10 Causes of Abnormal Vaginal Lumps and Bumps

Some women may develop lumps or bumps in the vaginal area sometime during their lives.

The severity of the condition, indicated by these lumps and bumps, can be classified into three categories:

  • Harmless
  • Infection or sexually-transmitted disease
  • Malignancy

For the most part, these lumps or bumps are harmless. The following conditions fall under this group.

1.) Cysts

Cysts can occur anywhere in the body. They are sacs, that range in size, filled with liquid or other substances. In the vaginal area, these cysts are usually benign and painless unless infected. It would feel like a small pebble just underneath the skin of the vulva.

There are two kinds of cysts:

Sebaceous Cysts

Sebaceous cysts result from the blocked hair follicles and ingrown hair when shaving or waxing. Most of these cysts do not require treatment and can be ignored if it does not cause any problems. However, some may need a small incision if they enlarge or become infected.

Bartholin Cysts

When the Bartholin gland (a gland in the vaginal and vulva region) becomes blocked and swells, this will cause a Bartholin cyst to form. The cyst is also harmless unless it becomes infected and turns into an abscess (a swollen area containing pus). In such cases, a trial of antibiotics usually is effective. In some cases, minor surgery may be necessary.

2.) Molluscum Contagiosum

A virus called pox virus causes molluscum contagiosum. It is a skin infection which causes multiple tiny bumps to spread across the area of infected skin. These harmless bumps or raised lesions are pearly white to skin-coloured and will eventually vanish after 1-2 years.
Molluscum contagiosum commonly appears in children and other parts of their bodies. However, it may pose as a sign of an STD when it occurs in adults. It is then advised for these people to get tested for other STDs.
Effective treatment options available to cure this particular type of molluscum contagiosum include:

  • Electrosurgery
  • Freezing (liquid nitrogen)
  • Topical cream

3.) Vestibular Papillomatosis

VP is a skin condition whereby multiple shiny small papules appear over the skin of the inner labia and vaginal opening. Similar to pearly penile papules (PPP) in men, VP is a normal variant of female genitalia; therefore treatment is not necessary.
It should be noted that Vestibular Papillomatosis is commonly mistaken for genital warts because of their similar appearance. Genital wart is a type of Sexually Transmitted Disease (STD). Therefore it is essential to have a correct diagnosis of the condition as a measure to prevent undue stress or prolonged deterioration. Our doctors are able to distinguish between both conditions.

4.) Fordyce Spots

Fordyce spots are enlarged oil glands materialising as small white to yellow lumps over the inner labia. These spots can also appear on the lining of the mouth and occasionally on the penis in men. They are completely painless and harmless.
The condition where lumps and bumps associated with an infection is folliculitis. Other conditions that are STD-related include genital warts, syphilis and herpes.

5.) Folliculitis

Folliculitis is the skin condition where the hair follicles in the labia region become inflamed and infected, causing tender red spots containing pus to surface. The hair follicles become inflamed from bacterial, fungal or even viral infection (e.g. herpes), due to situations that irritate ingrown hair, like shaving or waxing. The treatment is dependent on the type of infection.

6.) Genital Warts

Genital wart is a Sexually Transmitted Disease (STD) caused by the Human Papilloma Virus (HPV), usually, type 6 and 11. Genital warts present as small, skin-coloured cauliflower-like bumps that can either develop into one single lump or more commonly into multiple lumps. Genital warts are highly contagious through skin-to-skin contact.
Depending on the individual, the HPV warts may go away, remain present or spread and increase in amount. Even without developing these warts, the individual can still be a carrier of the HPV virus.
There are HPV vaccinations now available to protect you from certain strains of HPV including type 6 and 11.
(The new Gardasil 9 HPV Vaccination is available in all our clinics in Singapore and Malaysia)

7.) Syphilis

Syphilis is a sexually-transmitted disease that is caused by a bacterial infection. From this, a chancre, a painless sore, will appear in the genital or mouth area. The sore can eventually go away untreated in a few weeks. However, this will lead to the development of severe complications because the infection remains.
Please click here to find out more about syphilis, including treatment options.

8.) Genital Herpes

Genital herpes is a contagious sexually-transmitted disease appearing as multiple painful blisters or ulcers clustered in the genital area. The infection can spread quickly to sexual partners, even with the use of condoms.
Although there is currently no cure for the infection, there are different treatments, like antiviral medications, to prevent and control recurring outbreaks of blisters.

Lumps and bumps can also be a malignant growth, and potentially a sign of cancer.

 

9.) Vaginal Cancer

Vaginal or vulvar cancer can be presented as a lump or bump in the vaginal region. Besides the lumps, this type of cancer is also accompanied by other symptoms, including:

  • Abnormal vaginal bleeding
  • Unusual vaginal discharge
  • Pain during intercourse

In such cases, a pelvic examination and pap smear are done to look for any red flags. A pelvic examination and a pap smear test is done to check for signs of early changes and cancer.
If the results are positive, the doctor will then discuss the next steps for treatment.

