Please do reply as fast as you can!

Hi @anonymousgirl , some variations in period cycles are expected during periods of stress during exam periods for example, however they shouldn't be less than 21 days or more than 35 days on a regular basis, and there shouldn't be large variations (>2 weeks) between your longer and shorter cycles. These would be features that require further assessment and potentially investigations to rule-out possible causes such as thyroid disorder or polycystic ovarian syndrome (PCOS).

You may not have anything to worry about based on your cycle and that one-off incident alone, however given the accompanying thinning of hair, you would benefit from further assessment to be assured that there are no underlying reversible causes such as thyroid disorder. I would recommend for your to speak to your parents about this and arrange a review with your doctor for a more detailed assessment. I hope this helps!

Hi @brontosaurus this sounds like a long-standing and persistent condition that needs to be evaluated.

Some variations in period cycles are expected during periods of stress for example, however they shouldn't be less than 21 days or more than 35 days on a regular basis, and there shouldn't be large variations (>2 weeks) between your longer and shorter cycles. These are features that require further assessment and potentially investigations to rule-out possible causes such as thyroid disorder or polycystic ovarian syndrome (PCOS).

You may not have anything to worry about, however given that you have some of those abovementioned features requiring further assessment, I would recommend for your to speak to your parents and/or arrange a review with your doctor for a more detailed conversation about this. 

Hi @curiousdaughter , it is generally safe to take panadol to relieve your menstrual cramps. Panadol is a safe medication as long as you keep to the dosage indicated - usually 2 tablets 3 to 4 times a day as needed. Panadol is prescribed even to young babies with fever, so it is a safe medication!
Panadol Menstrual contains panadol (paracetamol) and this component called pamabrom. Pamabrom is a mild diuretic, meaning it helps to relieve some water retention and bloating that can come during menstruation.
If your menstrual cramps worsen, I will advise you to consult a doctor. 

Dear Adena- braun. It is certainly frustrating to have an itchy and flaky scalp. You are likely to have eczema/ seborrhoeic dermatitis of  the scalp. They usually present with irritated, inflammed, red, itchy scalp.

You might wish to consider a change of shampoo to something gentle such as head and shoulder wash. Alternatively you may wish to consult a doctor and prescription medications such as anti fungal shampoo eg Pristine shampoo is useful for scalp eczema. Application of topical steroids such as clobetasol/ dermasone scalp lotion will also be useful for your condition. Lastly anti histamines such as cetirizine helps to reduce the itch.

You might find staying in air conditioned environment useful as hot and humid environment tends to trigger eczema and take note of any hair gel/ wax/ dye/ wash you apply to your hair/ scalp that could have irritated your scalp.

Hope this helps!

Hi @adena-braun , it is an interesting question. The term gynaecologist is sometimes understood differently by different people. The specialty itself is known as Obstetrics and Gynaecology (O&G). Obstetrics is the field of medicine dealing with pregnancy and childbirth. So when one is pregnant, she will consult a obstetrician.
A gynaecologist is a specialist dealing with problems related to menses, the womb, the ovaries and the woman genital area. So commonly, women will visit the gynaecologist for women problems like menstrual disorders, menopause, urinary incontinence, growths in the womb and ovaries etc.
To add on, since I am a family physician, many preventive women health issues are handled by family physicians - your friendly neighbourhood GP! Things like HPV vaccine to prevent cervical cancer, pap smear/HPV test to screen for early cervical cancer, oral hormonal contraception etc. Yes and of course we will assess your problem and discuss with you whether you need to be referred on to a gynaecologist - private or subsidized. Subsidized referrals to restructured hospitals (KKH/SGH/NUH) can be made via polyclinics or CHAS GPs (if you have a CHAS card of any colour).

Hi @gurlie, condoms are quoted in medical literature to be 98% effective in preventing pregnancy, provided they are used correctly. By correct usage, I mean that the condom has to be put on from the start to the end of sexual activity, including oral, anal and vaginal sex. Even before ejaculation, some semen might come out of the penis, so it is safer to put on the condom right at the beginning, and even if there is no penetration.
Condoms is not merely sufficient to prevent STDs. It is the only contraceptive that is effective in preventing STDs. All other methods - the oral contraceptive pill, arm implant, intrauterine device and injectable hormonal contraceptive do not prevent STDs.
To further decrease the chance of pregnancy, especially if there is penetration, you can use condoms together with another hormonal contraception.

