Mycoplasma Hominis

What is Mycoplasma hominis?

Mycoplasma hominis is a tiny bacterium which can be transmitted through sexual contact. It is a member of the Mycoplasma spp. family which also include Mycoplasma genitalium

How is Mycoplasma hominis transmitted?

Mycoplasma hominis is most commonly transmitted through sexual contact – genital-to-genital intercourse as well as oral-genital intercourse. It can also be transmitted from mother to neonate during vaginal delivery.

Most infections are acquired in sexually active adults and colonization, which is when one carries the bacterium but has no symptoms, can occur. 

What are the symptoms of Mycoplasma hominis?

Many individuals with Mycoplasma hominis may be asymptomatic, i.e. they have no symptoms whatsoever. 

In men who do experience symptoms, they may notice possible symptoms of urethritis (inflammation of the urine tube) – pain or discomfort in the urine tract/when passing urine or penile discharge. 

Women with Mycoplasma hominis infrequently have symptoms. However, Mycoplasma hominis can be associated with bacterial vaginosis, a vaginal infection with overgrowth of bacteria that are not normally part of the normal vaginal flora. 

Also read: Common Medical Conditions That Are Asymptomatic

What are possible complications of Mycoplasma hominis?

While there is some research that suggests Mycoplasma hominis infection may be possibly associated with complications in pregnancy and that it may have a correlation with developing pelvic inflammation and infertility, there is currently no consensus or conclusive data about this. 

How is Mycoplasma hominis diagnosed and treated?

Mycoplasma hominis can be diagnosed through a culture test, where the bacterium is grown from either a urine sample (if from a male) or a swab sample (if from a female), or a PCR test, which looks for the presence of the bacterial DNA in the aforementioned samples. 

Various types of antibiotic treatment can be used to clear a Mycoplasma hominis infection. However, the choice of antibiotics will depend on whether the specific strain of Mycoplasma hominis isolated has any antibiotic resistance or not. 

How can I prevent or avoid Mycoplasma hominis? 

As with all STDs, safe and responsible sexual practices are crucial in prevention of Mycoplasma hominis infection. These include using barrier protection if possible e.g. condoms, doing regular sexual health screening and also ensuring that you know your sexual partner’s infection status. 

Next read: 10 things you didn’t know about this STD: Mycoplasma Genitalium


The epididymis is a ductal system behind the testis and serves as a conduit for sperm produced in the testicle to be transported into the Vas Derferens to eventually reach the urethra. Epididymitis is a condition where the epididymis becomes inflamed usually from an infection, though trauma and autoimmune disease is a possible cause.

Signs & Symptoms

Symptoms of epididymitis include localised testicular pain and swelling of the posterior aspect of the testicle. The area can sometimes be warm to touch with redness of the scrotal skin. The area will be  painful when being examined with relief of the pain achieved when the area is elevated. 

Severity and etiology of epididymitis varies with the age of the patient. For young children presenting with testicular pain, a diagnosis of Testicular Torsion needs to be considered first, after which a mumps infection affecting the testicle needs to be ruled out. For sexually active men under 35 years of age, Gonorrhea and Chlamydia are the 2 most common organisms responsible for epididymitis. In older patients, epididymitis can occur concurrently with prostatitis especially if there is an underlying prostatic obstruction such as Benign Prostatic Hyperplasia (BPH) or recent catheterization.

Rapid STD Test for Chlamydia and Gonorrhoea

Most cases of epididymitis can be treated outpatient with oral non-steroidal antiinflamatory drugs (NSAIDS), local application of ice and oral antibiotics. A urine test is sometimes done to determine the organism causing the infection. Patients with epididymitis generally improve within 48 – 72 hours. If the symptoms do not abate within that period, an alternative diagnosis needs to be considered and further imaging such as a scrotal ultrasound performed.

The Signs & Symptoms Of Chlamydia In Women & Men


Today we are going to talk about the signs and symptoms of Chlamydia in Men and Women.

Chlamydia is one of the most common bacterial Sexually Transmitted Infections (STIs) worldwide. It is caused by a bacterium called Chlamydia trachomatis. According to the United States Centers for Diseases Control and Prevention, Chlamydia is the most frequently reported bacterial STI in the US, with approximately 2.86 million infections reported every year.

