The menopause is a time of change that is experienced and assessed differently by different individuals. For some it’s a welcome change, for others it’s accompanied by symptoms that can lead to illness. Maybe you notice changes early on that you can’t pinpoint exactly? Are you unsure about the various statements about hormone replacement therapy? Do you have questions about contraception – is it still necessary now? Your weight goes up even though you always eat the same diet? We would be happy to advise and accompany you on this path, according to your individual needs.

From falling in love for the first time to the menopause, whether with or without hormones, we support and advise you in choosing the right contraceptive method.

Since every contraceptive method can have side effects, it is important to carefully assess your needs and history.

Sometimes, the right method for you isn’t found at first, and your needs may change over the course of your life. That’s why we plan regular follow-up appointments so that we can work with you to find and maintain the best method to suit your current needs.

Young, and very young women in particular, often don’t feel like taking the pill. After careful consideration and the necessary preliminary investigations, you can also use an IUD if you wish. The prerequisite for this are both the exclusion of infections (especially chlamydia) and an ultrasound examination to assess the uterus.

We evaluate whether a hormonal or copper IUD is more suitable based on your history and personal preferences.

An unwanted pregnancy is a crisis situation for the woman or couple concerned. We will offer you a timely appointment to give you non-judgmental advice and to support you on the way to making the best decision for you.
Please note that we are bound by the legal regulations and deadlines for an impunity free abortion and consistently comply with them. 
www.fedlex.admin.ch/eli/oc/2002/429/de

You are welcome to come to the interview as a couple.

Bacterial and fungal infections of the vagina are very common and are usually harmless. However, those affected can experience considerable suffering if they are repeatedly plagued by unpleasant discharge and itching.

It is important to us to diagnose these precisely, in order to distinguish and differentiate infections from chronic skin diseases, and to explain both possible causes and preventive measures to you.

The first visit to the gynaecologist goes hand in hand with many questions: When is a visit necessary? Do I need to be examined? Does an examination hurt? Is it embarrassing? … lots of questions – which we are happy to help clarify!

It is important to us to be a relaxed point of contact for young women, where they can easily obtain information and advice. Commonly asked questions are often regarding painful menstruation. An examination is not always necessary to help with this. Help can often be provided through various complementary medicine and pain-relieving measures.

An initial appointment can also simply serve as orientation and getting to know each other. That way, you know where to go if you ever need to. We can explain the examination in theory and thus often reduce any anxiety around the subject. Patients are often very nervous before their first visit. You are also very welcome to bring along a good friend, your mother or your partner to support you during your appointment.

Sexual education is the basic building block for learning and experiencing relaxed sexuality. Being informed is everything and there are no “stupid questions”! That’s why Juliane Trensz offers courses in schools, where I am happy to provide information and offer workshops on topics of sexual health and education. You are welcome to ask me about these courses.

We will invite you to undertake regular check-ups. We offer both the PAP/cervical smear, and a professional breast examination. A mammography and an ultrasound examination of the breasts are recommended from the age of 50 (possibly earlier if risk factors are present). We offer breast ultrasound screening in our Practice. For a mammography, we will refer you to our trusted partners, or a Center of your choice. Please note that basic insurance only covers preventive examinations every 3 years. Before visiting the doctor, please find out from your insurance how the bill from us should be coded and whether any additional insurance will cover the examinations in the years in between. This saves a lot of bureaucratic complications and effort. Please also note that we can only bill a consultation as “prevention” if no other questions/problems arise.

Often, otherwise healthy patients do not have a family doctor who they consult regularly. We would therefore be happy to also advise you on preventive blood tests (e.g. cholesterol and blood sugar levels).

If a PAP smear shows abnormalities, which often happens (even despite HPV vaccination), this is no reason to worry.
We will explain the respective change to you and offer a colposcopic assessment and, if necessary, a biopsy of the cervix during the consultation.

In most cases, only close monitoring is necessary and the dysplasia will resolve on its own. Rarely, after some observation, conization is necessary (the affected area of the cervix is surgically removed). This requires an outpatient hospital stay.

We can also advise you on HPV vaccination and offer this in our Practice.

Please note that an HPV vaccination does not replace prevention, as the current vaccine only contains the 9 most common HPV strains, but there are several hundred of them in total with which you can still become infected.

