Dr Kirsten Connan

Endometriosis is increasingly recognised as a treatable cause of pelvic pain, with about 10% of Australian women having this gynaecological condition. Although first identified more than 150 years ago, women today can still suffer with significant pain for many years before they are diagnosed and offered treatment.

Endometriosis occurs when the cells that line the uterus, the endometrium (or endometrium-like cells), are found in other sites of the pelvis such as the ovaries, fallopian tubes, peritoneum, bladder and bowel. Endometriosis can lead to pelvic pain, infertility, fatigue, nausea, bloating, and other problems. The pelvic pain associated with endometriosis is often cyclical, occurring with the menstrual period (dysmenorrhoea), but can lead to constant and chronic pelvic pain. Endometriosis is also often associated with pain during sexual intercourse (dyspareunia), with urination (dysuria), and with bowel motions (dyschezia).

Dr Connan has a special interest and expertise in managing pelvic pain, and in particular, pain due to endometriosis. 

Although surgery is an important and sometimes life-changing component of endometriosis treatment, it should not occur without considering other important aspects of gynaecological care. Women need holistic, multi-disciplinary care, considering not just the need for surgery but the social, psychological and lifestyle impact of endometriosis. Some cases of endometriosis can be managed with lifestyle modification, such as exercise, medication to reduce pain, hormones to manage a woman's cycle and sometimes even hormone-blocking medications.

Over her years in Hobart, Dr Connan has put together a team of healthcare professionals that provide their expertise to give the care that women with endometriosis deserve: specialist endocrinologists to assist with managing complex hormonal issues, women's healthcare psychologists, and pelvic floor physiotherapists. When endometriosis involves the bowel or bladder, Kirsten has professional relationships with specialist colorectal surgeons and urologists that can be available to assist with this treatment.

Abnormal uterine bleeding with heavy menstrual bleeding (menorrhagia), large clots or flooding, bleeding between periods (intermenstrual bleeding), and bleeding during or after sexual intercourse (post coital bleeding), are problems that many women are challenged with at some time during their life. This does not necessarily indicate sinister causes such as uterine or cervical cancer, but it can still have a devastating impact on a woman's life, work and family.

Dr Connan has a special interest in managing abnormal uterine bleeding, and recognises that this can be a very stressful and worrying time for many women.

Abnormal uterine bleeding should be reviewed by a gynaecologist or women's health specialist GP. In particular, post-menopausal bleeding can be an early sign of endometrial cancer, and should be investigated. Review of these conditions can occur with a consultation in the TasOGS rooms, and if needed a gynaecological ultrasound can be performed to measure the thickness of the endometrium (lining of the uterus).  The finding of a thickened or abnormal endometrium on ultrasound often requires a hysteroscopy and sampling of the endometrium under an anaesthetic. This can often provide welcome reassurance.

Heavy uterine bleeding can often be managed with hormone therapies such as the oral contraceptive pill (OCP), insertion of a hormone IUD, such as the Mirena®, or progesterone tablets. Minor surgical management options include an endometrial ablation under an anaesthetic with the Novasure® or Thermablate® system. If bleeding cannot be adequately managed with these treatments sometimes a hysterectomy may be required. Any diagnosis of endometrial cancer is always referred to one of Hobart's sub-specialist gynae-oncology surgeons to ensure that women receive the best care and outcomes.

Many women's health issues and gynaecological conditions can be managed medically without needing operations or surgery. Dr Connan and the TasOGS team of women's healthcare professionals offer a wide-range of clinic services from the TasOGS practice, including:

Your TasOGS doctor will refer you to a gynae-oncology sub-specialist if you require investigation and management of PAP smear abnormalities.

Dr Connan operates exclusively at Hobart Private Hospital with an experienced and dedicated surgical team. In addition to her interest and experience in advanced laparoscopic surgery, she also performs a range of other surgical procedures as part of treatment for common gynaecological conditions.

These include:

• Diagnostic and operative hysteroscopy, for investigation of heavy periods and removal of uterine polyps.
• Endoscopic cystoscopy for diagnosis of interstitial cystitis.
• Resection and excision of uterine fibroids (myomectomy).
• Total abdominal hysterectomies (TAH), when a laparoscopic hysterectomy is not possible.
• Novasure® and Thermablate® endometrial ablation for abnormally heavy periods (menorrhagia).
• Excision of Bartholin cysts and vulval lesions.
• Medically-indicated functional labioplasty.
• Insertion or removal of Mirena IUD, copper IUD or Implanon hormone implants under an anaesthetic if required.

Many of these smaller procedures can be performed as ambulatory day surgery at Hobart Private Hospital, allowing you to avoid staying overnight in hospital. If you do stay in hospital post-operatively, you will be reviewed each day by Dr Connan, or if she is away, a covering gynaecology specialist. Follow-up appointments will be made upon your discharge for review by Dr Connan in the TasOGS rooms.