Dr. Irum Rizwan, MD, CCFP Dr. Irum Rizwan is a family physician who holds a special designation in Women's Health. Dr. Rizwan completed her medical training at the University of Alberta and currently has a family practice in Oakville. She has a passion for contraceptive care and gynecological medicine. She also practices low risk obstetrics and newborn care at Oakville Trafalgar Memorial Hospital. Outside of medicine, she loves the outdoors and hiking with her dog.

Medical Services IUD Insertion and Removal Read More Implant Insertion and Removal Read More Perimenopause/Menopause Read More Colposcopy Read More Pessary Care Read More Abnormal Uterine Bleeding Read More Cosmetic Removals of Vulva Lesions Read More Vulva Disorders Read More

Cosmetic Vulvar Procedures Cysts and lesions on your vulva are mostly benign but can be bothersome. We get a lot of requests to remove them. These lesions are usually benign and the procedures to remove them are considered cosmetic/elective and will not be covered by OHIP. You do NOT require a referral for elective procedures, so you can just email or call our office for consultation. Fee will depend on the type, size, and number of cysts/lesions you have but generally start at $300+.

Quick expert access to IUD and Implant consultation, insertion, removal and replacement Perimenopause/ Menopause Perimenopause/Menopause Menopause is the cessation of menstrual periods for 12 consecutive months due to declining ovarian function and estrogen levels, typically preceded by perimenopause. Many experience hot flashes/night sweats, mood swings, irritability, cognitive changes, and an average weight gain of 2.3 kg (5 lbs), often around the midsection. We have partnered with Allied Health Professionals, such as Naturopathic Doctors, Pelvic Physiotherapist, and Dietician to be able to deliver the most comprehensive care. To learn more, click here . (image source: Responsum Health) More information Request Consultation

Quick expert access to IUD and Implant consultation, insertion, removal and replacement Implant (Nexplanon) Implant The newest method of birth control in Canada is the Progestin Implant called Nexplanon ®. It is a single 4cm by 2mm rod that is placed in your non-dominant arm. It is estrogen-free and lasts for 3-5 years. This is the most effective method of birth control with a failure rate of less than 5 per 10 000 users (that’s 180 times more effective than the pill!). This is perfect for patients who do not want to have anything placed in the uterus. It is easy to insert and lowers pelvic pain and menstrual cramps. About 50% of patients report minimal or no bleeding after 6 months but about 10% patients would like to have it removed due to irregular bleeding. More information Nexplanon ® Insertion Nexplanon ® Removal Nexplanon ® Replacement Request Consultation

For Physicians How long is the wait time for a referral? For non- urgent referrals, current wait time is about 1-2 months. We prioritize postmenopausal bleeding, abnormal uterine bleeding, abnormal pap/colposcopy, IUD, nexplanon procedures. To ensure a timely appointment, the patient will be scheduled with the first available doctor in the clinic. If you want to request a specific doctor, please mention it in the referral. Please also indicate if you are part of FHO/FHT to avoid negation if scheduled with GP with women's health focus but not yet designation (Dr Yasin). Do you provide surgeries and care for pregnant patients? No, we only see office based gynecological patients. How can I get further training in IUD procedures other than through SOGC? Dr. Yuh offers individualized training as well as group training depending on your need. Please contact admin@tulipwomenshealth.com or click here for more information. Referral Form For IUDs and implants, kindly use the designated form, which can be accessed by clicking the button below. For all other referrals, please continue to use the standard forms utilized in your clinic. IUD Referral Form

RESOURCES It's a Plan Gynaecology Quality Improvement Collaboration Sex and U Kyleena & Mirena Info Publications - Canadian Menopause Society Patient Education | The Menopause Society

Privacy & SMS Communication Policy At Tulip Women’s Health (Dr. Jeanie Yuh & Associates), we are committed to protecting your privacy and ensuring respectful, secure communication with our patients. Privacy Policy We collect personal information only as needed to provide medical care, schedule appointments, and support secure communication. We do not share or sell patient information, including phone numbers, to any third parties for marketing or commercial purposes. Your information is used only for clinical and administrative purposes in accordance with applicable privacy laws. SMS Communication Policy We use SMS (text messaging) only for: Appointment reminders and confirmations Secure video consultation links Important scheduling updates Consent By providing your mobile number in the referral, you consent to receive SMS messages from Tulip Women’s Health. Standard carrier rates may apply. Consent may be withdrawn at any time by contacting us. Limitations Messages are for appointment-related communication only. Privacy Your phone number and other personal information are kept confidential and protected under our Privacy Policy.

