Women’s Health

Hi @madiii_kaddi The resolution of your photo is not very clear. It will be helpful if you are able to take a higher resolution photograph and point to the area that you are concerned about. I will be able to better advise further subsequently. Thank you.

Dear @Shameela Depo-Provera is given as an intramuscular injection.  Im inferring that the nurse gave the injection closer to your hip instead of the middle of your buttock as the upper outer quadrant of the buttock is recommended for intramuscular injection, in order to avoid the sciatic nerve which lies deep in the buttock. It is alright to lie on your side or prone position while receiving the injection. Hope this helps.

Hi @lolololol Thank you for your question!

I would say that the HPV vaccination is important regardless as it has been proven to reduce the risk of cervical cancer in women (most common cancer in females). Many people who have HPV are asymptomatic and can easily transmit it to another person. In Singapore, the estimate is that 8 of every 10 people have some form of HPV. 

Although you are only looking to have a single sexual partner, I would say that the benefit of the vaccination would still outweigh the risks/drawbacks. You may not know if your partner has had a sexual contact before/been exposed unknowingly. 

In Singapore, you can use your medisave to pay for a portion of the HPV vaccination for certain brands so do consider getting it early! Prevention is always better than the cure (though there is no cure for HPV technically). 

Hope this helps!

Hi @htg . Thank you for your question!

I would say that if this is unusual for you, you should definitely see a gynaecologist. Sudden increase in menstrual flow/blood clots can indicate underlying disease which can be as simple as Fibroids/thickened uterus lining all the way to forms of cancer (though much less likely). The initial evaluation usually just involves a simple ultrasound. Rest assured, there is usually a benign/no cause but you should get it evaluated regardless. You may want to approach polyclinic to get a referral to KKH/NUH Gynaecology or seek help with a private gynaecologist. 

Hope this helps!

Hi @Flowerqueen . 

Apologies I don't quite understand your question. Are you asking why they recommended STI screening for you?

Thanks! Apologies

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. 

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 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!

Dear @Xxx_ I'm a breast surgeon, but I can advise a bit on this common woman's health concern. From what you share, if recurrent, and you have seen several doctors, do make an appointment to see a gynaecologist. Off hand, I believe you will need a internal pelvic examination, maybe a PAP smear. Your doctor might also need to check for diabetes, and share tips on post-coital hygiene. Hope this helps!

Dear @cpqsa  I'm a breast surgeon, but I can advise a bit on this woman's health concern. From what you share, do make an appointment to see a urologist, or a uro-gynaecologist. Urge incontinence, or frequency has several causes- may be weak/sensitive bladder muscle, small stone, mild infection, or rarely, a kind of early bladder cancer. Off hand, I believe you will need some urine tests, and maybe even more specialist tests by the urologist. Your doctor might also need to check for diabetes.  If this info helps, I refer patients to Dr Shirley Bang, or Dr Tricia Kuo for such a condition. 

Hi @qek. Thank you for your question!

I'm sorry to hear about your symptoms as they sound quite severe. I do hope you can get an answer soon. 

The short of it is, yes, you should get it checked out usually by a OBGYN. The main purpose of further evaluation is to identify any possible secondary causes of your painful mensus (dysmenorrhea). 

Painful menus is not always due to an organic cause, but such a diagnosis of "primary" dysmenorrhea can only be made once other causes have been excluded especially in your case where this has been going on for quite some time. "Primary" Dysmenorrhea typically improves with age compared to secondary causes which tend to worsen with age. 

Secondary causes can include simple issues such as cysts or a thickened uterus lining which can be treated. 

If nothing is found, you may be given hormonal tablets to help control your mensus and reduce the pain. 

A typical check up would usually only require an ultrasound and is relatively non invasive. 

I 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.