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Quick access to an expert IUD and Implant consultation, insertion, removal and replacement All appointments require a valid referral from a healthcare provider. Please note that s ubmitting a referral does not guarantee acceptance or an appointment, as all referrals must first be reviewed by our physicians to determine whether they meet the clinic's criteria. Our processing time is approximately 2-8 weeks. If you are experiencing a medical emergency, go to your nearest emergency department or call 911. We are a referral-based specialist clinic and are not equipped to provide emergency or urgent care services. IUD/Nexplanon Patients: Initial appointments for IUD/Nexplanon consultations are typically conducted virtually. If you already have your device and ready for an insertion, or if you require a removal without a consultation, you may be booked directly for an in-person procedure. We recommend that your provider use our form. IUD/Nexplanon Referral Form All Other Physician Referrals: Ask your healthcare provider to fax your referral to 289-837-1018 To help us review your referral and schedule your appointment efficiently, please ensure your referral includes any relevant medical information, including applicable test results, imaging reports, and previous consultation notes. Incomplete referrals may result in delays in processing your appointment. Appointment Confirmation: Once we receive your referral, it will be reviewed by our clinical team to determine if our clinic is the appropriate setting for your care needs. If your referral is accepted, you will receive an appointment invitation by email through EMERGE with your scheduled appointment date and time. Please ensure your personal email address is included on your referral form, as all appointment notifications and updates will be sent electronically. Allied Health Professionals: Appointments with our Allied Health Professionals do not require a referral, except for Naturopathic appointments. Naturopathic Doctor (ND) Your initial appointment includes both a Naturopathic Doctor and a Physician. A valid physician referral is required before your appointment can be booked or confirmed . Please ensure your referral has been sent to our clinic before requesting an appointment. Pelvic Physiotherapy, Psychotherapy & Registered Dietitian Referrals are not required for these services. Please note that Allied Health services are not covered by OHIP (this includes ND appointments), but they may be eligible for reimbursement through your extended health insurance plan . To book an appointment with one of our Allied Health Professionals, including our Naturopathic Doctor, Pelvic Physiotherapist, Psychotherapist, or Registered Dietitian. * Click below to book an appointment BOOK APPOINTMENT Cancellation Policy: If you need to cancel or reschedule your appointment, please notify our office at least 2 business days in advance. Appts cancelled with less than 2 business days' notice, or missed without notice, may subject to a no-show fee.

Tulip Women's Health provides timely care for women as well as quick access to IUD and Implant consultation, insertion, removal, and replacement/ We also provide the usual gynecological care such as menopause hormone therapy, colposcopy for abnormal pap test, endometrial and vulvar biopsies, pessary management along with HPV testing. HOME ABOUT SERVICES FAQs POLICIES RESOURCES LOCATION & PARKING HOW TO BOOK FOR PATIENTS More WELCOME ! Tulip Women's Health is a dedicated team of Gynecologists and General Practitioners with women' s health focus as well as Allied Health Professionals (Naturopaths, Pelvic Physiotherapist, Psychotherapist, and Dietian) Fully committed to providing timely expert care for gynecological conditions we best serve. We are proud to offer the Tulip Comfort Experience , designed to make our patients' gynecological procedures as comfortable and pain-free as possible in our office setting. We also specialize in a wide range of gynecological procedures, including IUD and Nexplanon insertion and removal, HPV testing, colposcopy, cervical polyp, endometrial and vulvar biopsies, prolapse and pessary management, and menopause hormone therapy. BOOK APPOINTMENT REFERRAL FORM FAQ RESOURCES

For Physicians How long is the wait time for a referral? Current wait time is about 1-2 months. We prioritize contraception (IUDs/Nexplanons), postmenopausal bleeding, abnormal uterine bleeding, and abnormal pap/colposcopy. Non urgent referrals have a longer wait time. 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. * Please fax the referral. IUD Referral Form

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

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

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

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

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.

Dr. Denise Handscomb, ND Dr. Denise Handscomb is a licensed Naturopathic Doctor with over 10 years of experience supporting patients in reaching their health care goals. She is the co-owner of Abaton Integrative Medicine, in Oakville, and she has a special focus in women’s health, supporting women during peri-menopause, menopause, and pregnancy. Dr. Handscomb has completed additional training in prenatal care, pediatric care, environmental medicine, is a Naturopathic Doula who attends births and has met the College of Naturopaths of Ontario's Standard of Practice for Prescribing. This allows Dr. Handscomb to prescribe Menopausal Hormone Therapy (MHT) and provide comprehensive hormone support for women during the transitional years. Dr. Handscomb is a Menopause Society Certified Practitioner.

Quick expert access to IUD and Implant consultation, insertion, removal and replacement Pessary Care Pessary Care Pessary is one of the options to treat Pelvic Organ Prolapse. A prolapse occurs when pelvic organs drop from their natural position and sometimes protrude. There are several different types of prolapses. Often a woman can have more than one type of prolapse. Request Consultation

MENOPAUSE CARE PROGRAM At Tulip Women’s Health, we understand that perimenopause and menopause can affect many areas of life, including sleep, mood, energy, sexual health, weight, and overall well-being. Our Tulip Menopause Care Program provides comprehensive menopause support through a team-based approach. Medical Doctors and Allied Health professionals work together to help patients better understand their symptoms and create a care plan tailored to their needs. What the Program Aims to Support Hot flashes and night sweats Sleep concerns Mood changes and brain fog Hormone therapy discussions Sexual health and vaginal symptoms Nutrition and lifestyle support Pelvic health concerns Overall wellness during menopause Your Care Team The initial consultation includes both a Medical Doctor and a Naturopathic Doctor. Depending on your needs, you will also be supported with: Pelvic Physiotherapy Psychotherapy Registered Dietitian/ Nutritionist Coverage Medical Doctor visits are covered by OHIP. Naturopathic and allied health services are not covered by OHIP, but many extended health benefit plans may provide coverage. Please note: If additional services such as Dietitian Support, Pelvic Physiotherapy, or Psychotherapy are recommended, these are provided as separate appointments and billed separately. Fees may vary depending on the provider and service. Patients are responsible for any costs not covered by their personal or extended health insurance benefits. Referrals and Wait Times Due to the high volume of menopause referrals, our standard menopause referral stream currently has an estimated wait time of approximately 6–12 months. As an alternative, patients are invited to consider Tulip Menopause Care Program , which currently has an estimated wait time of approximately 1-2 months . Patients who are referred to Tulip Women’s Health may be contacted directly to discuss the Menopause Care Program as an alternative option. For questions or more information, please contact info@tulipwomenshealth.com.

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