Melissa Koch, Registered Dietitian Melissa Koch is a Registered Dietitian with over 15 years of experience in women’s health, perinatal care, and pediatric nutrition. She earned her Bachelor of Applied Science in Nutrition and Food from Toronto Metropolitan University and then completed a graduate-level dietetic internship with Capital Health in Nova Scotia. Melissa also holds a Master’s in Adult Education and Community Development from OISE. She has spent much of her career with Toronto Public Health, supporting women and families with hormonal imbalances, fertility, prenatal and postnatal nutrition, and pediatric nutrition. Her expertise includes nutrition therapy for PCOS, thyroid conditions, insulin resistance, perimenopause, and menopause, and she helps families build healthy, sustainable eating routines. Melissa works collaboratively with clients to create flexible, personalized nutrition strategies that align with their unique goals and lifestyles. She can help you with: • Personalized meal plans and nutritious snack ideas • Using food to help relieve symptoms and boost energy • Guidance on supplementation when needed • Optimizing your diet to prevent or manage chronic conditions • Building sustainable habits that nurture long-term health and well-being She is passionate about empowering women to feel confident and balanced in their relationship with food and their bodies. Outside of work, she is a wife and mother of three children who enjoys baking, biking, and exploring new places with her family.

Uninsured Services Some medical procedures, and most forms and notes, are not insured by OHIP and therefore are subject to a fee. The current fees are determined at the suggestion of the OMA. Payments can be made in the office (debit, credit, and e-transfer are accepted). List of uninsured services are as below: Doctor's notes: $50 Prescription refills without an appointment: $40 Insurance forms : $100

Cancellation/No Show Policy Please provide at least 72 hours notice to cancel an appointment as there are many other patients waiting for time with the doctors. If you need to cancel an appointment for Monday at 9am, you must contact the office before 9am on Friday. Failure to do so and not showing up to the appointment will result in a charge based on OMA recommended rates. You will receive a reminder email ahead of your appointment through a secure message. The office does not give reminder calls for appointments.

Post IUD Insertion Care Congratulations! You had an intrauterine device (IUD) inserted! There are 2 types of IUDs: one that releases a hormone (hormonal IUD) and one that does not (copper IUD). When does my IUD start working? The copper IUD begins working now. Hormonal IUDs (Mirena/ Kyleena) start working in 7 days, unless you started your period. If you started your period less than 7 days ago, it will start working now. If you were taking oral contraceptives, continue it for 7 days after your hormonal IUD insertion. What should I do today? When can I have sex? Today, you may go back to school or work if you feel well. Please abstain from vaginal intercourse, baths, swimming, tampon use, and menstrual cup use for at least 24 hours after IUD insertion. Mirena/Kyleena users will need back-up contraception (i.e. condoms) to prevent pregnancy in the first 7 days after placement, unless you are on your period now. If you have sex without a condom before 7 days, you should take emergency contraception to prevent pregnancy. What should I expect? You can expect to have some cramps and bleeding and or spotting (on and off bleeding or brown discharge) in the first few months but may be worse in the first 1 - 2 weeks. The cramping and bleeding can last for 3-6 months with the hormonal IUDs. After 6 months, the cramping and bleeding should get better. Many hormonal IUD users will stop having periods after 1 or 2 years, which is safe. If you have a copper IUD, you may have more cramping and bleeding with your periods as long as you have the IUD inside you, but worse in the first 3-6 months. How should I take care of myself? Ibuprofen/Motrin/Aleeve (NSAIDs) helps decrease the bleeding and cramping. You can buy them at any drug store without a prescription. You can take as many as 3 pills (600 mg) every 6 hours with food (each pill contains 200 mg). To prevent cramping, start taking it as soon as your period starts and keep taking it every 6 hours for the first 2-3 days of your period. You can also put a warm water bottle on your belly if you have bad cramps. Will my IUD come out? What should I do if it comes out? Your IUD may come out by itself in the first three months. If you can feel the strings, the IUD is most likely in the right place. If you feel the string is longer than usual, the IUD may be moving down. If your IUD comes out, you can become pregnant immediately. Use condoms if you think your IUD may have come out and please contact your family doctor or our office. How do I check for my IUD strings? If you want, you may check for the strings by inserting one finger into the vagina and feeling for the cervix. The cervix feels similar to the tip of your nose. You should feel strings similar in texture to fishing lines coming out of the cervix. Sometimes the strings are tucked high up and can be difficult to feel and that is usually not a concern. We will send you for an US to make sure it is still in place. Does the IUD protect against sexually transmitted infections (STIs)? The IUD does NOT protect you against STIs (HIV, syphilis, gonorrhea, chlamydia, herpes, HPV, etc.) You should ALWAYS use protection against sexually transmitted infections with condoms if you are at risk. Contact your doctor if: • You have persistent, worsening abdominal pain, unrelieved with medications • You have a fever at or above 38.5°C or 101.3°F • You have foul-smelling or unusual vaginal discharge • Your menstrual periods have stopped with the copper IUD • You or your partner can feel the lower post (hard plastic feel, not the string) of the IUD • You think you are pregnant