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. 

We provide a private and discreet environment for you to discuss your medical issues with our female doctors at our DUO Galleria Branch and Robertson Branch.
Make an appointment today. Call our Women’s Clinic @ +65 6976 5023 or drop us an email at hello@dtapclinic.com 

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!


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

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

Vaginal Douching – To Douche or Not to Douche?

What is Vaginal Douching?

Vaginal douching is the practice of washing the vaginal canal with fluid – this may come in the form of a bottle or bag of water or various over-the-counter or self-concocted mixtures of fluid- which is squirted up into the vaginal canal. The fluid then comes back out of the vaginal entrance.
Most women who practice vaginal douching do so because of hygiene or health concerns. Common reasons for douching include wanting to keep the vaginal canal clean or trying to get rid of bad vaginal odour or abnormal vaginal discharge.

Why Do I Have Abnormal Vaginal Discharge?

Is Vaginal Douching Recommended?

To put an end to the confusion regarding the practice of douching: douching is not medically recommended.
The vaginal canal is a self-cleaning organ. There are various glands in the walls of the vagina which produce fluids responsible for maintaining the natural balance in the vaginal environment. The vagina also has naturally occurred “good” bacterial flora which is important for your vaginal health. You do not need additional external chemicals or water to “wash” or cleanse the vagina.

What are the Consequences of Douching?

In fact, the practice of douching can give rise to more health problems and do more harm than good. Douching may disrupt the delicate, natural balance of the vaginal flora, leading to an increased risk of common vaginal infections like yeast or bacterial vaginosis. These may manifest as abnormal vaginal discharge, vaginal itching, or a bad odour. In the setting of a pre-existing sexually transmitted infection (STI), douching may potentially increase the risk of pelvic inflammatory disease, where the infection spreads to the uterus (womb), or the fallopian tubes and ovaries. Furthermore, douching can also result in irritation of the skin both in and around the vaginal canal, particularly if one is sensitive to the chemicals or components of the douche.

What Are The Common STD Symptoms in Women” 
An Overview of STDs – By An STD Doctor

How Can One Get Rid of Vaginal Odour or Abnormal Discharge?

Vaginal odour or discharge is usually due to an underlying vaginal infection and it is best that you see a doctor for appropriate testing and treatment. With treatment of the underlying offending organism, you can also expect that the abnormal discharge and odour will resolve.
In terms of hygiene, washing externally with warm water or a gentle, non-scented cleanser will suffice. There is absolutely no need to worry about washing or cleaning the vaginal canal itself.

Misconceptions About Vaginal Douching

Some women may persist with douching because of certain misconceptions they have. Vaginal douching does NOT – prevent pregnancy after unprotected sexual intercourse. Vaginal douching also does NOT prevent or reduce the spread of STIs from intercourse.
Instead, you should ensure you have safe sexual practices, such as the use of barrier protection, regular STI checks, and having a regular partner whose infection status you are aware of. If you are not planning to conceive, other reliable and safe forms of contraception are available and you can have a discussion with your doctor about these.

If you wish to speak to female doctors if you have experienced the above Treatment & Testing, please visit us at our clinics. Alternately,  call us or email us for an appointment 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. 10 Causes of Abnormal Vaginal Lumps and Bumps
  5. 11 Causes of Dyspareunia (Pain During Intercourse)
  6. Sex During Period (Sex & Menstruation) What To Know
  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

Bumps on Vaginal Area – Vaginal Lumps & Vaginal Bumps

Lumps and bumps over the external genitalia (the vulva) or vagina are a fairly common concern that ladies may have. These can be normal or benign, or due to infections, sexually transmitted diseases, and less commonly, due to cancers (malignancy).

Here are some of the Causes of Vaginal Lumps & Bumps:

1) Benign bumps

Causes of benign bumps in the genital region include vestibular papillomatosis, Fordyce spots, ingrown hairs and folliculitis, various cysts (sebaceous cysts, Bartholin cysts).

Vestibular papillomatosis

This is a variation of normal anatomy. Vestibular papillomatosis appears as multiple, symmetrical, tiny bumps or finger-like projections over the labia minora and vestibule (vaginal opening). This can often be mistaken for warts and may thus be an undue cause for worry but there are features which help differentiate it from warts. No treatment is required for vestibular papillomatosis. It is harmless and it is NOT due to infection and cannot be spread to your sexual partners.