10.) Vaginal Melanoma

Melanoma is a type of skin cancer arising from pigmented cells. 2% of melanoma are diagnosed in the vagina or vulva. This cancer is more prevalent in women older than 50.
Vaginal melanoma appears as a pigmented lump in the vaginal area. Other non-specific symptoms include itching, bleeding and pain.

If you are experiencing Abnormal Vaginal Lumps & Bumps, it is highly recommended to visit our female doctors at our Women Clinics as soon as possible.

Take Care!

Other Interesting Reads:

    1. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
    2. 11 Causes of Dyspareunia (Pain During Intercourse)
    3. What is HPV Vaccination (Gardasil 9)
    4. 10 Causes of abnormal Vaginal Lumps and Bumps
    5. An Overview of Gonorrhoea
    6. What is the Treatment for Cold Sores? What causes Cold Sores?

 

9合1 加卫苗(Gardasil 9)疫苗

9合1 加卫苗(Gardasil 9)疫苗可预防9种病毒株的人类乳头瘤病毒(HPV)所引起的癌症与疾病。
HPV是一种可分为两大类型的病毒,一组可致癌而另一组可致疣或乳头状瘤。
现今有超过一百种HPV病毒株并且每一株都有自己指定的数字,例如HPV16或HPV52。迄今为止,能致疣的HPV病毒株不会致癌而能致癌的病毒株并不会致疣!
HPV受诱惑于并仅活于体内的鳞状上皮细胞。这类细胞可存在于皮肤表面和潮湿的粘膜表面,例如:

  1. 阴道、肛门、子宫颈、外阴部(围绕阴道外)
  2. 阴茎的内包皮和尿道
  3. 内鼻、口、喉气管(主要呼吸管)和支气管(较小的呼吸管,分支于气管)
  4. 内眼睑

因此,这些表面的感染导致疣和癌细胞的形成。
9合1加卫苗有助于防止9种HPV病毒株的感染,因而适当的命名为9合1加卫苗。疫苗里的9种HPV病毒株当中,有2种用于预防疣(HPV16和18),而其余的7种用于预防癌症(HPV16、18、31、33、45、52与58)。
关于癌症,HPV是大多数宫颈癌、阴道癌、外阴癌、肛门癌、阴茎癌和口咽癌(咽喉癌和舌癌)病例的主要致癌病毒。

了解更多: 水货九价hpv疫苗-到底能够采取什么措施来避免接受

这个疫苗与旧款疫苗希瑞适(卉妍康 Cervarix)和4合1加卫苗(Gardasil 4)有什么区别?

与4合1加卫苗相比,9合1加卫苗对于HPV可提供更广泛的保护,它不仅能预防4合1加卫苗所预防的4种病毒株,它还能预防另外5种高危型的病毒株:HPV31、33、45、52合58。这几种病毒株加起来就已经覆盖了能导致百分之九十的宫颈癌病例的病毒株。
两种加卫苗都可预防致癌的HPV16、18,以及致疣的HPV6与11。
另一方面,希瑞适只针最常致癌的HPV16与18,而且并不能预防疣。

男女性都能接种9合1加卫苗吗?

是的,男女行都能接种9合1加卫苗,反观,希瑞适只适用于女性。

适合接种9合1加卫苗的最小年龄是?

9合1加卫苗可接种的最小年龄是9岁。在发生任何HPV接触之前接种疫苗是最有效的。

对女性而言,9合1加卫苗有多重要?

宫颈癌是新加坡15-44岁女性因癌症死亡的第三大主要原因,每月有6名妇女因宫劲癌而死。
通过疫苗接种可轻易预防宫颈癌,因此在女性当中受到了极大的推荐。
请记住,接种疫苗预防宫颈癌、阴道癌、外阴癌、肛门癌或口咽癌并不是百分之一百的有效的,但至少它现今提供了最好的预防机会,更何况,这些癌症还有其他致癌的HPV病毒株和其他致病因素。

对男性而言,9合1加卫苗又是如何重要?

