Which Contraceptive Is Most Suitable For You?

Here’s All You Need to Know About Choosing the Right Contraceptive Method!


What are the types of contraception available?

There are many different forms of contraception available and picking one can often be confusing. Contraception can be divided into a few types as detailed below. For the purpose of this article, we will focus more on hormonal contraception and long acting reversible contraception. 

  1. Hormonal contraception
    • Oral pills taken daily – either the combined oral contraceptive pill (COCP) which contains both a synthetic estrogen and progestin hormone, and the progesterone only pill (POP), also known as the “mini pill”. 
    • Contraceptive patch (Evra), which contains both estrogen and progesterone, which is stuck onto the skin and changed once a week
    • Contraceptive injection, Depo-Provera, a progesterone-only injection administered in clinic, which lasts 12 weeks
  1. Long acting reversible contraception (LARC)
    • Contraceptive implant (Implanon/Nexplanon), a flexible small plastic rod which is inserted beneath the skin of the upper arm. It contains a progesterone hormone which is slowly released over time and lasts 3 years
    • Intrauterine device – a T-shaped device that sits in the cavity of the womb uterus. It can either be copper (non-hormonal) or hormonal based. The lifespan of the IUD is anything between 3-10 years. 
  1. Barrier methods
    • Condoms or diaphragms 
  1. Emergency contraception
  2. Sterilisation

What sort of considerations should I keep in mind when selecting a form of contraception?

The wide variety of contraception methods available can be intimidating and you may be wondering what suits you best. There are various considerations that will help guide you in selecting the best form of contraception for yourself.

  1. Patient factors

One of the considerations is age, for instance, women above the age of 50 should not take the combined hormonal contraception because their risk of complications like venous thromboembolism (dangerous blood clots in the veins), strokes and cardiovascular disease. 

Smokers above the age of 35 should also avoid combined hormonal contraception for similar reasons. 

For breastfeeding mothers, progesterone-only contraceptives are preferred. This includes the mini-pill, Depo-Provera injection, Implanon and the hormonal IUD. 

  1. Pre-existing medical conditions

If you have pre-existing medical conditions, some forms of contraception may not be suitable.

Estrogen-containing contraceptive methods should be avoided in women with previous medical conditions including a personal or family history of venous thromboembolism, strokes, heart disease, migraines with aura, smoking over the age of 35, high blood pressure. Individuals with a history of breast or any female hormone related cancers, or genital bleeding with no diagnosed cause, should avoid hormonal contraception.

Certain medications can also interact with some forms of contraception, for instance, some anti-epileptic medications may interact with the combined oral contraceptive pill.

Speak to your doctor if you have pre-existing medical conditions or regular medications you take to ensure that the choice of contraception is compatible.

  1. Duration of contraception

Another consideration would be how long you wish to take contraception for. If you are certain that you do not wish to conceive in the next few years then long acting reversible contraception like Implanon or the IUD may be suitable for you. 

Otherwise, shorter acting hormonal methods may be a better choice. However, you should note that even with shorter acting forms of contraception like the pill or Depo Provera injection, while you can get pregnant the moment you stop taking these, some women may find that their periods take several months before the return to normal.  

  1. Lifestyle or practicality 

The type of contraception you choose should also be something that suits your lifestyle. 

If you are able to consistently adhere to taking medication on a daily or weekly basis then hormonal methods like the pill or patch will be suitable for you. However, if you are likely to miss doses, then these will not be the best choice as multiple missed doses will greatly reduce the efficacy of contraception. 

If you pick the Depo Provera injection, then you will have to ensure you are able to make a trip down to the clinic every 12 weeks. 

  1. Concern about side effects or complications 

All forms of contraception come with benefits and side effects. 

Contraception can affect your menstrual cycle. For women with menorrhagia (heavy menses) and dysmenorrhea (painful menses), hormonal contraception can help in reducing these symptoms. The copper IUD causes heavier and more painful periods, so if you are already suffering from these, you should stay away from it. You may not get your period altogether with some forms of hormonal contraception, like the hormonal IUD. Some women may like this but others may prefer to still regularly get their period. 

If you have skin concerns, certain forms of combined oral contraceptive pills can be helpful in reducing acne. 

If weight gain is of paramount concern to you, then certain progesterone only forms of contraception like the Depo Provera injection may not be ideal although research has largely shown that there is no significant weight gain from most forms of hormonal contraception. 

Long acting reversible contraception like the implant and IUD are slightly more invasive as they involve insertion and eventual removal of the device, and these procedures, while simple and can be done in clinic, do come with risks which your doctor will be able to tell you about. 