Fordyce spots

These are due to enlarged oil glands, which appear as tiny (1-3mm) whitish or yellowish bumps over the labia minora. These can also occur in other parts of the body, for instance around the edges of the lips or on the penis in men. They are completely harmless and painless and are part of normal anatomy. There is no need for any treatment or worry.

Folliculitis and ingrown hairs

Ingrown hairs may manifest as bumps, particularly in someone who shaves. Both ingrown hairs, as well as hair follicles, can get infected (known as folliculitis), resulting in small, red, tender bumps. Usually, topical creams will suffice for treatment.  Good hygiene, particularly relating to hair removal, is helpful in reducing the risk of folliculitis.

Cysts

Cysts are small round bumps that can be felt underneath the skin. These may arise from structures in the skin layer itself e.g. sebaceous cysts, or from glands which are found in the genital region near the labia minora (Bartholin’s glands).

Sebaceous Cysts

Sebaceous cysts are the result of oil glands which get blocked. They are painless unless they become infected. Most of the time, they can be left alone—but in the event of infection or if they become too large, incision and drainage or removal may be necessary.

Bartholin Cysts

Bartholin cysts are the result of Bartholin’s glands which are blocked. These cysts can enlarge, become infected and tender. They also have a tendency to recur and a minor surgery to remove them may be required.

2) Infections and Sexually Transmitted Diseases (STDs)

Warts

These are caused by certain strains (type 6, 11) of the Human Papilloma Virus (HPV). They appear as small skin-coloured bumps or irregular, cauliflower-like skin growths. They and can occur in isolation but are usually multiple. Genital warts usually appear anytime between weeks to 8 months (average 3 months) from the time of HPV infection and are highly infectious. The clinical course of warts can vary – in some individuals, genital warts may spontaneously resolve, while in others they may stay the same or increase in size and number.
The treatment of genital warts does not remove the underlying HPV infection and the only medication available against this is the HPV vaccine. The HPV vaccine protects against future infection but does not get rid of existing strains, so it is best to get vaccinated as soon as possible before one is exposed to more strains of HPV.
Read: Cervical Cancer, PAP SMEAR & HPV Vaccination – What you need to know

Molluscum contagiosum

This is skin infection caused by the Molluscum contagiosum virus which causes multiple small, pearly white or skin coloured bumps, sometimes with a central dimple (“central umbilication”). These are painless, non-itchy and can occur not just in the genital region but elsewhere on the body as well. The virus is spread through direct skin contact, or through contaminated clothing and towels. These lesions are harmless and will generally resolve within 6 months to a year (occasionally longer). Treatments available to address these bumps include topical medications like imiquimoid cream, freezing, and electrosurgery (laser).

Herpes

One of the stages of genital herpes is painful genital blisters – red bumps which eventually become fluid filled and later burst to form ulcers. Genital herpes is caused by the Herpes Simplex Virus which can be transmitted through secretions such as saliva or genital fluids. There is no cure for herpes, but antiviral medications are prescribed when an individual has a painful flare of blisters and ulcers.

Read: Genital Warts, Genital Blister & Genital Ulcer – Causes and Treatments
Read: Syphilis Symptoms – Painless Sores & Rashes

3) Malignancy

Vaginal cancer

Vulval or vaginal cancer are rare but serious causes of a vaginal lump or bump. These may be accompanied by other features such as persistent itching, pain, a persistent ulcer, and abnormal vaginal bleeding or discharge.

Melanoma

Vaginal melanoma (a type of cancer of the skin) can appear as a pigmented lump which may be associated with itching, bleeding and pain.

Malignancies tend to occur in older women but as their symptoms can be rather nonspecific, it is best to get any abnormal lump/bump checked.

If you wish to speak to female doctors if you have experienced the above signs and symptoms, call us or email us for an appointment at hello@dtapclinic.com.

Take Care!


Other Reads:

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

Urinary Tract Infections (UTI) in Women

What is a Urinary Tract Infections (UTI)?