Pregnancy is a special time in the life of a woman, and a couple. Pregnancy, which lasts nine months, or 40 weeks, is associated with many physical changes. Many questions arise. You get to know yourself in a new way.

We are happy to be at your side during this time. In the case of an uncomplicated pregnancy without risk factors, the planned check-ups take place at four-week intervals up to the 30th week of pregnancy. From the 30th week of pregnancy, more frequent checks every 2 weeks are recommended.

Your partner is of course welcome to the preventive examinations.

We provide you with comprehensive advice on nutrition, prenatal diagnostics, vaccinations during pregnancy, measures against nausea, heartburn, etc.

Together we will decide the place of birth and register you for the birth at the hospital of your choice. If you have private/semi-private insurance and would like to go to the Bethanien Hospital, Klinik im Park or Hirslanden, then we would be happy to provide you with competent attending physicians who will look after you for the birth.

We would also be happy to advise you on recommended vaccinations, folic acid prophylaxis and examinations before a planned pregnancy.

In Switzerland, two screening ultrasound examinations are generally recommended for all pregnant women and paid for by the health insurance company. These take place between the 11th and 14th weeks of pregnancy and again between the 20th and 22nd weeks of pregnancy. Additional examinations are only necessary for medical reasons or as part of the care of high-risk pregnancies.

We offer both of these screening examinations in our Practice. It is important for you as an expectant parent to know that all examinations are an offer or recommended, and that you can choose your own path at any time and have a “right not to know”. Ideally, you should consider early in your pregnancy the extent to which you would like to carry out prenatal diagnostic tests and what any abnormal results would mean for you personally. There is a wide range of considerations here that are shaped by your personal experiences and that only you can decide for yourself.

However, we are happy to support you if you have any questions, or in the event of any abnormalities, to refer you to experienced colleagues in prenatal diagnostics and/or genetics. It is also important to know that there is no guarantee that the child will be healthy, despite carefully carried out examinations, a malformation may only become apparent after birth.

First trimester test/ETT 
This is offered as part of the 1st trimester screening, and is part of the preventive examinations (covered by the health insurance company) and is primarily used to rule out the 3 most common chromosomal abnormalities: trisomy 13, 18 and 21. The ETT is a risk calculation: If the risk is increased (<1:1000), further, initially non-invasive diagnostics are offered (NIPT). If the risk is not significant (>1:1000), no further examinations will normally be carried out unless you request this. Further examinations will then be carried out at your expense.

The following values are included in the risk calculation of the ETT:
– age of the mother
– width of the nuchal fold
– two values that are 
determined from the mother’s blood: PAPP-A and free beta-HCG

NIPT = Non Invasive Prenatal Test 

Cell-free DNA from mother and child is examined in the mother’s blood. This means that the most common chromosomal disorders (trisomy 21, 18 and 13) can be ruled out with a very high degree of probability. NIPT is only recommended if there are abnormal ETT results. However, it can also be carried out on request. Please note
that a positive test result must always be confirmed by invasive diagnostics, as false positive results can occur in rare cases.

Ultrasound screening 2nd trimester (20th-22nd week of pregnancy) “organ screening”
– detection of malformations and fetal growth monitoring. If desired, the gender of the child can be communicated to you.
– Position of the placenta and, if necessary, Doppler ultrasonography to measure blood flow
– Measurement of the cervix length (= length of the cervix)

Procedere following an abnormality in the Ultrasound 
If an abnormality is discovered during the ultrasound, we will discuss together how to proceed. In order to assess this in further detail, we would refer you to an ultrasound expert in accordance with the four-eye principle. If necessary, you will be offered further invasive inverventions: this could be, for example, an amniocentesis (examination of the amniotic fluid in the womb) or chorionic villus sampling (biopsy of the placenta).

Certain diseases can be treated in utero. Others, if already known about during the pregnancy, mean you can plan the birth in advance (e.g. if paediatric care is necessary immediately after the birth) as well as any other necessary interventions after the birth, and be prepared for it. If there is evidence of a serious, incurable problem in the child, the question may also arise as to whether you want to continue with the pregnancy. In this case, we will also look after you together with colleagues who specialise in this area and support you in your decision.

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We are very pleased to have Joanna Heldner working with us. Joana specialises in pelvic floor physiotherapy. Appointments can be made via our Practice, or directly via her own homepage: www.joanaheldner.ch