find a place to smoke.
  • You will never have to worry about running out of cigarettes.
  • The smell of cigarettes will fade from your clothes, car, and home.
  • You will set a good example for your children and others.

Weight Control: Eat right, keep fit

What is the body mass index?

The body mass index (BMI) is a tool that often is used to measure body fat. It is based on height and weight. To find out your BMI, you can use the online calculator at www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.

What health problems are associated with being overweight?

Many serious health problems are linked to being overweight or obese:

  • Cardiovascular disease
  • Diabetes
  • Gallbladder disease
  • Certain types of cancer, such as cancer of the endometrium, breast, colon, and gallbladder; obesity also may increase the risk of ovarian cancer.
  • Sleep apnea
  • Joint disease
  • Infertility

Does exercise have additional benefits other than helping with weight loss and maintaining a healthy weight?

Exercise promotes general health and increases mental well-being. Your endurance increases, as does your flexibility and muscle strength. Exercise can help reduce symptoms of depression and anxiety in some people. Your risk of heart disease, colon cancer, and diabetes decreases with regular physical activity.

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