首先,我们将根据不同的性行为进行两大分类:进行穿插性肛门性交的男性和不进行该行为的男性。
进行穿插性肛门性交并是接受一方的男性一般患上HPV相关肛门癌的风险较高,因HPV将贮藏于肛门粘膜表面。
无论往后的性取向如何,男孩或年轻男性进行早期接种疫苗都有助于预防肛门癌。与女性不同的是,进行肛门性交的男性目前尚无类似宫颈抹片实验(PAP Smear)这类受批准的筛查检测方案可实行。
不接受肛门性交的男性依然可从接种疫苗中受益。该疫苗可降低其口腔癌和阴茎癌的风险,因为在进行阴道性交或口交期间HPV可贮存于阴茎上,同样地,HPV也可在口交时贮存于口腔内。
许多异性恋男人可能会问:“HPV一般常导致宫颈癌,似乎更是个女性的问题而非是男性的。”仔细想想,HPV相关癌症对于女性是致命的,只要接种疫苗的男性人数越多,免疫人群就越大,从而降低把HPV传播给女性的风险。这被称为”“群体免疫力”。
相反,随着更多的女性接种疫苗,更多的男性就被赋予“群体免疫力”的保护,HPV流行率下降从而降低了感染HPV相关疾病的风险。
因此,我们也应该鼓励男性接种9合1加卫苗以降低HPV相关癌症和疣的总体风险和发生率。以澳洲为例,HPV疫苗接种已被纳入其国家免疫计划赞助的以学校为基础的举措,广泛接种12至13岁的男孩。

疫苗的使用方式和计量方案是什么?

医师将在您的胳膊、大腿或臀部肌肉上进行9合1加卫苗注射。
计量方案一共是3剂,在理想情况下,这3剂应在6个月内分散注射,例如:如果您今天已注射了第一剂,那么您的第二剂量将在2个月后注射,而第三剂将在第一剂的6个月后。
即使您忘记或延迟您的后续剂量,只要您在12个月以内完成所有3次剂量注射仍然可以实现有效的免疫力。

注射了9合1加卫苗后女性还需要进行宫颈抹片检查(PAP Smear)吗?

是的。虽然9合1加卫苗比旧款疫苗更覆盖了更多的HPV病毒株,但它仍然不能覆盖所有致癌的病毒株,而这其中就有7种。请记住,已知晓能导致癌症的HPV病毒株有15种,或许还有更多是我们还不知道的呢!
宫颈抹片检查应至少每三年进行一次,若您的检验异常,您的医师可能会建议您每6-12个月复查一次以便进行更密切的监测。
若您有意注射HPV疫苗或想了解更多相关信息,请联系我们在新加坡与马来西亚的诊所。
新加坡诊所
马来西亚诊所

What is HIV PrEP & Event-Driven Based HIV PrEP Strategy?

What is HIV PrEP?

HIV PrEP is an option for HIV prevention and involves taking medication that can reduce the risk of HIV transmission by up to 95% if taken properly.
Most of the time, Pre-Exposure Prophylaxis, or HIV PrEP for short is taken as a daily tablet and needs to be taken consistently to provide the greatest level of protection.
HIV PrEP is recommended for at-risk groups, including men-who-have-sex-with-men, patients who have a known partner who is living with HIV (PLHIV), or those with multiple partners of unknown HIV status.

What is the difference between HIV PEP (HIV Post Exposure Prophylaxis) & HIV PrEP?

HIV PrEP should not be mistaken for HIV PEP or HIV Post Exposure Prophylaxis.

HIV PEP is for any individual who is at risk of HIV infection after an HIV exposed to HIV to take HIV medicines for a month to reduce his or her chances of HIV infection.

HIV Pre Exposure prophylaxis and HIV Post Exposure Prophylaxis do not 100% reduce your chances of HIV infection, nor prevent you from being infected with other Sexually Transmitted Diseases (STDs) besides HIV.

HIV PEP as an HIV prevention strategy was first developed for healthcare workers, who are being exposed to contaminated blood or needles prick. It has since expanded to other HIV high-risk activities such as sexual exposure and intravenous drugs used.

Another development of HIV prevention is by using HIV Pre Exposure Prophylaxis (PrEP) as a strategy to reduce the chances of HIV infection even before any potential HIV exposure.

What is Event Driven Based HIV PrEP Strategy?

Some people may find that taking a daily table is just not suitable for them.
If this is the case, they may consider an option called Event-Based Dosing, or EBD for short.
This entails taking tablets one day before the exposure, the days of exposure, and for one day after the last exposure.
It is a much shorter course of tablets than regular HIV PrEP, and can still provide a high level of protection from HIV, with up to 85% risk reduction.
HIV PrEP is most effective when used in combination with other protective strategies such as condoms and regular STD screening.

Descovy As New HIV Medication For HIV PrEP

Descovy (brand name) is a FDA approved new drug combination of tenofovir alafenamide (TAF) + emtricitabine for use as HIV PrEP, which has shown to be equally effective in preventing HIV infection whilst touting an improved safety profile for renal and bone toxicity.

Descovy is currently available in all DTAP clinics in Singapore. It is a prescription only medication and must be prescribed by a doctor. Speak to our doctors for more information about Descovy and find out if a HIV-1 treatment that contains Descovy is right for you.

If you are interested in learning more about HIV PrEP or EBD, please come down to our any of our clinics to speak to our doctors, and see if these options are suitable for you. You can learn more about the What is HIV PrEP or HIV Pre-Exposure Prophylaxis.
We can advise you in more detail on the indications, dosage and timing, and potential side effects of the medications, as well as how to follow up with appropriate HIV Testing and STD testing.
Take Care!


Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. The HIV Proviral DNA Test can be done 10 days post exposure.
  3. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  4. HPV Infection & HPV Vaccination for Men who have sex with Men
  5. STD Risk for Receptive Unprotected Anal Sex in Men
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know about Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related Opportunistic Infections

 

How is the Adult Circumcision (Foreskin Removal) Procedure Done?

What is Male Circumcision?

Male circumcision is the removal of the foreskin from the penis.

Why Do Some Some Adults Undergo Circumcision?

Circumcision for adults is a medical treatment option for patients with recurrent foreskin infections, phimosis (tight foreskin opening), and for religious reasons. Some choose to do it for aesthetic reasons. 

How is Circumcision Done?

Shang Ring Method

In our clinics, we perform circumcision using the Shang Ring Method. A numbing cream will be applied to the foreskin and left for at least 30 minutes.
Once the skin is numb, the Shang Ring will be applied. The size of the ring will be measured prior to the procedure.
The foreskin will be clamped in between the inner and outer ring.
The excess skin will then be removed by surgical scissors. The ring will be left in place for one to two weeks.
After surgery, the patient will be prescribed oral painkillers and antibiotics.

 

What are the Advantages of the Shang Ring and Stapler Method?

It is a revolutionary circumcision device that shortens the procedure duration down to 5 minutes only instead of the usual 45 minutes or 1 hour via conventional circumcision methods.

  • No sutures necessary
  • No injections
  • Short procedure time (around 5 minutes)
  • Minimal bleeding
  • Frenulum preserved
  • Very low risk of complications
  • Excellent cosmesis
  • High satisfaction rate among patients

What do you need to beware of After the circumcision procedure?

With the Shang Ring method, there is a very low risk of bleeding and infection.
Usually, the patient may experience some pain or discomfort during nocturnal or morning erections.
You can apply a frozen bag of peas on the penis when an erection occurs and if it causes a lot of pain.
You are advised to avoid any activities that may cause pressure or friction at the wound site for 2 weeks like strenuous physical activities or sexual intercourse.
It is advisable to wear brief or underwear to hold the penis up.
Usually, after 4 to 6 weeks, you can start being sexually active.
Also, a medical certificate is usually given for 1 to 2 weeks to recover.
That is everything there is to Adult Circumcision.

Should you require further information about the circumcision for the adult, please visit drop us an email at  hello@dtapclinic.com.sg.

Take Care!


Other Read

  1. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  2. Things to do to maintain your penis health
  3. Weak Erection: Does Penis Size Matters?
  4. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  5. What are the Causes of Abnormal Penile Discharge?

Nose Cancer and Nose Cancer Screening

Nose Cancer and Nose Cancer Screening

What is Nose Cancer (Nasopharyngeal carcinoma)?

Nasopharyngeal carcinoma (NPC) is a cancer that arises from the back of the nasal cavity. It is more common in Asia than in Western countries.

What are the Signs and Symptoms of Nose Cancer?

What to look out for?
Common presenting complaints include:
• Block nose
• Headache
• Double vision
• Neck lumps and bumps
• Nosebleed
• Blood stained saliva
• Hearing loss

NPC can behave like a silent killer. One can be asymptomatic or showing no symptoms before experiencing symptoms.
Over time, the tumour can grow, ulcerate and invade into nearby structures leading to nerve involvement and other symptoms as stated above.
A tumour can also spread to distant spread to other parts of the body.

What are the risk factors for Nose Cancer?

  • Age and Gender
    It is a cancer that is more common in males.
    There is also a bimodal age presentation where occurrence peaks in younger and older adults.
  • Infective
    Epstein – Barr virus (EBV) infection
    The strong association between EBV infection and NPC is evident by anti-EBV antibody in the blood, an increased amount of EBV DNA levels in NPC tumour cells.
    This is why EBV antibodies are used in the clinical setting for the screening of Nose cancer.
    Human Papillomavirus (HPV) infection
    The role of HPV in NPC is less clear-cut in comparison to EBV in NPC but studies have shown that there might be an association with Nose Cancer.
  • Lifestyle
    Smoking
    There is postulation that smoking contributes to risks of NPC by causing reactivation of EBV.
    Even though there might not be sufficient evidence, smoking itself does cause many other diseases.
    Dietary practice
    Consuming preserved food which contains a high level of nitrosamines like salted fish, bacterial mutagens and EBV-reactivating substances is another risk of NPC.
    Some traditional Chinese medical herbs intake can lead to reactivation of EBV. 

Genetic Susceptibility
NPC has been associated with certain genetic predisposition and risks of NPC is increased in patients with first-degree relatives with NPC.