First, let’s talk about the urinary tract. The urinary tract begins with the kidneys, which are responsible for producing urine. Each kidney is connected to a tube called a ureter, which carries the urine from the kidney to the bladder. Urine is stored in the bladder before it is released through another tube (called the urethra) when we pee.
A urinary tract infection (UTI) is when there is a bacterial infection affecting any of the above components mentioned, most commonly the bladder. This is called “cystitis”. In rarer but more serious cases, important structures like the kidneys may be affected as well.
Urinary tract infections tend to affect women much more than men, simply because women have a shorter urethra than men. UTIs in healthy men are uncommon because the length of their urethra protects against bacteria spreading upwards.

What are the Causes of a UTI in Women?

Certain risk factors for UTIs are specific to women:

  • Sexual intercourse
  • Contraception (diaphragms and spermicide use)
  • Menopause

In women of all ages, common triggers include sexual intercourse (through the introduction of bacteria due to the mechanical nature of intercourse). Certain forms of contraception such as the use of diaphragms and spermicides may increase the risk of UTIs as well. In ladies who are post-menopausal, decreased levels of estrogen result in vaginal atrophy (thinning and dryness of the vaginal lining and walls) and stress incontinence, leading to an increased risk of UTIs as well.

Other risk factors are common to both males and females alike and include:

  • A weakened immune state – as may be seen in diabetes or with cancer, chemotherapy or people who are on long term immunosuppressive medications
  • Structural abnormalities in the urine tract (some people may be born with abnormalities in their urinary tract which place them at increased risk of frequent UTIs from early childhood onwards and throughout their life)
  • Kidney stones
  • Any factors which increase the risk of urine retention – this includes constipation in the elderly, certain medications, and in older men, an enlarged prostate gland
  • Foreign bodies like a urinary catheter

What are Symptoms of an UTI in Women?

Urinary tract infections can affect the urethra (urethritis), the bladder (cystitis), and the ureter and kidneys (pyelonephritis).
Common symptoms include:

  • Dysuria (a stinging or burning pain when passing urine)
  • Frequency and urgency (always feeling the urge to pee and going more often)
  • Hematuria (blood in the urine)
  • Foul smelling or cloudy urine
  • Suprapubic pain (pain over the lower part of your abdomen where your bladder is located)

Symptoms of a more serious infection affecting the kidneys and upper urine tract:

  • Flank pain (pain over the lower back region either on the left or right side corresponding to the kidney affected)
  • Fever and chills
  • Nausea, vomiting

It is best to see a doctor early, as soon as the symptoms of a UTI begin because if left untreated, there is a risk that what was initially simple cystitis or bladder infection may spread upwards to the kidney and turn into a serious and even potentially life-threatening infection that might leave permanent kidney damage.

How Will My Doctor Diagnose a UTI?

Diagnosis of a UTI begins with the history (symptoms and risk factors) you tell your doctor as well as a physical examination to see if there are any alarming red flags that suggest you have a more serious infection like pyelonephritis.
Your doctor may also ask you to provide a urine sample for a urine dipstick test in clinic – this is a simple and immediate test which can detect the presence of blood, white blood cells (infection-fighting cells which suggest ongoing inflammation), and nitrites (which are present when there is a bacterial infection) in your urine.
Another useful test that your doctor may order is a urine culture. This is when your urine sample is sent off to the lab to check for bacterial growth over the course of a few days. This is useful as it can tell your doctor which specific bacteria is responsible for your UTI, as well as what antibiotics the bacterium is susceptible to.
If you have recurrent urinary tract infections, you may benefit from additional imaging investigations, such as an ultrasound scan, to look at the structure of your urinary tract as well as look for any stones that may be triggering these infections.

How Is a UTI Treated?

Antibiotics are required to treat a UTI. Most simple cases of UTIs require only oral antibiotics, but if you have a more severe infection affecting the kidneys, you may end up having to go to hospital for intravenous antibiotics.
Medications (usually in the form of a powder that you dissolve in water and drink) that help alkalinise your urine will also be helpful in reducing your urinary discomfort while the antibiotics kick in.

What Can I Do To Reduce My Risk Of Getting a UTI?