Hi @mona0lisa! This certainly sounds like a problem which is causing alot of distress. Sometimes, people can experience certain parts of their bodies sweating more often (eg. palms, armpit, feet), or even 'generalised increased sweatiness'  just based on how one's body reacts to external stimuli. 

Specific to the feet, good foot hygiene is key! This would include ensuring proper washing of feet with soap every time a person takes a bath, thorough drying of feet, and sometimes even applying powder on the feet to absorb moisture (which can be from sweating). Wearing sandals and slippers can help at times as well. If your skin is sensitive to excessive sweating, this can cause itchiness. As such, proper

The problem is that when the feet are moist and warm, fungus and other microorganisms love to grow. We certainly do not want this situation to happen. So regular foot self-inspections can be helpful as well.

Itchiness can be mainly either due to the skin being too sensitive to excessive sweat and/or the presence of microorganisms/infections. As such, proper foot hygiene should be able to reduce at least some of the symptoms you are experiencing. If the symptoms remain persistent and/or are causing you significant distress, it will be advisable to seek attention from a medical doctor. 

Hi @mona0lisa I'm sorry to hear that this has troubled you! It is normal for there to be a slight odour, and for this to have slight variation throughout the menstrual cycle. An online search about this often yields results like vaginal douching or deodorants, however these products often cause more problems as they disrupt the body's protective mechanisms including the natural flora that help to ward off infections. Some rinsing of the external genital area with water and mild soap will suffice for regular care.

However, a strong odour or a "fishy smell", irritation, abnormal discharge, or pain/burning sensation are symptoms that can be indicative of more serious underlying problems. If ever in doubt, do have a review with your doctor for an examination to check for any potentially reversible causes that can be treated. Other considerations at your age include a HPV vaccination to reduce your risk of cancer, which you can also discuss with your doctor. This is most useful before you have your first sexual encounter, and you can find more information at this link: https://www.healthhub.sg/a-z/diseases-and-conditions/701/faqs-on-hpv-and-hpv-immunisation 

Hi @Flowerqueen that is not the case, there have not been any compelling evidence of this having an impact on future cycles. The main risks include transmission of certain infections, unplanned pregnancies, and others. Possible transmittable infections include HPV which can cause cervical cancer, and it would be good to have a HPV vaccination before the first sexual encounter. If this has been missed before the first encounter, there are options for 3 or 5 yearly screening based on age that one can consider. More about this at this link: https://www.healthhub.sg/a-z/diseases-and-conditions/701/faqs-on-hpv-and-hpv-immunisation Hope this helps!

Hi @demarcus thats an interesting question, and yes - infection/inflammation in the nasal passage can irritate the nerves in the area leading to activation of the sneezing reflex. Inflammation is mediated in part by the release of histamines, which can occur with mast cell activation. As you said, the histamine then triggers the release of other downstream inflammatory chemicals which together lead to vasodilation (increased blood flow) and immune/white blood cells in the blood stream being activated to the area.

If you're still curious to find out more about mast cells and histamine, heres a resource with more information:  
https://www.frontiersin.org/articles/10.3389/fimmu.2015.00620/full#:~:text=In%20the%20skin%2C%20antigens%2C%20via,this%20can%20lead%20to%20angioedema.

Hi @reed I'm sorry to hear about this! Yes you are right, these conditions can interact as the pattern of pain for these joints which are considered "weight bearing" often prompts the individual to adopt adaptive postures when standing/walking/exercising. While these relieve pain temporarily, they deviate from optimal biomechanics and can result in build of "over use"/strain related injuries or progression of underlying problems in other weight bearing joints in severe cases. 