The reason why Chlamydia is so common is because most individuals with Chlamydia do not have any symptoms. In fact, less than 50% of both men and women with Chlamydia develop symptoms. Asymptomatic individuals may be unaware that they are infected and continue to spread it to their sexual partners.

If symptoms do develop, they may occur anytime from days to weeks after the initial infection.

Symptoms of Chlamydia in men

  • Dysuria, or painful urination
  • Urinary frequency and urgency
  • Discomfort along the urethra, or urinary tract
  • Penile discharge 
  • Pain or swelling of the testicles due to a less common but serious infection known as epididymo-orchitis
  • Pain or discomfort in the pelvis due to prostatitis, which is inflammation of the prostate gland

Symptoms of Chlamydia in women

  • Abnormal vaginal discharge which may be different in colour, odour, quantity and consistency
  • Bleeding after sexual intercouse 
  • Abnormal spotting or bleeding in between menstrual periods
  • Painful sexual intercourse
  • Chronic pelvic or abdominal pain and/or fever due to a complication known as Pelvic Inflammatory Disease, whereby the infection spreads upwards to affect the uterus and fallopian tubes.

There are other complications of Chlamydia that can affect both men and women.

Firstly, conjunctivitis, which is an infection of the eye lining, can occur after contact with infected fluids. Symptoms include eye discharge, irritation, redness and lid swelling.

Next, proctitis, which is inflammation of the rectum due to anal sex, usually does not cause symptoms. If symptoms do occur, individuals may experience rectal discomfort, discharge or pain

Lastly, oral chlamydia, which results from providing oral sex, again usually does not cause symptoms. If symptoms do occur, individuals may experience sore throat, painless sores in the mouth, tonsillar swelling and painful swallowing.

Chlamydia can be tested using urine or swabs from the throat, rectum, cervix and urethra. Rapid testing is available at our clinics. Treatment involves a course of oral antibiotics to eliminate the bacteria.

Next read: Common STD Incubation Periods

If you would like to find out more about Chlamydia Testing and Treatment, come down to any of our clinics for a consultation.
Rapid Chlamydia & Gonorrhoea PCR Screening (Next Day Results) is available in all our clinics in Singapore.

Candidiasis in Men

Candida or yeast infection can affect men too. This may lead to a condition known as balanitis — inflammation of the head of the penis.

Yeast infections in men are common because the fungus that causes yeast infections (candida) is normally present on skin, especially moist skin. 

Balanitis is more common in uncircumcised men.

Signs and symptoms of Balanitis

  • Moist skin on the penis, possibly with areas of a thick, white substance collecting in skin folds
  • Areas of shiny, white skin on the penis
  • Redness, itching or a burning sensation on the penis

You may be more likely to develop balanitis from a yeast infection if you:

  • Aren’t circumcised
  • Use antibiotics for prolonged periods
  • Have diabetes
  • Have an impaired immune system, such as with HIV
  • Are overweight
  • Practice poor hygiene

If you and your partner both have symptoms of a yeast infection, it’s important that you both be treated to avoid reinfecting each other.

Treatment options

Treatment includes topical creams or oral medication. Usually this treatment works well in clearing the infection.

However, in some men, this infection may be recurrent and occurs several times a year. This happens more often among men with diabetes as they are at higher risk of infection. In cases of recurrent balanitis, circumcision would be the best solution to prevent recurrent balanitis.

Do see a doctor if you are experiencing any of these symptoms.

Just got diagnosed with HIV? What is next?

You have just been recently diagnosed with HIV. You’re likely experiencing a rollercoaster of emotions and have lots of questions which are understandable. As you go through these feelings, whether of anger, fear, sadness or guilt, it is important to first take a deep breath and begin the process of finding a health care provider and as much as possible, look for any form of support available. 

Finding Support


1. Friends & Family

As you are coming to grips with the new diagnosis, you may face difficulty as to what the next step will be. You may want to talk about it with a trusted friend or family member. Although you may feel uncomfortable with breaking the news, you may realize that shouldering the burden alone actually makes it more difficult to process the news and that telling someone you trust may be a positive experience as it can help you get the much-needed support and it may actually strengthen relationships. It is important to be informed of the condition yourself – it may be best to obtain information about HIV before telling others about the new diagnosis. There are many myths that surround HIV which contribute to the stigma attached to it but by knowing more about living with HIV can reassure your loved ones that with effective medications available, you can live a long and healthy life.

