Dr Fiona Li, Recipient of the New South Wales State Committee Trainee Research Grant 2023

Dr Fiona Li is a third-year FRANZCOG trainee at the Royal Hospital for Women in Sydney. She is pursuing a PhD on the management of postmenopausal vaginal symptoms, reflecting her interest in menopause and its impact on women’s health. Through her research, Dr Li aims to break down barriers, encourage open conversations, and raise awareness to empower individuals navigating menopause.

In addition to her research, Dr Li serves as the RANZCOG Trainee Representative for New South Wales and is a member of the Research Assessment Subcommittee. She is passionate about advocating for trainee wellbeing and improving the quality of obstetrics and gynaecology training and education.

Dr Li’s Research: Exploring Patient-Centred Approaches to Menopausal Care

Vaginal symptoms associated with menopause affect up to 50% of women during their lifetime, significantly impacting quality of life. However, unlike systemic menopausal symptoms such as hot flushes, women may hesitate to seek medical help for vaginal symptoms due to stigma and negative perceptions. The primary treatments include topical hormone therapies; however, many women experience application difficulties, limited symptom relief, or fears about hormone use—particularly those with a history of hormone-sensitive cancers.

Since 2012, vaginal energy-based treatments* have become increasingly accessible, but evidence for their use is limited. Dr Li’s project investigates women’s preferences and the acceptability of different treatments for managing these symptoms—an area that has not been explored before. The goal is to understand what matters most to women and promote patient-centred care. This project is the final part of my PhD which has been a deep dive into energy-based treatments, like laser, for vaginal symptoms associated with menopause.

Participants reported that effectiveness, cost, administration, hormone and the service provider were considerations in their decisions around care. The final data will help us to understand what is most important to women and help clinicians to provide better counselling and care. This funding supports novel research in gynaecology – an area that is historically underfunded. Ongoing research in women’s health is crucial in closing the gender gap for health outcomes. I hope to continue to contribute novel findings to help clinicians provide individualised and evidence-based medical care.

Rewards of the Trainee Research Grant experience

This project has fostered a new collaboration between our clinical team at the Gynaecological Research and Clinical Evaluation (GRACE) Unit at the University of New South Wales with the health economics team at the Centre for Health Economics Research and Evaluation at the University of Technology Sydney. We hope this collaboration will be ongoing so we can continue to understand patient preference and treatment acceptability in gynaecology and in healthcare. The New South Wales State Committee Trainee Research Grant has given me financial support to realise this final part of my PhD, and to further my journey as an early career researcher and clinician. The primary goal of this project is to promote patient-centred and evidence-based care. In gynaecology, where research has historically been disadvantaged in funding, it is even more crucial to promote research in women’s health and close the gender gap in health outcomes, and this project contributes to that mission.

*In December 2024, the Therapeutic Goods Administration (TGA) announced that it had completed a post-market review of all energy-based devices used for vaginal rejuvenation included in the Australian Register of Therapeutic Goods (ARTG). The review found there was insufficient clinical evidence to support the therapeutic use and long-term safety of these devices. All energy-based devices intended to be used for vaginal rejuvenation sold in Australia have now been cancelled from the ARTG by the TGA or the sponsor.