In terms of determining what to do next, the progression in symptoms along with numbness/pain indicate potential worsening nerve impingement and requires a review with a trained orthopaedic specialist for an examination. It would be best to arrange a follow-up with your original doctor as they will be familiar with your condition. In the mean time until your review with them, do minimise strenuous activity and avoid carrying any heavy weights. Hope this helps!

Hi Victor,  this is usually a symptom of kneecap pain (patellofemoral pain). Running puts a lot of stress on the kneecap. If you are happy to modify your exercises to doing cycling and walking then that’s fine. Otherwise if you would like to return to running it would be good to get your knee checked by an orthopaedic/sports Dr to recommend treatments for kneecap pain.

Dear ozzie. You might wish to consult a urologist for neurologic bladder.. If deemed necessary, the urologist will refer to the relevant specialist for further treatment of any underlying illness. Hope this helps.

Hello @wendy . You are 54 years old and experiencing bleeding during bowel motion. You should consult your family doctor or the Polyclinic doctor. The most likely cause of the bleeding is haemorrhoids (statistically). However, the greatest concern is the possibility of colorectal cancer as the cause of your bleeding. Currently, based on the Ministry of Health Guideline of Screening of Diseases, any Singaporean above the age of 50 is recommended to screen for colorectal cancer. If the person has bleeding in the stools, a colonoscopy is recommended.

Hi @meilee. Thank you for your question!

Unfortunately this is a rather broad query and requires quite a detailed history and assessment by your doctor as to what the cause may be. In some women they have "naturally irregular mensus" i.e. no organic cause is found but if there is a problem e.g. Fibroids/endometriosis/hormonal imbalances, correcting these will often resolve your periods. 

There is medication to take to make your periods more regular but I would not suggest taking them without consulting your doctor as it can affect your fertility and if you have significant risk factors, you may not be able to take it. 

Hope this helps!

Hi @Asilamallymkun. Thank you for your question!

Based on your description it does sound like you possibly may have an anal fissure with an associated skin tag. As such, you should not be applying any over the counter medications without consulting a doctor first. I would advise you to see your doctor as soon as possible for management. Most of these conditions are self resolving and the mainstay of management involves (a) management of pain and (b) Changes to diet/stool calibre. 

While waiting for your appointment, i would suggest you start the following
1. High fiber diets
2. Over the counter stool softeners e.g. lactulose
3. Sitz bath - (sitting in a warm bath for at least 20 minutes 3 times a day) 
     > This primarily promotes anal relaxation and allows faster healing

Your doctor may prescribe you with topical antibiotics/topical analgesic medication to help relieve the pain. 

If you do develop worsening pain/increasing swelling over the perianal area/Incontinence/High fever, please do consult a doctor ASAP as these can be signs of a serious infection. 

Hope this helps! 

Hi @ravisante. Thank you for your question!

Hair loss can be quite difficult to deal with but rest assured that post partum hair loss is quite a common condition and usually self resolving within 6 - 12 months even without any form of treatment.

I would say that you should consult your OBGYN and not just start on any over the counter vitamins as many of these products contain way more Vitamins compared to what is normally required. 

For example, lactating women would only require about 35 micrograms of biotin/day. Biotin is secreted in breast milk but has a wide range of concentrations and so far there has not been much documented evidence of toxicity to the infant. 

Vitamin C/B supplements should be fine for consumption if you are unable to obtain enough from your diet. If you eat a balanced diet you should have enough of these vitamins without supplementation. Nonetheless, if you chose to take additional tabs of these vitamins, if has not been proven to cause any issues to the infant. 

I would recommend more of topical treatments such as volumizing shampoo and typically hair care products that contain biotin or silica. 

Hope this helps! 

Hi @alonso, this is a symptom of nerve dysfunction which can have either local or systemic causes. Local causes are more likely given what you describe and especially if there was a particular injury or inciting event you can recall. These include slip disc or nerve impingement. Possible systemic causes include nutrition and metabolism related diseases. The distinction is made based on your previous medical history and a physical examination, followed up with tests if needed. Based on this, my recommendation would be to see a doctor in-person for an examination, and to avoid any strenuous activities or carrying of heavy things until you do so. Hope this helps!