2. Telling your partner

It is important to let your current or former partners know that they may have been exposed. They then should be tested for HIV. It is encouraging to know that many people living with HIV continue to have relationships and can have children who don’t have HIV. The term ‘undetectable = untransmittable’ (shortened to U=U) was coined and is used as a campaign to prevent sexual transmission of HIV without the use of condoms based on numerous studies that demonstrated this. This is achievable by taking treatment daily and having undetectable viral load levels for at least 6 months. However, until U=U is achieved, the proper use of condoms must be done to prevent transmission. In addition, your partner may also want to consider PrEP, in addition, to use of condom before you achieve undetectable viral loads for at least 6 months.

3. Clinics & Support Groups

As HIV is a chronic medical condition that requires lifelong follow-up and treatment, it is essential to establish a relationship with an HIV health care provider that is as honest and open as possible. You may either be managed at the clinic where the HIV diagnosis was made or referred to an HIV specialist and their team for HIV management. 

Among other tests, the key ones that will be done at the first clinic visit as well as during subsequent visits are HIV viral load as well as CD4 counts. The HIV viral load is a measure of the amount of virus detectable in the blood and the CD4 count is the amount of CD4 cells, which are white blood cells that play an important role in the immune system. The goal for everyone living with HIV is to reach an undetectable HIV viral load as quickly as possible.

Many guidelines recommend that HIV treatment be started immediately after the diagnosis is made. This is because studies have shown that immediate treatment can lower the risk of long term effects on the immune system and reduce the risk of HIV transmission.  

There are many support groups available where you can be a part of, to obtain further information from or would simply like to reach out for a listening ear as you may not be ready to tell your friends or family about the new diagnosis.

Here is a list of support groups available in Singapore & Malaysia:

Action for AIDS (AFA) (Singapore)

Oogachaga (Singapore) (Singapore)

PT Foundation (Malaysia)

Lelaki Dan Diabetes

Menjelang tahun 2030, jumlah penduduk Singapura yang berumur di atas 40 tahun dengan diabetes diramalkan  meningkat sebanyak 200,000 lagi dari sekitar 400,000 orang sekarang.

Penyebaran diabetes di kalangan orang dewasa meningkat dari 8.2% pada tahun 2004 kepada 11.3% pada tahun 2010. Sebilangan besar lelaki adalah diabetes (12.3%) berbanding dengan wanita (10.4%). Kita dapat membayangkan bagaimana jumlahnya akan bertambah lebih banyak pada hari ini.

Bagi lelaki yang hidup dengan diabetes jenis 2, mereka juga berisiko lebih tinggi untuk penyakit  tertentu berbanding lelaki lain. Dalam artikel ini saya akan berkongsi lebih banyak mengenai masalah kesihatan lelaki yang dihadapi oleh lelaki dengan diabetes jenis 2.

1) Disfungsi ereksi (ED)

Menurut kajian yang diterbitkan dalam Journal of Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, lelaki yang menghidap diabetes lebih cenderung mengalami ED berbanding lelaki yang tidak menghidap diabetes. Glukosa darah tinggi menyebabkan kerosakan pada saluran darah kecil dan / atau saraf seperti yang membekalkan zakar. Oleh itu diabetes yang kurang terkawal menyumbang kepada ED.

Selain kawalan gula, terdapat juga beberapa ubat diabetes yang menyebabkan kesan sampingan seperti ED.

Selain diabetes, lelaki ini biasanya juga gemuk dan menderita hipertensi, yang mana kedua-duanya juga menambah risiko ED.

2) Jangkitan saluran kencing: Jangkitan saluran kencing (UTI) biasanya disebabkan oleh bakteria.

Ia boleh menjejaskan bahagian saluran kencing. Di mana sahaja termasuk buah pinggang, pundi kencing, ureter, uretra, dan, pada lelaki, kelenjar prostat. Selalunya jangkitan berlaku di pundi kencing. Wanita 10 kali lebih mungkin mendapat UTI berbanding lelaki. Namun lelaki yang menghidap diabetes berisiko lebih tinggi mendapat UTI daripada lelaki tanpa diabetes. Mengapa lelaki yang menghidap diabetes lebih cenderung kepada UTI? Terdapat beberapa kemungkinan sebab. Satu, lelaki yang menghidap diabetes mempunyai peredaran yang lemah. Ini mengurangkan keupayaan sel darah putih untuk bergerak di dalam badan dan melawan segala jenis jangkitan. Dua, tahap glukosa yang tinggi juga dapat meningkatkan risiko UTI. Tiga, beberapa lelaki yang menghidap diabetes mempunyai kemampuan yang lemah untuk mengosongkan pundi kencing mereka. Apa yang berlaku adalah, air kencing berada di dalam pundi kencing terlalu lama dan ini menjadi kondusif untuk pertumbuhan bakteria.