Nose Cancer Screening

  • History and Physical Examination.
    A thin camera also known as a flexible naso-endoscopy is useful for examination of the back of the nasal cavity and if needed, a tissue biopsy sample to be obtained at the same setting.
  • Future Tests include:
    Blood Tests
    A simple non-fasting screening blood test can be done to aid the detection of NPC.
    Given the close association between EBV and NPC, laboratory blood tests like EBV viral DNA and EBV IgA serology tests can be performed in the screening of NPC for patients belonging in high risks groups.
    Screening tests are recommended for patients who fall under the high risks group eg, those with positive family history.
    However, studies have also shown that early NPC being an indolent killer due to its relatively asymptomatic nature, has a higher 5-year survival rate when detected at an early stage. (see reference below)
    In addition, these tests can help to prognosticate treatment response and future recurrence of the same disease in patients diagnosed with NPC.
    Radiological
    Other imaging studies include magnetic resonance imaging (MRI) might be useful.

Treatment for Nose Cancer

Treatment options include radiotherapy, chemotherapy and surgery. Combined therapy of radiotherapy and chemotherapy together with surgery might be considered based on the location and extent of the lesion.

If you are interested in this service and wish to find out more, please call +65 6962 7144 or visit our clinic or drop us an email at hello@dtapclinic.com.sg.


Reference:
1 ) Chan, K. C. A., Woo, J. K. S., King, A., Zee, B. C. Y., Lam, W. K. J., Chan, S. L., … Lo, Y. M. D. (2017). Analysis of Plasma Epstein–Barr Virus DNA to screen for nasopharyngeal cancer. New England Journal of Medicine,378(10), 973-973. doi:10.1056/nejmx180004

What Causes Male Pattern Hair Loss (Androgenic Alopecia)

What is Male Pattern Hair Loss (Androgenic Alopecia)?

It is a very common form of hair loss which can affect up to 50% of men by age 50. It is usually inherited (meaning that your father or mother is likely to have it as well). It can start as early as after puberty in some cases.

What are the causes of Male Pattern Hair Loss (Androgenic Alopecia)?

In most cases, it is due to the genes you inherited from either your father or mother or both. Typically, if you are affected by the condition, the hair follicles start to shrink with time under the influence of male hormones.

and then what happens?

As the condition progress, the hair thickness also starts to become thinner and over time, the hair is lost.
In most cases, it starts with the recession of the hairline around the temples and also around the forehead area. Then hair around the top of the head (the crown) also becomes less. In time, the areas of baldness will join together. However, hair at the back of the head is usually not affected in this condition.
See other types of Hair Loss Conditions
Male-pattern-hair-loss-Androgenic-Alopecia

Is male pattern hair loss only a cosmetic concern?

No. There are studies that show a link between those affected by the condition to be at higher risk of cardiovascular disease (i.e. hypertension, heart attacks, strokes)
Also, it is associated with benign prostate hypertrophy (BPH) which is a non-cancerous enlargement of the prostate, which can cause symptoms like, an increase in frequency to pass urine, waking up multiple times at night to pass urine and as a result affect the quality of your sleep.
In addition, it has been found in studies that men who use anabolic steroids are also associated with increased risk of the condition. Similarly, persons on testosterone replacement therapy for hypogonadism are at increased risk of the condition as well.
Some studies also found that increased levels of DHEA (another sex hormone ) or low levels of SHBG (sex hormone binding globulin) which in turn means that there is more free man hormones that your body can use are also associated with the condition as well.
There are also studies to show that there is a link between the condition and prostate cancer. A large Australian study suggests that loss of hair at the top of the head at age 40 may be an early marker of prostate cancer.

What are the available treatments for Male Pattern Hair Loss (Androgenic Alopecia)?

Medical Treatment for Male Pattern Hair Loss (Andorgenic Alopecia)

1. Topical Solution for Hair Loss

This Hair loss treatment works by slowing the shrinkage of the hair follicles
The Advantage of using  Topical Solution for Hair Loss

  • Simple to use
  • Apply on hair daily up to twice a day

The Disadvantage of using  Topical Solution for Hair Loss

  • Takes up to 6 months to notice the effect
  • Need to use it on a permanent basis as hair loss resumes after stopping
2. Oral Medication for Hair Loss

This Hair loss Treatment works by blocking the conversion of male hormones to DHT which causes shrinkage of the hair follicles
The Advantage of using Oral Medication for Hair Loss

  • Unlike lotion which only slows the shrinkage of hair follicles, it has been suggested that medication is able to reverse the shrinkage of hair follicles

The Disadvantage of using  Oral Medication for Hair Loss

  • In about 1-2% of men who take the medication, they reported a decrease in sex drive or erectile dysfunction.
  • A decrease in PSA levels which may cause an underestimation of risk of prostate cancer
  • Takes up to 6 months to notice effects
  • Need to use it on a permanent basis as hair loss resumes after stopping
3.) Hair Transplant for Hair Loss

Strips of hair from the back of your head are removed and then individually transplanted to the area of hair loss.
The Advantage of Hair Transplant

