We are delighted to have Dr Nalini Ambiavagar & Dr Andree Rochfort here at The palms GP Surgery who specialise in women’s health ,along with our own midwife and highly skilled nurses. We provide information and application of all aspects of contraception & family planning including:

  • Mirena Insertion / Removal
  • Implanon Insertion / Removal
  • Emergency Contraception
  • Contraceptive Depot Injections
  • Advice On All Forms Of Contraception And Prescriptions
  • Preconceptual Advice
  • Unplanned Pregnancy – Help And Advice



The most effective contraceptive methods are known as LARC (Long Acting Reversible or Longer Lasting Contraception).

These are highly effective methods, with very low failure rates as they are essentially “fit and forget” methods so no need for daily reminders. These methods are also highly cost effective, with no need for regular checks that might be needed with other methods.

Long Acting Reversible Contraceptive methods include:
  • Intra-uterine devices (also known as coils)
  • Implants (often referred to as ‘the bar’) – inserted under the skin in the upper arm
  • Injections, given every three months
  • Intra-uterine devices (IUD) are small T-shaped plastic devices which are available in different sizes. They come with hormones or without hormones, the latter known as a copper coil. They act as a contraceptive device largely by preventing fertilization, with some other local effects.

The range of hormonal devices has recently expanded and we can now offer a wider choice of device to suit individual needs. These devices vary in the length of time they are effective for and can be chosen based on this requirement.  

The contraceptive implant is inserted under the skin of the upper arm. This device has the lowest dose of hormone of all hormonal methods of contraception. Dr Ambiavagar is a LARC tutor and along with Dr Andree Rochfort have a special interest in women’s health.


Cervical Cancer Screening (Smears)

What is a Smear Test?

A smear test is used for cervical screening. It is a simple procedure where a doctor or nurse takes a sample of cells from the cervix to look for early changes. A smear test can identify cell changes before they can become cancer cells. If these cells are not found and treated, they can become cancerous.

Who Should Have A Smear Test?

Every woman aged between 25 and 44 is advised to have a smear test every three years and if ages between 45 and 60 you are advised to have a smear test every 5 years.

Is There A Cost For Smear Tests?

NO – The Palms GP Surgery participates in the National Cervical Screening Programme. The Programme offers FREE smear tests to women aged 25 -60 who are eligible for screening.

How Do I Avail Of My FREE Smear Test?

You must register with the National Cervical Screening Programme to avail of your free smear test. To register, visit www.cervicalcheck.ie or phone 1800 454 555. On completion of registration, you will be posted a letter of invitation which you must bring with you when you attend for your appointment.


Are You Breast Aware?

Even the healthiest of women can get cancer. One in nine women will develop breast cancer in their lifetime, but it’s not all bad news. As more women become breast aware, they’re spotting lumps and changes in their breast much earlier, which increases their chances of a cure. At the same time medical science is making huge strides forward in developing treatments that save lives.

How Do I Check My Breasts?

There is no right or wrong way to check. You simply need to take a few minutes to look at and feel your breasts regularly, so you know what is normal for you. M.B Always check all parts of your breasts, your armpits and up to your collarbone.

What Changes Should I Check For?

Everyone’s breasts look and feel different. For many women its normal to have lumpy breasts, or for their breasts to feel tender around their period, or to have one breast larger than the other. That’s why it’s important to know what is normal for you, and to be aware of any changes that are unusual.

Changes such as:
  • A change in size or shape.
  • Constant pain in your breast or armpit.
  • Your nipple becomes inverted (pulled in) or changes shape.
  • A change in skin texture , such as dimpling.
  • Discharge (liquid) form your nipple.
  • A lump, or thickening that feels different from the rest of your breast.
  • A rash or redness on the skin around your nipple.
  • A swelling in your armpit or around your collarbone.
What if I Notice A Change?

If you notice a change you should see your doctor as soon as possible. Most breast changes aren’t the result of anything serious but you do need to find out what s causing the change. You can ask to see a female doctor and you can take a friend or relative to the appointment with you. For further information visit www.breastcancer.org or www.cancer.ie

Breast Screening

Breast screening involves a MAMMOGRAM of the breasts , which can detect early signs of cancer before it can be seen or felt. The National Breast Screening Programme, began offering FREE mammography to women aged 50-64 in 2000. The Programme invites eligible women, on an area by area basis, for screening every two years.

Women can check that they are on the register by calling FREEPHONE 1800 45 45 55. We would encourage all women invited for screening to attend their appointment. Visit www.breastcheck.ie


The Menopause / Change Of Life

The menopause, also called “the change of life” is defined as the end of the last menstrual period. Research into the menopause is relatively recent. One hundred years ago, when life expectancy was shorter, most women did not live long after the menopause and so little was known about it. Most women go through the menopause between the ages of 45 and 55, but in some cases this can vary significantly.

The menopause occurs when the ovaries no longer respond to the controlling hormones, released by the pituitary gland of the brain. As a result, the ovaries fail to release an egg each month and produce the female sex hormones oestrogen and progesterone. It is the fall in the levels of these hormones in the blood stream that give rise to the symptoms of menopause. Almost all women notice early symptoms while still having periods. This stage of gradually falling and fluctuating hormone levels is called perimenopause, and often begins in the early 40’s.

Symptoms may include:
  • Irregular and or heavy periods
  • Hot Flushes
  • Vaginal dryness
  • Feeling down
  • Leaking of urine
  • Headaches
  • Panic attacks
  • Breast Pain
  • Night Swaets
  • Tiredness
  • Irritability / mood swings
  • Sleep problems
  • Lower sex drive
  • Concentration / memory problems

There is no treatment for menopause itself but there are treatment options for the symptoms associated with menopause. If you are experiencing severe symptoms which are effecting you and / or your family members, your GP will be able to discuss these options with you.

A HSE booklet “Menopause A Guide” is available by calling 1850 241 850 or online at www.healthpromotion.ie


Managing The Menopause

Your body’s changing and the mood swings aren’t helping. But don’t panic – it is a great time to take control and improve your health, lifestyle, and at the same time reduce the effects of your symptoms.

Oestrogen does much more than control your periods. It also helps your heart and bones stay healthy, as well as keeping your brain in good working order. So as the levels drop, you may become prone to health problems such as heart disease and osteoporosis.

What can you do?
  • Eat plenty of fresh fruit and vegetables to boost your energy levels.
  • Reduce your intake of saturated and trans fats and sugar, as this may help reduce mood swings.
  • If you smoke, try giving up. The menopause increases your risk of heart disease and osteoporosis, and smoking pushes these risks still higher.  Visit your GP for help and advice on giving up smoking.
  • Help protect your bones by eating food in rich calcium, such as sardines, yogurt, milk, cheese, spinach and oranges.
  • Cut back on tea, coffee and alcohol and try to drink one or two liters of water a day
  • Regular exercise helps to keep your weight down and your spirits up. It also helps you to sleep well and is good for bone and heart health. Include some weight bearing activity, such as walking or dancing, to help protect bones against osteoporosis.
  • Boost your intake of soya (tofu and soya milk are good sources), as some studies suggest it may help to ease the symptoms.
Your GP can help

Women experience the symptoms of the menopause in varying degrees and while some women may seem to “sail through” the menopause with no great distress, others are more severely effected. Many women do not seek help, for many different reasons:

  • you may be unaware that the symptoms you are experiencing are related to the menopause – the good news is that your not going “mad”
  • you may feel your friends seem to be able to cope, why can’t you?
  • you believe its just part of life so you just have to get on with it.

Whatever the reason, help is available DO NOT suffer in silence, speak to your GP.