3) Balanitis: Balanitis adalah jangkitan pada kulit pada kepala (glans) zakar.

Pada lelaki yang tidak disunat, kawasan ini dilindungi oleh kulup, atau kulit. Balanitis boleh berlaku pada lelaki yang disunat dan tidak disunat, namun, lelaki yang tidak disunat berisiko lebih tinggi untuk balanitis dan juga jangkitan berulang.

Mana-mana lelaki boleh mengalami balanitis, tetapi keadaannya kemungkinan besar terjadi pada lelaki yang mengalami phimosis (kulup ketat) atau kebersihan yang buruk. Selain kumpulan lelaki ini, lelaki yang menghidap diabetes juga berisiko tinggi mengalami balanitis terutamanya jika mereka mempunyai kawalan gula yang buruk. Apabila gula kurang terkawal, gula berlebihan dapat dikeluarkan dalam air kencing. Air kencing kaya gula ini apabila terperangkap di bawah kulup, akan memberikan persekitaran yang kondusif untuk ragi dan bakteria. Selain itu, lelaki dengan diabetes yang tidak terkawal juga tidak dapat melawan jangkitan dengan berkesan.

4) Posthitis: Posthitis adalah radang kulup.

Ia dicirikan oleh bengkak atau kemerahan kulup. Dalam beberapa kes, ia mungkin berlaku bersama dengan air mata di kulup yang mungkin agak menyakitkan. Biasanya disebabkan oleh jangkitan seperti jamur atau bakteria. Dalam beberapa kes, ini mungkin disebabkan oleh air mata di kulit akibat lelasan atau geseran semasa persetubuhan. Penjualannya boleh menyebabkan phimosis dan keketatan pada kulup yang menyukarkan kulit untuk menarik kembali.

Sunat biasanya merupakan rawatan yang pasti bagi lelaki yang mengalami balanitis posthitis berulang atau UTI. Merupakan rawatan yang sangat berkesan untuk mengurangkan risiko UTI, balanitis dan juga tidak akan ada lagi penyakit posthitis ketika kulup dikeluarkan.

5) Testosteron Rendah: Dalam beberapa tahun kebelakangan ini, saintis menemui beberapa kaitan antara testosteron rendah dan diabetes.

Satu kajian menunjukkan bahawa pada 2.100 lelaki berusia lebih dari 45 tahun, kemungkinan mempunyai testosteron rendah adalah 2.1 kali lebih tinggi pada lelaki dengan diabetes. Testosteron rendah tidak menyebabkan diabetes tetapi mungkin sebaliknya. Lelaki yang menghidap diabetes mungkin mengalami testosteron rendah. Hubungan antara diabetes dan testosteron rendah sudah terjalin. Lelaki dengan diabetes lebih cenderung mempunyai testosteron rendah sementara lelaki dengan testosteron rendah juga cenderung menghidap diabetes. Testosteron meningkatkan keupayaan tubuh untuk mengambil gula sebagai tindak balas terhadap insulin. Lelaki dengan testosteron rendah mungkin mempunyai ketahanan terhadap insulin. Dalam keadaan ini, tubuh mereka perlu menghasilkan lebih banyak insulin untuk mengurangkan jumlah gula yang sama dalam darah.

Oleh itu, sekiranya anda didiagnosis menghidap diabetes jenis 2, perhatikan beberapa perkara yang dinyatakan di atas. Sekiranya anda mengalami salah satu daripada syarat di atas, pertimbangkan untuk menjalani pemeriksaan kesihatan. Rujuk doktor anda sekiranya anda mengalami gejala dan keadaan di atas

Itchy Testicles – Is it a sign of STDs?

It is common to experience a need to itch every now and then, but if you feel the need to scratch all the time it’s probably time to seek some help. Inadvertently, there would be a concern of any possible sexually transmitted diseases (STD), but not all itches are sexually transmitted. – STD Screening in Singapore

Listed below are some of the more common causes of itchy testicles.