  • Can notice effect around 3 months

The Disadvantage of Hair Transplant

  • Downtime (recovery time after hair transplant)
  • Can take up to few hours for the procedure depending on the area that needs to be transplanted
  • Expensive (Average cost > $15,000)
  • Failure of the hair grafts may occur
4.) Regenera Activa for Hair Loss

Similar to hair transplant, hair from the back of the head is removed and then using a specialised machine, hair follicular units are harvested and then injected into the area of hair loss.
The Advantage of Regenera Activa

  • It has been approved by FDA for medical treatment
  • Much smaller area of hair (3 x 2.5 mm) needed to be removed from the back of the head compared to hair transplant
  • Can notice effect around 3 months
  • Faster than hair transplant procedure (generally takes about 30 mins)
  • No downtime
  • Cheaper than hair transplant
  • Last for 18 months to 24 months depending on individuals

Learn more about Regenera Activa Hair Loss Treatment.

If you think you may have male pattern hair loss, please speak to any of our friendly doctors at any of our clinics to discuss further, or Drop us an email at hello@dtapclinic.com.sg

Phimosis – Unusually Tight Foreskin (Video)

How Do I Know If I Have Phimosis (Tight Foreskin)?

Phimosis is a condition of unusually tight foreskin that cannot be drawn back from the head of the penis.
It is a constriction of the opening of the foreskin that – it can’t be drawn back over the tip of the penis.
A simple way to find out is just to try to pull your foreskin all the way back until you see the whole head of the penis.
If you cannot do this or if it hurts to do this, you likely suffer from phimosis (tight foreskin).

How Severe are My Phimosis (Tight Foreskin) Condition?

Score 1: Full retraction of the foreskin, tight behind the glans. ☑
Score 2: Partial exposure of glans, prepuce (not congenital adhesions) limiting factor. ☑
Score 3: Partial retraction, meatus just visible. ☑
Score 4: Slight retraction, but some distance between tip and glans, i.e. neither meatus nor glans can be exposed. ☑
Score 5: Absolutely no retraction of the foreskin. ☑

What are the Risk Factors of Phimosis (Tight Foreskin)?

The tightness of the foreskin may interfere with the normal passage of urine.
In severe cases, this may cause retention of urine and urine infection. It also increases the risk of infections of the foreskin and head of the penis.
This problem is especially severe in people with Diabetes.
Also, it may cause pain during sex. If you have phimosis using a condom during sexual intercourse may make the penis more comfortable.

What are the Possible Treatments of Phimosis (Tight Foreskin)?

Your doctor may give you antibiotics if the swabs did showed signs of infection, or may give you a cream for application.
Sometimes, phimosis can be treated simply by stretching the foreskin. Sometimes, doctors will prescribe a cream to help the foreskin stretch.
If the problem is severe and stretching does not help or if the foreskin is badly scarred, the patient may need a circumcision.
Circumcision for adults is a medical treatment option for patients with recurrent foreskin infections, phimosis (tight foreskin opening), and for religious reasons.

If you think you may be suffering from phimosis, see our doctors for a consultation.

An Overview of Gonorrhoea Symptoms

Gonorrhoea symptoms in Men & Women can include discharge, painful urination and itch. Some people who are infected may not display any signs or symptoms.

What is the Cause of Gonorrhea?

Gonorrhoea is one of the most common Sexually Transmitted Infection (STI) in women.  It can cause infections in the vagina, rectum, and throat.
Gonorrhoea is known to be easily transmittable via both penetrative and oral sex. It can infect the reproductive system and less commonly, the throat or eyes. A maternal to child transmission is also possible here.
Similar to Gonorrhoea, Chlamydia is a common sexually transmitted disease caused by bacteria called Chlamydia trachomatis. Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae.

In women, gonorrhoea affects the cervix and its functions 90% of the time.

via GIPHY

What are the risk factors for contracting Gonorrhea?

  • Multiple sexual partners
  • New sexual partner
  • Unprotected sex
  • Men that have sex with Men (MSM)
  • A sexual partner who has an STI
  • Having concurrent STI

What are the Gonorrhoea Symptoms:

Gonorrhoea can be a silent infection in most of the population. Often time, women and men with Gonorrhea will not display any signs and symptoms.
Gonorrhoea Symptoms & Chlamydia Symptoms can be overlaping.

The Symptoms of gonorrhoea can differ between men and women.

via GIPHY

Gonorrhoea Symptoms in women:

Gonorrhoea Symptoms in Men

  • Penile discharge – colour may vary from white, yellow, green, or occasionally blood-tinged
  • Pain when passing urine
  • Pain in the testicles – rare

Read more about what are the other causes of penile infection & foreskin infection
Depending on the nature of the sexual activity and the severity of the infection, both men and women may experience pain, itchiness or discharge from the anus. They may also have pain, swelling, irritation, or discharge from the eye or both eyes (otherwise diagnosed as conjunctivitis).

