Women’s Health

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 @Lynette , varicose veins is a common problem especially in women, and the occurrence increases with age, previous pregnancy, being overweight and inactivity.
Thankfully, in most cases, varicose veins is just a cosmetic issue. In more severe and longstanding cases, it may lead to pain, skin problems (eczema) and ulcers.
There are some things you can do help relieve your problem, or at least prevent it from worsening: 
- Regular exercise like brisk walking, swimming, leg gym exercises
- Try not to remain in one sitting or standing position for too long. Take short breaks, walk around, exercise your calf muscles.
- Elevating your legs 2-3 times a day, about 30 mins each time, eg while watching TV or reading a book. You can also prop up your legs at about 30 degrees angle when sleeping.
- Watching your weight , by exercising, watching your diet eg taking less carbohydrates and more fibre
- Wearing special compression stockings (these can be bought from retail pharmacies)

Doctors also give a trial of diosmin tablets (Daflon).

For persistent and troublesome varicose veins, you will then need to see a Vascular/Vein specialist for procedures like vein stripping or laser therapy.

Hi @igotz99problemz , I am making an assumption that this is the 1st gynae (obstetrician) check-up for pregnancy.
Usually for the 1st obstetrician visit, a few things happen:
- the obstetrician will want to know about your medical history, any long term medical problems, current medications / supplements, any previous pregnancies, any past surgeries
- a general examination which could include checking your blood pressure, height and weight measurements, abdominal examination 
- usually an ultrasound will be performed to look at the gestational sac or early fetus to confirm the pregnancy, and based on this to, check how many weeks gestation is your baby, and thus give you the estimated date of delivery (EDD)
- some blood and urine tests may be done, depending on the number of weeks of pregnancy you are at
- you will be prescribed some supplements and vitamins, which will include folic acid
- of course, the obstetrician will have a chat with you about what to expect throughout the different stages of pregnancy, what to eat, any activities to avoid etc. So you could ask the obstetrician about any concerns you have about the pregnancy and how to look after your own health and the baby's health.
I hope this answers your question.

Hi @truffle2014 , congratulations on reaching 37 weeks of pregnancy! Almost there. The cervix examination is commonly done towards the end of pregnancy. The obstetrician does this to assess the condition of the cervix and see how soon the delivery will be.
37 weeks of pregnancy is considered full-term pregnancy. So you might go into labour any time from today till 40 weeks pregnancy.
Rest assured that the obstetrician will not induce labour by doing a cervix examination. Do share your concerns with your obstetrician at the next check-up. 

Dear @curiousdaughter I am sorry to hear about your mum's condition.
For a more thorough answer, please accompany your mother to the next appointment with the medical oncologist (not the surgeon) and ask the doctors directly. (Disclaimer, I'm a surgeon!)

Briefly, Tamoxifen and Letrozole are both suitable medications for patients with ER+ breast cancer. Only Tamoxifen may be used in a woman who still has menses. Once a lady has stopped having any menses, the oncologist may continue the patient on Tamoxifen, or may recommend a switch to letrozole. 
There are other consideration to side effects of both medications, such as abnormal bleeding from the womb, clots in the deep veins of the legs and bone loss. 

Hi @alexis , yes I would heartily recommend all young ladies like yourself to get a HPV vaccine. Cervical cancer is a common cancer in ladies. Thankfully with the advent of pap smears and HPV vaccine, the cervical cancer rates and associated death rate have come down. It is one of few cancers that can be prevented with a vaccine. The reason is that most cervical cancers are caused by HPV. Thus preventing HPV infection will greatly reduce your risk of cervical cancer in future.
So yes you should get it done!
When? As soon as you are ready! The best time to get vaccinated is actually before you become sexually active. This is the reason why the HPV vaccine is offered to Secondary School girls today, and is part of the national childhood immunisation schedule. But even if you are already sexually active, it is good to get the HPV vaccine as soon as possible.
The vaccine series consist of 3 doses given at 0, 2 and 6 months.
There are currently 3 types of HPV vaccine in Singapore - Cervarix, Gardasil 4 and Gardasil 9. They differ in the number of strains of HPV the vaccine confers protection against. Gardasil 9 gives the greatest protection. However it is also the most expensive and is currently not Medisave claimable. Do talk to your GP to discuss and find out more.
The below HealthHub site gives a good summary of HPV and cervical cancer prevention.
https://www.healthhub.sg/programmes/157/cervical-cancer-screening

Dear MaxyyLush. Thank you for your question. The vaginal area felt sore likely due to friction from the fingering. However it is hard for us to advise further as it is hard to interpret " did some things together".  The abdominal discomfort and loose stools the day after the sleep over can possibly be due to gastroenteritis or a result of other activities performed. I would suggest a private consultation with a doctor and physical examination to be performed to evaluate you better. Hope this helps.

Dear Slid. Thank you for your question. It is possible to have breakthrough bleeding when you just get started on oral contraceptive pills. I will recommend starting the 2nd pack of your oral contraceptive pills on the first day of your menses and take your medication daily at about the same time. Please use barrier contraceptives for the first 2 months of oral contraceptives to prevent unplanned pregnancy. 

A hard lump in the breast is of concern.
I would advise you to consult a doctor for proper examination and evaluation. 

Hi, thank you for the question. There is no medical evidence or medical reason linking drinking cold water/ eating cold food and menstrual cramps. Having said that, sometimes what you experience and what medical evidence and reason says might be different. Everyone's body and mind responds differently to different stimuli. So if you personally notice and experience a correlation between drinking cold water / eating cold food and making your menstrual cramps worse, then do avoid it and drink warm water and take warm food.
Soaking in a warm bath and applying a warm water bottle to your lower abdomen might help ease your menstrual cramps.

How early a person starts undergoing mammogram depends on the background risk. For normal risk individuals, Hpb Guidelines recommend mammogram after 50 years old once every 2 years. However, in individuals with risk factors such as history of BRCA mutation in the family, strong family history of breast cancers, and in patients who experience symptoms, they shd undergo some form of screening at an earlier age.