  1. Chafing

Chafing is an irritation of the skin caused by repetitive friction. This is typically caused by inappropriately sized clothing and is commonly experienced by guys doing biking or running. It can happen anywhere on the skin but vulnerable areas are the groin, thighs, underarms and even the nipples. Chafing is easy to prevent though, by wearing the right clothes and using some form of barrier cream/ointment like vaseline to protect vulnerable areas.

  1. Jock Itch

Jock Itch, also known as tinea cruris, this is a fairly common condition seen in gentlemen who exercise a lot or are involved in jobs involving heavy physical activity. This creates a warm, moist environment on the scrotum that is ideal for fungal growth. Common symptoms are an itchy and red rash on the scrotum that can be scaly in nature. Treatment is through the use of oral or topical antifungal medications. Jock Itch can be prevented by regular change of clothing after heavy exertion as well as use of antiperspirants.

  1. Contact Dermatitis

Contact dermatitis is a type of eczema triggered by contact with a particular substance. The skin can become red and cracked with blistering and sometimes can resemble jock itch. Common causes of contact dermatitis are new soaps and detergents, so if the new soap/detergent is causing itchy testicles, it might be a good idea to swab back.

  1. Lichen Simplex Chronicus

This is what happens when you leave an itch too long without seeing a doctor. After prolonged itchy, rubbing and scratching of the skin, the scrotum can become lichenified. Like lichen on the trees, the skin can become thick and scaly with accentuated skin fold lines. This is an extremely pruritic chronic itch, and the treatment is usually the use of a strong steroid cream to thin out the lichenified skin. 

  1. Psoriasis

Psoriasis is an unpleasant skin condition presenting as reddish rashes with silvery scaling over the whole body. It commonly involves the scrotum and it can be itchy as well. There are also other dermatological conditions which may look similar to psoriasis and can involve the scrotum as well. This is why it is important to see a doctor if there is an odd looking rash over the scrotum that does not go away on its own. 

  1. Pubic Lice

Also known as crabs, Pthirus pubis is a very small insect that parasites humans. Pubic Lice are commonly found attached to the hair in the pubic region but can also be found in other coarse hair elsewhere on the body, for example eyebrows or armpits. Other than the adult insects, eggs known as “nits” can also be found attached to the hair. Pubic lice is normally spread through sexual contact. It is however very easily treatable by over the counter anti-louse preparations. 

  1. Scabies

Sarcoptes scabiei are tiny eight legged mites that live within the human skin. Allergic reaction to the mites, eggs and faeces can lead to an intense itching that is worse at night. Symptoms are a pimple like rash over the scrotum that can be very itchy out of proportion to the rash. Scabies is spread through skin to skin contact and hence can be sexually transmitted. It’s treated with an anti-mite topical preparation known as permethrin. 

The astute reader might realise that not a lot of STDs are found on the above list. The truth is that the majority of STDs do not lead to testicular itching but rather other symptoms like ulcers or discharge. If itchy testicles are still a problem, it is still better to seek a doctor for a medical consultation.

Ureaplasma Symptoms

Signs & Symptoms of Ureaplasma

Ureaplasma are a group of tiny bacteria that can commonly be found in the urinary and genital tracts of men and women. The most clinically relevant type of Ureaplasma species is Ureaplasma Urealyticum, which can cause urethritis (inflammation of the urethra) in men, and bacterial vaginosis in women.

These infections may have few or no symptoms at all for many people, and may only get picked up on routine STD screening or when an individual presents with symptoms from another infection such as Chlamydia or Gonorrhea. For those who develop symptoms directly from a Ureaplasma infection, common presentations would be with pain or burning on passing urine, penile discharge or vaginal discharge, or pelvic/genital discomfort. As their name suggests, these bacteria also hydrolyse urea to produce ammonia, which can result in a strong or unpleasant odour as well.

How is Ureaplasma transmitted?

Ureaplasma is predominantly transmitted through sexual contact (vaginal, anal, and oral sex). However, it is not typically classified as an STD due to its relatively low degree of pathogenicity (ability to cause disease). Although many infections may be asymptomatic or have very mild symptoms, there are still risks for complications including pelvic inflammatory disease and epididymo-orchitis. Studies have also found associations with complications in pregnancy such as preterm labour, as well as infertility in both men and women. As Ureaplasma infection can cause inflammation of the mucous membrane, it can also increase the risk of transmission of other STDs and is commonly found to cause co-infections. 

Testing for Ureaplasma can be done with urine samples or swab tests, and would generally be detected through special cultures or through PCR testing. It would not be detected through a normal bacterial culture for non-STD infections. Treatment of Ureaplasma would generally be a course of oral antibiotics and of course, partner testing and treatment would be recommended as well. STD Testing in Singapore

Next read: 10 things you didn’t know about this STD: Mycoplasma Genitalium

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. 


7 Common Causes Of Anal Itching

Anal itching, also known as pruritus ani, is a common condition. Some studies have shown that it can affect as much as 1-5% of the population.

The reason why cases of anal itching are not always relieved with scratching is because of a self-propagating itch-scratch cycle: the scratching exacerbates the inflammation, causing an irresistible urge to scratch even more.

There are many causes of anal itching.

Here are 7 broad groups of conditions that can present with anal itch.

1. Dermatologic conditions

Topical irritants such as Deodorants, Detergent/fabric softener, Hemorrhoid remedies, Soaps, Suppositories, Talcum powder, Tight clothing and Toilet paper dyes and perfumes can cause Irritant dermatitis leading to itching. Atopic dermatitis, Hidradenitis suppurativa, Lichen planus, Lichen sclerosis, Psoriasis and Seborrheic dermatitis are all conditions that can cause anal itch.


2. Dietary irritants

Certain types of foods, when ingested, can become dietary irritants when passed out from the other end. They include foods such as Beer, Caffeine, Chili peppers, Citrus foods, Milk and Tomatoes.


3. Anal conditions

Such as Anal fissures, Chronic constipation, Chronic diarrhoea, Fistula, Incontinence, Prolapsed haemorrhoids, Rectal prolapse, Irritable bowel syndrome, Inflammatory bowel conditions and Skin tags.


4. Infections

Abscesses, Candidal infections (intertrigo), Corynebacterium minutissimum (erythrasma), Molluscum contagiosum, Parasites (e.g., pinworms, scabies), Staphylococcus aureus infections can cause anal itch. A big group of infections are sexually transmitted infections. These infections have to be considered especially in people who partake in anal intercourse. Some of the infections include Chlamydia, Gonorrhoea, Herpes and Human papillomavirus to name a few.


5. Malignancies/Cancers

Such as Bowen disease, Extramammary Paget disease, Squamous cell carcinoma can present with itch.


6. Medications

Such as Chemotherapy, Colchicine, Neomycin and Quinidine can trigger itch too.


7. Systemic diseases

Aplastic anaemia, Diabetes mellitus, Inflammatory bowel disease, Jaundice, Leukemia, Lymphoma and Thyroid disease can have anal itch as a symptom.

In many instances, we may not actually identify any specific cause and label the itch as idiopathic pruritus ani. The itch could also be due to psychological disorders.

While many people worry that anal itch is due to a sexually transmitted infection, as you can see above, there are so many reasons why a person may develop an anal itch.



The most important thing is to seek medical attention so your doctor can assess you and come to a diagnosis.

The doctor will take a detailed medical history from you and do a physical examination, including an examination of your perineal area and possibly do a proctoscopy. If need be, we may do some swabs to send off for investigation. The doctor may advise for further investigations such as a colonoscopy depending on what is found and your age group.


Treatment & Prevention

Treatment of pruritus ani should address the underlying cause. The goal of treatment is also to prevent further irritation and moisture in the affected area and avoiding scratching. Patients should be aware of proper hygiene and avoidance of perfumes, dyes, dietary irritants (especially caffeine), and tight clothing.

Patients should also keep the area dry and be aware of the itch-scratch cycle. A sedating antihistamine can reduce scratching during sleep. If the itch is very bad, wear cotton gloves or socks on the hands at night to prevent scratching. Patients with hemorrhoidal skin tags that make hygiene difficult can clean the area using a handheld showerhead, squirt bottle, sitz bath, or a bidet. After which, pat the area dry or use a hairdryer set on “cool.” Avoid using soap on the anal area as the skin there is sensitive and can dry out easily. Do not scrub the perineal area with anything including toilet paper.

Besides the conservative measures above, low-potency topical steroids can be used for a short duration of time. If the itch persists after treatment, a biopsy can be considered. If you wish to speak to our doctors about the following symptoms, please call us or email us for an appointment at