How to Treat Gonorrhoea?

As with most bacterial infections, gonorrhoea is treated with antibiotics. The first choice is a wide spectrum antibiotic. It is, however, proving to be getting more resistant to antibiotics.
Gonorrhoea is also challenging to treat because most people who have this STI also have concurrent sexually transmitted illnesses like chlamydia.

via GIPHY
Also, like with any other sexually transmitted illness, treatment must be extended to all partners, and once treatment is completed, routine testing is highly recommended in view of relapse due to the increasing resistant nature of the gonorrhoea bacteria.
Abstinence is recommended during treatment.

What are the Complications of Gonorrhoea

Rarely, untreated gonorrhoea can spread throughout the body giving rise to skin pustules, infection of the joints (fingers, ankles, knees, and toes), brain or heart valves.

Complications of Gonorrhea in Men

More commonly, in men, infections of the epididymis, prostate and urethra are noted. Gonorrhoea can cause subfertility in some patients.

Complications of Gonorrhea in Women

In women, similar to other sexually transmitted diseases, untreated gonorrhoea may cause pelvic inflammatory disease (via an ascending infection involving the uterus, fallopian tubes, and ovaries) in up to 20% of patients. With inflammation, scarring and/or multiple infections, issues of subfertility and extra-uterine pregnancy will arise.
More annoyingly is the chronic, relapsing pelvic pain. This pain is characteristically stubborn and may require multiple analgesic medications in some women.
Read more about Herpes: Everything You Need to Know!

How is Gonorrhea Test Performed?

In most cases, usually for men, a urine sample will be required for the test. However, for female patients, ideally, the doctor will need to take a sample from the cervix ( neck of the womb).
For this, patients will lie down on the examination couch with knees bent and a small plastic instrument called a speculum will be used to open the vagina, then a soft brush will be used to collect a sample from the cervix. This procedure is very quick and painless, with only some minimal
discomfort.
Depending on sexual history, gonorrhoea swab may also be taken from the throat and rectum, in both men and women.

Any preparation needed before the test?

Vaginal douching and rectal douches, as well as creams, should be avoided 1 day before the test.
For the urine test, it is best to not urinate at least 2 hours before the sample is taken.

How long will the results take?

The test is usually performed together with chlamydia screening and results will be ready by the NEXT DAY. This allows treatment to be given as soon as possible when needed.
We can provide Rapid Chlamydia and Gonorrhea STD Testing. STD Test result will be available the following day.
If you are interested in getting a Rapid STD Testing or treatment for gonorrhoea, please visit our clinics and speak to our male and female doctors.
That’s All Folks!


Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. What are the Signs & Symptoms of HIV and AIDS?
  3. STD Symptoms
  4. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  5. Weak Erection? Erectile Dysfunction? Improv Erection with Pills
  6. 11 Causes of Dyspareunia (Pain During Intercourse)
  7. What are the Causes of Genital Ulcers, Genital Warts and Genital Blisters
  8. What is HPV Vaccination (Gardasil 9)
  9. How to Get Rid of Genital Warts?
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. HPV Infection & HPV Vaccination for Men who have sex with Men
  12. STD Risk for Receptive Unprotected Anal Sex in Men
  13. 7 FAQs HIV Preexposure prophylaxis (HIV PrEP)
  14. What is the Treatment for Cold Sores? What causes Cold Sores?
  15. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  16. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

Genital Warts: The Cauliflower-Like Lumps on the Genitals

Genital warts are white or flesh-coloured, smooth, small bumps that can appear anywhere in the general area of the genitals. They can also grow larger and appear as fleshy, cauliflower-like lumps on the genitals. Neither of which are more dangerous than the other, it is merely a characteristic and the stage that the illness was noticed.
Genital warts is an STD symptom caused by the Human Papilloma Virus (HPV).

HPV can cause multiple illnesses in the body as there are multiple strains of the virus attributing to different diseases in humans. Out of the hundreds of known strains of HPV, about 30 strains of the virus cause diseases of the genital area. These include warts, or in more sinister cases, cancer of the anus, cervix, vagina, and penis. Read: Causes of Vaginal Lumps & Bumps & Perianal Warts (Peri-Anal Warts)

Most of the other strains have no known effect on humans.


How do I get infected by the Human Papilloma Virus (HPV)?

Human Papilloma Virus (HPV) is a contagious disease that is transmitted through genital skin contact or through direct contact with genital fluids of a person already infected with HPV.
For transmissible illness such as these, using barrier methods of protection for sexual intercourse such as condoms should be emphasised. However, condoms are not very effective against transmitting HPV just because the HPV virus does not require penetrative sex to transmit the virus.

It can also be transmitted from a mother to an unborn child if the mother has an active HPV infection during the course of the pregnancy.


How do I know I am infected with HPV? How can it be detected?