Adequate hydration and passing urine regularly may help flush bacteria out and helps reduce your risk of kidney stones. Passing motion regularly also helps reduce the risk of urinary retention from constipation.
In women, emptying your bladder after sexual intercourse, as well as avoiding the use of diaphragms and spermicides may be helpful. Wiping from front to back after defecation also helps reduce the risk of introducing faecal bacteria.
Cranberry juice does contain a compound which inhibits bacteria from sticking to the walls of your bladder but there is no conclusive research that demonstrates cranberry juice reduces the risk of UTIs. Essentially, there is no harm in drinking cranberry juice, but it may not necessarily help as much as you hope it will.
UTIs are common and treatable! The most important thing is to see a doctor early for assessment and treatment and you’ll feel better in no time at all.
If you have any concern about UTI and wish to speak to our doctor, you may walk into any of our clinics or call us for an appointment or email us at hello@dtapclinic.com.
Take Care!


Other Reads:

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

Menstrual cramps? Period Cramps? What is The Causes of Dysmenorrhea

Menstrual cramps are what a girl dreads the most during that time of the month.
That intense crampy pain in the lower abdomen that just doesn’t seem to go away. Sounds familiar?
Well, you are not alone.
Menstrual cramps can affect more than 50% of women each month during their period, and approximately 10% suffer from debilitating pain during this time, affecting their daily lifestyle.
But what exactly causes this excruciating and annoying symptom that seems to plague so many girls almost every month?

What Causes Menstrual Cramps?

Every month during our menstrual cycle, our uterus sheds its inner lining (also known as the endometrium) as a result of hormonal changes that occur when our body senses that we are not pregnant. Additionally, the womb also contracts to help in the expulsion of this inner lining.
This shedding of the endometrium results in the bleeding that girls experience during their period.
This action also releases hormones into our body also known as prostaglandins. Prostaglandins are hormones that are involved in causing pain and inflammation, which hence leads to the pain we experience in our lower abdomen known as cramps.

What Are the Common Symptoms Associated with Menstrual Cramps?

Menstrual cramps are extremely common and can occur a few days before, during or after your menstrual period.
You may experience a cramping sensation most commonly over the lower abdomen and back and can range from mild to severe intensity.
Some people may also experience additional symptoms such as bloating, nausea, vomiting or diarrhoea.

How Do I Know If My Menstrual Cramps Could Mean Something More?

The cause behind the majority of the menstrual cramps a girl experiences are part of the normal menstrual cycle. This is known as primary dysmenorrhea. Dysmenorrhea is the medical term that refers to menstrual cramps.
However, sometimes, these menstrual cramps could be due to an underlying problem in the womb or pelvic organs. So when should you worry if your cramps are more than your regular period pains? When should you seek a doctor’s opinion?
If you experience severe or excruciating pain during each period that affects your activities of daily living, if you persistently experience pain that is out of your menstrual cycle, or if you have any other symptoms that are out of the usual, then you should get it checked if in doubt!

What Could Be the Other Causes of Menstrual Cramps?

Menstrual cramps that are caused by an underlying pathology is referred to as secondary dysmenorrhea.
Common reasons why you could be having recurrent and persistent menstrual cramps could be due to underlying conditions such as endometriosis or adenomyosis.
Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus
Adenomyosis is a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium).
Your doctor will perform a physical examination and detailed investigations to look for these conditions.
 

Can Menstrual Cramps be cured? What Is the Best Way of Treating It?

Menstrual cramps, unfortunately, cannot be cured.
However, the good news is they can be well controlled with various types of medication.
A good way to control and reduce the discomfort that is caused by menstrual cramps is by taking painkillers. In particular, painkillers that belong to the NSAIDs group are particularly useful in controlling the symptoms of dysmenorrhea.
This is due to the mechanism of action of the painkillers in the NSAID group, which specifically target and block the prostaglandins that are the cause of the period pains!
Other good ways to manage period cramps can also include:

  • Using a heating pad or hot water bottle
  • Drinking a warm drink
  • Avoid smoking or alcohol
  • Regular exercise

If you are experiencing any worrying menstrual cramps, please call or visit any of our Women’s Health Clinics or drop us an email at hello@dtapclinic.com for an appointment for a proper evaluation and treatment.

Take Care!


Other Reads:

  1. What Is the Cause & Treatment For Oral Herpes (Cold Sores)
  2. How Late Can a Period Be (Delayed Menstrual Cycle)
  3. Sex During Period (Sex & Menstruation) What To Know
  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