Ultimately, selection of contraception should be individualised to each patient. Feel free to speak to your doctor to find out what might best suit your health and lifestyle needs. 


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Vaginal Piercings

Female Genital Piercings

What are some different types of genital piercings in females?

Curious about genital piercings?

While the location may seem unusual to some, people still do opt for genital piercings either to enhance sexual pleasure or for ornamental purposes. 

“Vaginal” or “clitoral” piercings are actually misnomers; piercings are most commonly located around the clitoral hood or labia (majora/minora).

  1. Vertical clitoral hood (VCH) – a vertical piercing done through the skin above the glans of the clitoris and rests on top of the glans. This is often done to enhance sexual pleasure for the female as the piercing jewellery places pressure on the clitoris during sexual activity 
  2. Horizontal clitoral hood (HCH) – a horizontal piercing done through the skin above the glans of the clitoris. This is usually more ornamental as it does not come into contact with the clitoris and thus does not provide any sexual stimulation
  3. Triangle – a horizontal piercing that is done through the skin beneath the base of the clitoral hood and rests under the clitoral shaft 
  4. Princess Diana – similar to a VCH but it is done to one side rather than in the centre of the clitoral hood 
  5. Clitoral piercing – actual piercing of the clitoris itself is not so common as it comes with risks of pain and nerve damage 
  6. Labial piercings – either the labia majora or labia minora can be pierced
  7. Fourchette piercing – a vertical piercing through the skin of the perineum (between the vaginal entrance and the anus) 
  8. Christina – a surface piercing through the mons pubis and is purely decorative 

Do they provide any sexual benefits for both partners?

Not all female genital piercings help with sexual pleasure but for those which do (e.g. the VCH, triangle), the female will enjoy more physical stimulation from the piercing than her male partner will. Piercings such as the VCH or triangle, which place pressure on or come into contact with the clitoris, contribute to clitoral stimulation during foreplay or intercourse, increasing sexual pleasure for the woman. 

Fourchette piercings may be felt by your male partner during penetrative vaginal intercourse. 

What are the risks that come with female genital piercings?

The usual risks associated with any piercings apply, such as the risk of blood borne infections if correct sterile standards are not observed, as well as risk of piercing infection which could potentially lead to scarring. Botched piercings where the clitoris is pierced instead of the clitoral hood alone can cause significant pain and nerve damage. 

During the healing process, the piercing is essentially an open wound and you would be at increased risk of sexually transmitted diseases (STDs) so using condoms during this period is important. 

Are female genital piercings painful?

Female genital piercings are not quite as painful as one would imagine. While the perceived pain level is bound to differ between individuals depending on your pain threshold, it is generally accepted that the pain level is similar to piercings elsewhere. This is because the piercing is actually done through the skin (e.g. the clitoral hood rather than the clitoris itself).

During the healing period, using condoms is a must as contact with your partner’s body fluids (genital fluids or saliva) places you at great risk of infection. 

How long does it take for the piercing wound to heal?

Healing time for female genital piercings generally ranges between weeks to months. VCH, HCH and Princess Diana piercings heal between 4-8 weeks, while triangle piercings may take 3-4 months. Christina piercings take upward of 6 months for healing. 

Will the piercing hole close if I remove the piercing jewellery?

Fresh genital piercings close extremely quickly once you remove the piercing jewellery. For healed piercings, the duration they remain open can vary and depends on how long or well healed the piercings have been for. It is generally accepted that even well healed piercings may close within days. 

Also read: Penile Piercings

Also on this site: hiv test, pep hiv, std test singapore


Viagra For Women

Can Women take Viagra?

The short answer is Yes!

What is a more pertinent question is does it work?


To avoid confusion, this article is not about Viagra (Sildenafil) which is commonly prescribed to men for erectile dysfunction. This article is not about Addyi (Flibanserin) which is commonly called the “Female Viagra” but is a completely different product. 

Let’s first get into the basic science of what Viagra is and what it does.

Viagra was introduced to much fanfare as the first effective oral treatment for erectile problems in men. What it does is improve blood flow into the penis. Now, we know from embryology that the penis in men and the clitoris in women develop from the same bits of the embryo. Although they are far from identical, they do share certain types of tissue that respond in the same way to Viagra. 

So unsurprisingly, studies have shown that when women take Viagra, blood flow to not only the clitoris improves, but also blood flow to the labia minora (inner lips) and also the pelvic floor in general. This better blood flow can lead to more sensitivity and more lubrication in the vagina.

So naturally we also have seen studies that conclude taking Viagra helps in the sexual function of some women. Especially women who suffer from other medical conditions that can reduce the blood flow to the pelvis for example Diabetes.  

Are there any side effects?

The potential side effects of taking Viagra are similar in both men and women. The most common side effects were headache, flushing, nausea, blocked and running nose. Either men or women who take certain medicines to treat the heart called Nitrates, cannot take Viagra because the combination of these medicines can cause the blood pressure to fall to dangerous levels. 

More on Viagra: “Cheap” Viagra, Fake/ Counterfeit Viagra

So what’s the catch?

Going by the above, if Viagra really is such a boon to women’s sexual issues like it is to men’s, why is it not more aggressively marketed and prescribed by Doctors to women?

Well, the catch is women’s sexual issues are usually much more complex. The medical term “Female Sexual Dysfunction (FSD)” has only received more research attention since the late 1990’s. Types of FSD can be very generally broken down into 4 categories – Desire, Arousal, Orgasm and Pain. Each category is influenced by a multitude of factors including emotional, psychological and sociocultural in addition to physical factors such as disease.

So it would be logical to conclude that Viagra cannot possibly be the cure all for FSD. 

So what now?

There is now a much better understanding by the medical community on women’s sexual function. If a woman finds herself affected by a poor sex-life be it not having any desire, not being able to get sexually aroused, not being able to reach orgasm or feeling pain during sex, she should seek help from her Doctor. 

Viagra may be the prescribed treatment. However, there are also many other possible interventions the Doctor can prescribe based on the diagnosis. These could be tablets like Viagra or could also be non-drug based interventions such as cognitive behavioural therapy or mindfulness-based interventions. There are also physical interventions available such as vaginal dilators and biofeedback devices.

FSD is real and it is a complex medical issue with many possible underlying causes.  Do not blame yourself and do not blame your partner. Seek medical help. Women’s Sexual Health Clinic Singapore

Next read: Where to buy Viagra, Cialis, Levitra in Singapore – Viagra Singapore

International Women’s Day 2020: “Each for Equal – An Equal World is an Enabled World”

International Women’s Day (IWD) which is on 8th March is a global celebration of women’s achievements. On IWD, we commemorate the political, social and economic accomplishments of women and continue to strive to raise awareness about issues relating to women’s empowerment. It is both a time for celebration as well as to push for progress and change. 

This year’s IWD theme is “Each for Equal. An equal world is an enabled world.” 

IWD 2020 is about building a gender equal world and pushing for gender equality across various aspects of society – in the government, workplace, boardroom, media etc, and recognising that gender equality is essential for economic success and for communities to thrive. Through our individual choices and actions, we can create change and move towards a gender equal society. 

At DTAP, we are firm advocates of women’s rights and empowerment. As an equal opportunity employer, DTAP believes in gender equality in the workplace and provides all employees, male and female alike, with equal opportunities to grow and excel. 

As a doctor working at DTAP, I am personally proud and glad to have had the privilege of working in a supportive and nurturing work environment, where female employees can excel in their careers, whilst continuing to fulfil their equally important family roles as mothers, wives and daughters. DTAP also strives to provide a safe and friendly workplace for women, where we know that our interests are protected and are able to focus on giving our utmost best in providing patient care. 

DTAP’s advocacy of women’s rights goes beyond the workplace. We have always believed in and will continue to push for equality in healthcare provision through our women’s health service. At DTAP, we support women’s right to choice through the provision of professional medical support for family planning. We also seek to enable women to take charge of their health by raising awareness and educating patients about female health issues. DTAP aims to provide a women’s health service where our female patients can feel safe, supported and empowered to take charge of their health. 

As we celebrate International Women’s Day 2020, DTAP looks forward to continuing to empower women and pushing for greater awareness about women’s health issues through our women’s health service. We look forward to working together with you to forge a gender equal world.


Dr Grace Huang

MBBS (Singapore), MRCP (UK), Cert. Men’s Health, Academy for Men’s Health (Singapore)

Dr Grace has a keen interest in women’s health and has a broad range of experience from working in subspecialty departments across various tertiary hospitals, ranging from Neurology, Rheumatology, Endocrinology, Cardiology, Geriatrics Medicine to Emergency Medicine, amongst many others. She believes that communication is the key to empowering patients through facilitating a better understanding of their own health and medical issues and is always more than glad to address and allay her patients’ concerns.

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Pap smear – Mengapakah anda perlu ketahui ujian ini?

Apakah itu barah cervix, HPV dan apakah pemeriksaan yang disyorkan?

Apakah itu ujian Pap smear?

  • Pap smear (atau ujian Papanicolaou) adalah ujian yang dijalankan oleh doktor untuk mengesan tanda-tanda kanser (barah) cervix. Cervix adalah bahagian antara vagina dan rahim di dalam badan wanita (bahagian bawah rahim). 
  • Semasa ujian Pap smear, doktor tersebut akan memasuki sesuatu alat pemeriksaan bernama speculum yang digunakan untuk menolak tepi belah vagina. Setelah ditolak tepi, cervix dilihat dan sesuatu berus kecil digunakan untuk mengiris sel-sel di cervix secara perlahan-lahan. 
  • Individu yang menjalani ujian Pap smear mungkin akan merasa kurang selesa tetapi biasanya tidak merasa sakit. 
  • Setelah ujian lengkap, sampel akan dihantar ke makmal untuk diperiksa di bawah mikroskope. 

Siapakah sesuai untuk menjalani ujian Pap smear?

  • Semua wanita yang berumur 25 tahun dan ke atas yang sudah aktif secara seksual sepatutnya menjalani ujian Pap smear. 
  • Bagi mereka yang tidak pernah mempunyai keputusan Pap smear yang tidak normal, Pap smear perlu dijalankan sekurang-kurangnya setiap 3 tahun. 

Apakah yang perlu disediakan sebelum wanita menjalani ujian Pap smear?

  • Tidak ada apa-apa yang spesifik yang perlu disediakan sebelum ujian Pap smear.
  • Wanita yang dalam haid juga boleh menjalani ujian ini. Jika haid terlalu berlebihan, individu tersebut boleh menghubungi klinik tersebeut untuk menukar tarikh temujanji.

Apakah itu barah atau kanser cervix?

  • Barah atau kanser cervix adalah barah ke-enam paling kerap antara wanita di Singapore. Barah cervix terjadi apabila sel-sel yang normal bertukar kepada sel yang tidak normal yang tumbuh diluar kawalan. Kebanyakan wanita yang mempunyai kanser cervix yang dikesan semasa peringkat awal boleh dirawat dengan sepenuhnya.
  • Faktor risiko barah cervix yang paling penting adalah jangkitan human papilloma virus (HPV).
  • Simptom-simptom barah cervix termasuk lelehan berdarah dari vagina yang berlaku di antara waktu haid (bukan semasa haid), selepas hubungan seks atau selepas menopaus.
  • Penyakit barah ini terbelah kepada beberapa peringkat (awal ke peringkat akhir). Barah ini boleh dirawat dalam beberapa cara termasuk pembedahan. Pembedahan termasuk “radical hysterectomy” atau pengeluaran cervix, rahim dan bahagian atas vagina atau pembedahan pengeluaran semua atau sebahagian daripada cervix – pembedahan ini boleh dilakukan dalam keadaan tertentu sahaja. 
  • Rawatan lain termasuk radiasi dan kemoterapi. 

 
Apakah itu human papillomavirus (HPV)?

  • HPV adalah virus yang boleh dijangkiti melalui sentuhan kulit, melalui hubungan seks (sama ada melalui vagina, oral atau lubang dubur) atau melalui sentuhan kawasan genital (alat kelamin). Individu tidak boleh dijangkiti HPV melalui sentuhan objek contohnya tempat duduk tandas. 
  • Disebabkan virus ini boleh dijangkiti melalui hubungan seks, jika individu mempunyai beberapa pasangan seksual, risikonya ditingkatkan. Tambahan pula, kondom hanya memberi perlindungan yang tidak sepenuhnya. Pengisapan rokok juga boleh meningkatkan risiko jangkitan HPV sebanyak 4 kali ganda, bersama juga jika individu mengambil ubat yang melemahkan sistem imun atau mempunyai penyakit yang melemahkan sistem imun. 

Adakah semua jenis atau strain HPV berbahaya?

  • Terdapat lebih daripada 100 strain atau jenis HPV tetapi kebanyakan jenis HPV tidak menyebabkan kanser. Lebih daripada 80% wanita akan terdedah kepada virus HPV dalam hidup mereka. Kebanyakannya, system imun badan akan menyingkirkan virus ini secara semula jadi sebelum virus ini menyebabkan penyakit teruk. Tetapi, peratusan kecil wanita akan menghidapi penyakit yang lebih serius seperti kanser. 
  • Terdapat jenis HPV yang berisiko rendah iaitu HPV jenis 6 dan 11 yang boleh menyebabkan penyakit ketuat kelamin (genital warts). Jenis berisiko rendah ini jarang sekali boleh menyebabkan kanser.
  • Antara jenis HPV yang berisiko tinggi adalah jenis 16 dan 18 yang boleh menyebabkan kanser cervix. Jenis 31, 33, 45, 52 dan 58 juga boleh menyebabkan kanser. 


Apakah ujian yang boleh dijalankan untuk mengesan HPV?

  • Ujian HPV boleh dilakukan pada masa yang sama dengan ujian Pap smear iaitu melalui pengunaan berus kecil yang digunakan untuk mengiris sel-sel di cervix secara perlahan-lahan. 
  • Di clinic Dr Tan & Partners, kita dilengkapi dengan mesin yang boleh mendapatkan keputusan HPV secara cepat iaitu melalui Rapid HPV test. Keputusannya boleh dihasilkan dalam masa 24 jam. 

Apakah cara yang boleh mengurangkan risiko seseorang dijangkiti HPV dan barah cervix yang disebabkan oleh HPV?

  • Vaksin adalah efektif untuk mengurangkan risiko ini dan boleh mengelakkan seseorang daripada dijangkiti 70-90% jenis HPV berisiko tinggi dan juga jenis HPV yang boleh menyebabkan penyakit genital warts. Vaksin tersebut dinamakan Gardasil 9.
  • Selepas individu menerima vaksin, individu tersebut masih lagi perlu menjalani ujian Pap smear sekurang-kurangnya setiap 3 tahun kerana vaksin tidak boleh mencegahkan seseorang daripada dijangkiti jenis HPV berisiko tinggi yang lain yang tidak dilindungi Gardasil 9. 

Siapakah sesuai untuk menerima Gardasil 9?

  • Vaksin Gardasil 9 diluluskan untuk diberi kepada perempuan yang berumur 9 tahun ke 26 tahun. Bagi mereka yang berumur lebih daripada 26 tahun, penerimaan Gardasil 9 boleh dibincangkan bersama doktor. 


Apakah beza Gardasil 9 dengan vaksin HPV yang lain? 

  • Terdapat vaksin yang lain yang dinamakan Gardasil dan Cervarix. Gardasil hanya boleh mencegah jangkitan HPV jenis 6, 11, 16 dan 18 sahaja (16 dan 18 adalah jenis HPV yang berisiko tinggi) dan Cervarix hanya mencegah jangkitan jenis 16 dan 18 sahaja. 
  • Gardasil 9 boleh mencegah jangkitan HPV jenis 6, 11, 16, 18 dan juga jenis 31, 33, 45, 52 dan 58 (31, 33, 45, 52 dan 58 juga boleh menyebabkan barah cervix).

____________________________________________________________________________
Jika anda mengalami simptom-simptom yang disebut di atas dan ingin berjumpa dengan doktor wanita, sila hubungi klinik kita di Dr. Tan & Partners cawangan:
Dr. Tan & Partners @ DUO Galleria



Nombor telefon +65 6976 5023
Dr. Tan & Partners @ Robertson
11 Unity St
#02-06/07 Robertson Walk
Singapore 237995
Nombor telefon +65 6238 7810
Klinik juga bersedia menerima pesakit tanpa membuat temu janji. 

5 Steps For Breast Self Examination

According to the statistics presented by the Singapore Cancer Society, Breast Cancer is the most commonly occurring cancer among women in Singapore. Each year, over 1,000 women are diagnosed with breast cancer, and over 400 die from the disease. 1 in 11 women will get breast cancer in their lifetime. The chances of surviving increases with early detection. 

What is Breast Cancer?

The female breast is made up of milk glands and ducts and is surrounded by a layer of fat. Breast cancer commonly develops within these milk ducts and glands. Breast cancer usually originates from the cells lining the milk ducts and glands. When breast cancer is detected at this non-invasive or in-situ stage, treatment is easier and patients have a higher chance of recovery.

5 Steps For Breast Self Examination


STEP 1: Stand in front of a mirror with your clothes removed, you should be able to see both your breasts clearly. Observe the breasts for signs of asymmetry, skin changes or nipple changes or any visible lumps.

STEP 2: Raise your hands behind your head and look for signs of abnormal skin or nipple changes, or any visible masses or lumps.

STEP 3: Observe your nipples for any abnormal nipple discharge. This may include bloody discharge, yellowish, watery or milk-ish discharge.

STEP 4: Lie down and use your right hand to feel your left breast. Using 3 fingers, gently palpate around the breast in a circular motion to palpate around each quadrant to feel for any palpable lumps.
Your hand should move outwards as you palpate in each quadrant. Your touch should be firm but smooth with an adequate amount of pressure. You should apply more pressure if you have dense breast tissue.
Make sure you feel the underarm area as well, palpating in the same circular motion to feel for any abnormal lumps. Repeat the same motion using your left hand for your right breast.

Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.


When to Perform Breast Self-Examination

Examine your breasts once a month – The best time to perform breast self-examination is about a week after your menstrual period starts.
If you no longer menstruate, do a breast self-examination the same day of each month, for example, the first of every month. Continue to perform a breast self-examination if you are pregnant, breastfeeding, or have breast implants.

All in All

Conducting a Breast Self-Exam (BSE) regularly can be an important way to detect Breast Cancer early. Early detection saves lives.
For a more reliable and accurate screening tool, consider getting a Breast Cancer Screening with a mammogram at our clinics. It can detect the presence of cancerous lumps even before they can be felt with the hand. 
If you are concerned about Breast Cancer, it is best to seek evaluation & screening early; you may call any of our clinics to arrange an appointment and our doctors will be more than glad to address your issue.
Other Reads:

  1. What Is the Cause & Treatment For Oral Herpes (Cold Sores)
  2. 5 Ways to Fight Depression
  3. Mycoplasma Genitalium Infection (Uncommon STD)
  4. How Late Can a Period Be (Delayed Menstrual Cycle)
  5. What You Should Know about Intrauterine Device (IUD)
  6. 10 Causes of Abnormal Vaginal Lumps and Bumps
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. What You Need to Know about HPV Vaccination, Cervical Cancer & Pap Smear
  9. Why Do I Have Abnormal Vaginal Discharge
  10. What is HPV Vaccination – Gardasil 9

Vaginismus Video – Cause, Symptom & Treatment

Vaginismus is a condition where a woman experiences discomfort, burning and pain during attempted penetration of the vagina, often leading to a difficulty in having sexual intercourse.

What is the Cause of Vaginismus?

In vaginismus, any attempt at penetration causes involuntary tensing of the pelvic muscles, specifically, the pubococcygeus muscle, as well as painful muscle spasms.
This is not intentional and women are often unaware that this is happening. The extent of vaginismus may vary between individuals and can range from mild discomfort to severe burning pain.
Women with vaginismus may find themselves unable to insert tampons or undergo a vaginal examination, inserting of Intrauterine Device (IUD) or PAP smear in the clinic, and most troubling of all, they may find sexual intimacy extremely painful or even impossible.
Vaginismus is far more common than people think and can affect any woman, even if they have previously been able to have pain free penetrative intercourse.

Primary Vaginismus & Secondary Vaginismus

Primary vaginismus is when a woman has never been able to have pain free intercourse.
Secondary vaginismus occurs in women who were previously able to have comfortable penetrative sex and may be triggered by events such as childbirth, surgeries, infections, or menopause.
While vaginismus can be deeply troubling, it is important to remember that it is a very treatable condition. Full recovery and achievement of a pain-free and fulfilling sexual intercourse are definitely possible.

What You Should Know Before Treating Vaginismus?

Before treatment, it is important to ensure there are no other medical conditions such as infections, structural abnormalities, or inflammatory skin conditions which are contributing to pain during attempted penetration of the vagina.
Your doctor will perform a thorough physical examination during your first visit and advise you on other investigations that may sometimes be needed to rule out these other problems.

Treatment of Vaginismus

How then is vaginismus treated? Treatment of vaginismus is aimed at releasing the tension in the pelvic floor muscles.
Retraining of the pelvic floor muscles to teach them to relax can be achieved through desensitisation techniques as well as the use of biofeedback devices.
Desensitisation techniques allow a woman to take conscious control of the pelvic floor muscles. These include Kegel exercises, reverse Kegel exercises or pelvic floor drop exercises and the use of vaginal dilators.
A set of vaginal dilators comes in gradually increasing sizes. These dilators are not meant to enlarge or stretch the vaginal opening, but rather, to desensitise the pelvic floor muscles.
The self-insertion of vaginal dilators enables a woman to learn to consciously override involuntary pelvic muscle spasms that occur during penetration. As these pelvic floor muscles learn to relax more over time, you will be able to progress through using the various sized dilators in the set. These dilators are often used in conjunction with a topical numbing cream or anaesthetic cream to make insertion more comfortable.

Conclusion

The treatment of vaginismus is not achieved in a single visit to the doctor; it is an individualised journey that will take perseverance and time. Your doctor will work together with you, your partner, a physiotherapist in a stress-free and encouraging environment to ultimately achieve pain-free penetration and full sexual function.
If you are experiencing Vaginismus and wish to speak to our female doctors about it, please contact our women’s clinic or drop us an email for an appointment.
Take Care!


Other Reads:

  1. What Is the Cause & Treatment For Oral Herpes (Cold Sores)
  2. Mycoplasma Genitalium Infection (Uncommon STD)
  3. How Late Can a Period Be (Delayed Menstrual Cycle)
  4. Breast implant Risk: Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL)
  5. 10 Causes of Abnormal Vaginal Lumps and Bumps
  6. 11 Causes of Dyspareunia (Pain During Intercourse)
  7. What You Need to Know about HPV Vaccination, Cervical Cancer & Pap Smear
  8. Why Do I Have Abnormal Vaginal Discharge
  9. What is HPV Vaccination – Gardasil 9


Also on DTAP: hiv clinic, anonymous hiv testing clinics singapore

Risk of Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL)

The Health Science Authority (HSA) of Singapore recently released a healthcare advisory informing medical practitioners and members of the public on the risk of Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), which have been shown to develop around breast implants. – risk of breast implant

What exactly is Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL)?

BIA-ALCL is a rare type of non-Hodgkins lymphoma that develops around breast implants. Is it not a cancer of the breast tissue.
If diagnosed early, BIA-ALCL can be successfully treated with surgery. However, in cases where the cancer has spread to other parts of the body, further treatment such as radiation or chemotherapy and targeted immunotherapy have been used.
 

When does it happen?

It usually occurs as early as 1 year after the breast implant surgery, or as late as 37 years after the breast implant surgery.

Who is at risk of getting BIA-ALCL?

Breast implants usually have a surface that is either smooth or textured. Globally, the majority of people who have developed BIA-ALCL have received textured implants. There have also been a few reports of people with smooth implants who got BIA-ALCL but these reports have been unconfirmed still. – risk of breast implant

In the Singapore Context

There has been one report of a patient with BIA-ALCL locally in Singapore, however, the diagnosis was made early and the patient’s prognosis is reported to be good.
There are currently 8 registered brands of breast implants in Singapore. Textured implants are associated with the highest risk of BIA-ALC L. The only brand in Singapore that is registered in Singapore is the Allergan Natrelle implant, which Singapore has since disallowed its sale as of April 2019. – risk of breast implant

What to do next?

If you are intending to get breast implants, have a discussion with your surgeon regarding the suitability of the various types of implants and the pros and cons.
If you already have a breast implant, there is currently no need for the removal of your implant.
However, it is important for you to take note of signs such as pain, swelling or lumps, especially around the implant.
Conduct regular breast self-examination and make sure you attend your regular check-ups with your doctor as this can aid in early detection of the disease.
Breast cancer screening can still be effectively carried out in women with breast implants, but special considerations do need to be taken.

Screening with mammogram can still be done for these women.

It is important for patients to inform the medical technologist conducting the scan about the presence of breast implants, so as to allow appropriate positioning to optimize visualization from the mammogram.
It may be possible that the implants may obscure the view of breast lumps depending on the location. Hence positioning of the breast is important, and additional views and images are also taken to minimize the chances of missing detection of a lesion.
While rare, there is also a slight risk of implant rupture due to compression during the mammogram.
Other imaging modalities such as MRI breast or ultrasound can also be conducted for women with breast implants.

Take Care!


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  5. What You Should Know about Intrauterine Device (IUD)
  6. 10 Causes of Abnormal Vaginal Lumps and Bumps
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. What You Need to Know about HPV Vaccination, Cervical Cancer & Pap Smear
  9. Why Do I Have Abnormal Vaginal Discharge
  10. What is HPV Vaccination – Gardasil 9

What You Should Know about Intrauterine Device (IUD)

An IUD is a long term, reversible mode of contraception. It is one of the most effective birth control methods available, with an over 99% success rate at preventing pregnancy. It is a tiny T-shaped device which is inserted through the vaginal canal and cervix into the uterus, where it sits and prevents pregnancy.

What are the Different Types of IUDs

There are two types of IUDs available – the copper IUD and the hormonal IUD. They both work to prevent pregnancy by affecting the way sperm cells move so that they are unable to get to the egg.
The hormonal IUD also changes your internal environment to prevent the sperm from meeting the egg and may also inhibit the release of an egg by your ovaries.
Depending on the type of IUD, it can last anything from between 2.5 to 10 years.

Are There Any Side Effects for IUD

The side effects of the IUD depend on the type. Some initial bleeding and spotting may occur with both types. The copper IUD results in heavier menstrual periods, while with the hormonal IUD, you can expect your period to become lighter over time and possibly even stop altogether.

Insertion of IUD

Insertion of the IUD is best done during your menses as this is when your cervix, the entrance to your womb, is most relaxed. An IUD is suitable even for women who have not given birth before. Your doctor will speak to you to determine which IUD is suitable for you depending on your needs.
During the insertion of the IUD, a speculum is inserted to open up the vaginal canal. The cervix is then cleaned, and a metal sounder is gently inserted through the cervix opening and into the womb to determine the depth of your womb and whether the IUD can be inserted. Your doctor may have to use a small pair of forceps to hold your cervix in place.
The IUD is then inserted into your womb. You may experience a little cramping and discomfort, as well as some minor bleeding.

What Happens After Insertion of the IUD

About 2-4 weeks after insertion of the IUD, you will have to do an ultrasound scan to confirm the placement of the IUD. When your IUD is due, it can be removed quickly and simply in the clinic. Your doctor simply pulls on the string to gently remove the IUD.
The IUD is a safe and convenient option for someone who is not looking to conceive in the immediate future. It lasts for years and is easily removed should you wish to conceive.

Find out more about IUD by speaking with our female doctors; make an appointment today.

Call our Women’s Clinic @ +65 6976 5023 or drop us an email at hello@dtapclinic.com 

Take Care!


Other Reads:

  1. What Is the Cause & Treatment For Oral Herpes (Cold Sores)
  2. Mycoplasma Genitalium Infection (Uncommon STD)
  3. How Late Can a Period Be (Delayed Menstrual Cycle)
  4. Breast implant Risk: Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL)
  5. 10 Causes of Abnormal Vaginal Lumps and Bumps
  6. 11 Causes of Dyspareunia (Pain During Intercourse)
  7. What You Need to Know about HPV Vaccination, Cervical Cancer & Pap Smear
  8. Why Do I Have Abnormal Vaginal Discharge
  9. What is HPV Vaccination – Gardasil 9

Sex During Period (Sex During Menstruation) What to Know

Sex During Period: Women get their periods about once a month, with each period lasting about five to seven days. This adds up to about two to three months’ worth of bleeding in a year.
While some women and their partners may shy away from sex during this time (either due to psychological discomfort or for hygiene or religious purposes), others are unfazed and continue with their regular sex lives, menses or not.

Are there real medical reasons to avoid sex during menses? Or are there benefits to coitus during menstruation?

Myth: It is not possible to get pregnant if one has sex while on her period.

One of the common misconceptions is that if one has unprotected sex during menses, pregnancy will not occur. While the probability of this happening is low, it is NOT zero; pregnancy is still possible.
Sperm can survive in the body for up to 5 days. Ovulation usually occurs 14 days before one’s period starts.
In women with shorter menstrual cycles, ovulation occurs earlier on in the cycle, e.g. someone with a menstrual cycle of 24 days would be ovulating around day 10.
It is theoretically possible that one could get pregnant from sex towards the end of one’s period because the sperm survives long enough to fertilise the egg which is released a few days after.
The safest option is to always use some form of contraception, period or not.

Sexually Transmitted Infections (STIs) & Sex during Period

Another concern is about sexually transmitted infections.
As with regular sex, sex during menses carries the risk of sexually transmitted infections.
Menstrual blood can carry blood-borne STDs like HIV, Hepatitis B and C. Other STDs which reside in the genital tract, like Chlamydia and Gonorrhea, can be transmitted as well.
There is also some possibility that there may also an increased risk of serious infections like pelvic inflammatory disease occurring as a result of sex during menses, because the cervix is more open during this time and bacteria can track upwards to infect the womb and fallopian tubes, but there is no definite research to conclusively support this.
Either way, STDs are a real risk which can be reduced by observing safe sexual practices and using barrier protection.
There is also a risk of yeast infections or bacterial vaginosis occurring as a result of a disruption to the natural microbiological balance in the vagina, as menstrual blood can act as a medium for bacterial growth.

What about the benefits of sex during menses?

While some may find menstrual blood makes things a little messy, it also acts as lubrication, facilitating more pleasurable or comfortable intercourse.
Uterine contractions from orgasm can also potentially reduce menstrual cramps (dysmenorrhea).
Endorphins (“feel good” chemicals) are also released during intercourse.
Ultimately, the decision to abstain or have sex during one’s menstrual period is up to you and your partner.
From a medical standpoint, as long as safe sexual practices are observed, there is no real reason to shy away from sex during period.

Take Care!


Other Reads:

  1. What Is the Cause & Treatment For Oral Herpes (Cold Sores)
  2. Mycoplasma Genitalium Infection (Uncommon STD)
  3. How Late Can a Period Be (Delayed Menstrual Cycle)
  4. 10 Causes of Abnormal Vaginal Lumps and Bumps
  5. 11 Causes of Dyspareunia (Pain During Intercourse)
  6. What You Need to Know about HPV Vaccination, Cervical Cancer & Pap Smear
  7. Why Do I Have Abnormal Vaginal Discharge
  8. What is HPV Vaccination – Gardasil 9