A majority of people infected with HPV do not realise they even have the virus as it does not present with any symptoms.

Some people will notice bumps or warts around the genital area, otherwise known as genital warts. These usually occur one to three months after initial infection with HPV.


The most sinister manifestation of the HPV disease is cervical cancer affecting women in their 30s or 40s. The simplest way to detect cervical cancer is by identifying if an individual is an active risk of getting the disease and doing regular PAP smears. MOH guidelines are also apparent on the timing and interval for PAP smears for women in the reproductive age group. Sometimes a biopsy of unhealthy cervical looking tissue may be needed.

For men-who-have-sex-with-men (MSM), it is recommended that they do an anal PAP smear to investigate for HPV.

We also provide Rapid HPV Testing (next day result) in all our clinics in Singapore.


How can HPV & Genital Warts be treated?

In most cases, the HPV infection is self-limiting therefore no treatment is deemed necessary.

Unless an individual has issues with antibodies or a weak immune system in general, the body should be able to contain and eradicate the virus from the body in due time.
If an individual has an impaired immune system or a weak immune response, a lingering infection or a co-infection with another sexually transmitted illness can occur.

In cases of genital warts, the treatment options are largely dependent on the severity of the infection. The most common treatment options include creams and paint-on ointments. These induce a state of cell death so warts around the genital will eventually wither and fall off the skin.

Some patients may be offered cryotherapy where the wart is frozen then removed. The wart is frozen prior to that so that there will be no transmission of the wart after.
Apart from the above surgical options for wart removal also exist. This is where a surgeon uses electrocautery or a scalpel and surgically excise warts. See: Genital Warts Removal

Unfortunately, the majority of genital warts or other warts can recur very frequently and is rather common to have warts recur post removal. Sometimes, repeated treatments are required for complete remission, but patients should be aware of the recurrence rates in such an infection.


HPV and Cervical cancer

Some HPV viruses are known as high-risk viruses. This is particularly true in virus strains 16 and 18. This is because it induces changes in the cells in the cervix of a woman and causes cervical if not detected early.

It is in this light that it is recommended that all sexually active women are advised to go for regular PAP smear tests, screen for HPV infections and visit your doctor for HPV vaccination in Singapore.


HPV and PAP Smear

Pap smear is a relatively painless test that can be quickly done. It involves inserting a speculum into the vagina of the patient to allow for inspection then a tool is inserted to obtain scraping. The patient should go back to resume activities of daily living with no hindrance once after the procedure completed by our female doctor.
These scrapings and obtained cells are then examined under a microscope to look for abnormal cells.

We also provide Rapid HPV Testing & Pap Smear in all our clinics in Singapore.

HPV and HPV Vaccination

Human Papilloma Virus (HPV) is a group of virus that can cause:

  • Vaginal Cancers
  • Vulvar Cancers
  • Anal Cancers
  • Penile Cancers
  • Oropharyngeal Cancers (cancers of the throat and tongue)
  • Genital warts or Papillomas

HPV vaccination is used to protect against HPV-related diseases and cancers.
To complete the HPV vaccination, 3 doses of injections will be given. The recommended HPV vaccine schedules are:
First dose: During your doctor visit.
Second dose: 1 – 2 months after the first dose
Third dose: 4-5 months after the second dose


Get More protection with New 9-valent HPV vaccine (Gardasil 9)

There are over a hundred strains of HPV and they are each given a designated number e.g. HPV 6 or HPV 16 or HPV52.
HPV strains that cause warts will NOT cause cancers and HPV strains that cause Cancer will NOT cause warts.

Compared to the older Gardasil, the new GARDASIL 9 offers a wider range of protection against HPV strains.
Both Gardasil and Gardasil 9 give you protection against the cancer-causing HPV 16 and 18 and the wart-causing HPV 6 and 11.
Gardasil 9 protects additional 5 other high-risk types: 31, 33, 45, 52 and 58.
Together these types cause about 90% of cervical cancers.

Another HPV vaccine Cervarix, on the other hand, protects only against the commonest cancer-causing HPV 16 and 18. There is no wart protection with Cervarix.
If you are interested in getting the HPV testing & PAP smear, genital warts treatment or HPV vaccine, please visit our STD clinics and speak to our male and female doctors.
If you or your partner are experiencing any possible signs or symptoms of infection, or have had any potential risk exposures, please see our STD doctors today.
Take Care. Be Safe!



Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. Anal Pap Smear for Anal Cancer Screening
  3. HIV Rash: What You Need To Know
  4. Genital Blister, Genital Ulcers & Genital Warts – What You Need to Know
  5. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  6. 11 Causes of Dyspareunia (Pain During Intercourse)
  7. 10 Common HIV related to Opportunistic Infections
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. What is the Treatment for Cold Sores? What causes Cold Sores?
  12. Herpes: Everything You Need to Know!
  13. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes)