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Health Weight Loss

Guide to Obesity and Doctor-Prescribed Weight Loss Pills in Singapore

Guide to Doctor-Prescribed Weight Loss Pills in Singapore

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. While eating a well-balanced, reduced-calorie diet and exercising regularly are the cornerstones of weight loss, certain drugs can serve as powerful adjuncts. Here is everything you need to know about obesity, prescription weight loss pills and where to get them in Singapore.

Importance Of Weight Management

Obesity is a major risk factor for chronic diseases such as:

  • cardiovascular diseases (mainly heart disease and stroke);
  • diabetes;
  • musculoskeletal disorders (especially osteoarthritis – a highly disabling degenerative disease of the joints);
  • some cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon).

On the social front, obesity can affect your self-esteem and body image, causing psychological stress. 

How Common Is Obesity?

Obesity is more common than you think. The World Health Organization (WHO) has described obesity as a global epidemic and one of today’s “most blatantly visible yet neglected public health problems”.

Worldwide obesity has nearly tripled since 1975 according to the WHO.

Based on the National Population Health Survey 2016/2017, findings have revealed that the rates of obese individuals in Singapore have steadily increased from 32.5% to 40.1% from 2004 to 2010. In 2019 and 2020, about two out of five are overweight according to the Based on the National Population Health Survey 2020, about two out of five Singaporeans are overweight in 2019 and 2020.

How Do I Know If I Am Overweight?

Body mass index (BMI) is a calculation that takes a person’s weight and height into account to measure body size and is often used to diagnose obesity.

Body mass index (BMI) = weight (kg) / [height(m)]²

According to WHO, the standard BMI interpretations are as follows:

BMIWeight Status
Below 18.5Underweight
18.5 – 24.9Normal weight
25 – 29.9Overweight
30 and aboveObese
Standard BMI Interpretations

However, the following BMI interpretations are recommended for the Asian population which usually features relatively smaller people:

BMIWeight Status
Below 18.5Underweight
18.5 – 22.9Normal weight
23 – 27.5Overweight
27.5 and aboveObese
Asians BMI Interpretations

Limitations of BMI

BMI has some limitations as a metric such as:

  • Factors such as age, sex, ethnicity, and muscle mass can influence the relationship between BMI and body fat
  • BMI does not distinguish between excess fat, muscle, or bone mass
  • BMI does not provide any indication of the distribution of fat among individuals.

Despite these limitations, BMI continues to be widely used as a way to measure body size as they help to give your doctor an idea of the standard weight compared to your height.

How Is Obesity Treated?

Common treatments for overweight and obesity include weight loss through healthy eating, diet, taking part in some moderate physical activity, and making other lifestyle changes. 

Some people who have obesity are unable to lose enough weight to improve their health or are unable to keep from regaining weight. In such cases, a doctor may consider adding other treatments, including weight loss medications or even surgery.

Common Prescription Weight Loss Pills in Singapore

There are multiple FDA-approved prescription weight loss drugs in Singapore and some common ones include:

Orlistat (Xenical, Alli)

Orlistat promotes weight loss by decreasing the amount of dietary fat absorbed in your intestines. Lipase, an enzyme found in the digestive tract, helps break down dietary fat into smaller components, so it can be used or stored for energy. Orlistat inhibits the work of lipase. When you take the drug with a meal, about 25% of the fat you consume isn’t broken down and is eliminated through bowel movements.

Phentermine (Duromine/Panbesy/Qsymia)

Phentermine helps weight loss by decreasing your hunger or making you feel full longer. The expected average weight loss with phentermine use is 5-10% of your initial body weight over 12 weeks.

Naltrexone-bupropion (Contrave)

Contrave contains 2 active ingredients – Naltrexone and Bupropionis and is the newest weight loss medicine available in Singapore.

It works by modifying 2 areas of the brain that control hunger and cravings.

It works especially well for people with a “hungry brain”. In other words, people who do not actually feel hungry but eat because their brains tell them to. Common symptoms of hungry brain include:

  1. Addiction eating – Eating to feel good (medically speaking to get the endorphin hit)
  2. Subconscious eating – Eating while distracted or tired
  3. Emotional eating – Eating for comfort when stressed or in a low mood

Studies have found that the effects of Contrave can be seen after four weeks of using the medication. After 16 weeks, roughly 45% of study participants experienced a 5% or greater reduction in body weight.

Semaglutide (Rybelsus)

Semaglutide belongs to a class of drugs known as GLP-1 receptor agonists (GLP-1 RAs), which mimic the function of the natural hormone glucagon-like peptide-1 (GLP-1) to regulate blood sugar levels and appetite. It can help support weight loss by:

  • Regulating blood sugar levels. Semaglutide helps increase insulin secretion and decrease glucagon secretion, keeping blood sugar levels steady. 
  • Impacting the appetite center of the brain. This reduces hunger and leads you to eat fewer calories per day.
  • Delaying gastric emptying making you feel fuller for longer, which leads to reduced caloric intake.

Rybelsus is an oral version of semaglutide, the active ingredient in Ozempic and Wegovy. While it is FDA-approved for the treatment of type 2 diabetes, it is often prescribed off label for weight loss patients who prefer a non-injectable option.

Do I still need to go on diet and exercise if I am on a weight loss medication?

Weight loss medications are not magic bullets. They need to be used alongside calorie restriction, behavioural modification and exercise programs.

Who Is Suitable For Prescription Weight Loss Pills?

All medical weight loss treatments are only for people who are overweight or obese.

Your doctor may consider a weight-loss drug for you if:

  • you haven’t been able to lose weight through diet and exercise; and
  • your BMI is:
    • greater or equal to 30 kg/m²; or
    • greater or equal to 27 kg/m² with obesity-related risk factors, such as high blood pressure, high cholesterol or type 2 diabetes.

Where Can I Buy Orlistat/Xenical or Phentermine/Duromine/Panbesy or Contrave or Semaglutide/Rybelsus in Singapore?

Prescription weight loss pills as the name suggests, are only available with a prescription from a licensed doctor in Singapore. 

At Siena, our doctors are best equipped with the knowledge to determine if and which weight loss medication is best suited for you. Connect with one of our doctors via an online video consultation and if prescribed, we deliver your treatment plan right to your door in a discreet packaging at $0.

Categories
Sexual Health

How To Have The Sex (& Sexual Health) Talk With Your Partner

This article is contributed by our partner, Noorindah from Shy & Curious.

Constant communication is an important part of all relationships — and that includes talking about sex.

What We Talk About When We Talk About Sex

Sex talks aren’t just about pleasure. Other topics about sex can include:

  • sexual health
  • family planning and contraception
  • what you and your partner like and how to deal with differences
  • consent and boundaries

Having these conversations help lay the groundwork for a better relationship as you learn about each other and try new things together, all while being on the same page.

It’s also worth getting past the awkwardness to talk about health, especially sexually transmitted infections (STIs) and birth control. Avoiding these important conversations might be endangering your health and altering the future you’d hoped for.

How To Start The Conversation

Here are some common difficult conversations related to sex and sexual health with some ideas on conversation starters. As always, speak in a neutral setting and time (e.g. outside the bedroom/NOT during sexy times) as you want both parties to be calm and feel safe since these conversations can be emotionally charged.

1. How do I bring up STI testing with a new sexual partner? 

Desired Outcome: You want to be sexy but still stay safe when it comes to a new partner. You want to know if they’ve been recently tested and practice safe sex.


Conversation Starter: “Just to make sure we’re on the same page, I’m sexually active and my last STI test was X. How about you?”


When it comes to discussing sexual health, keep it short, simple and direct. Lead with your own information first so they’ll feel less self-conscious about volunteering theirs.

2. How do I talk about birth control with my partner?

Desired Outcome: You’re thinking of getting intimate in bed with your partner and would like to find a birth control method(s) that best suits both of you.


Conversation Starter: “I think it’s great that we’re taking the next step in our relationship and it helps me feel closer to you. I do want to talk to you about sharing the costs for birth control together since I’m not ready to have a child yet. I definitely prefer the peace of mind with birth control instead of hoping we get lucky with the pull-out method.”

Birth control is a shared (and big) responsibility for everyone involved. Whether it’s pregnancy, STIs or how you feel while on different birth control methods, you and your partner share the experience. So why not make sure the end result is what you both wanted and expected by having the birth control talk before hitting the sheets?

When it comes to birth control, you’ve got options and even better, there are no bad options! At Siena, speak to a sex-positive and judgement-free doctor via tele-consultation about your options and get a personalized prescription that will work best for you and your health needs.

3. How do I bring up emergency contraception with my partner?

Desired Outcome: You’ve had unprotected sex in the past 72 hours and suspect that there might be a probability of getting pregnant. You want to let your partner know of your situation and purchase emergency contraception together.


Conversation Starter: “I don’t mean to alarm you but I think that the condom broke during our last session together. I want to be on the safe side and get the morning-after pill. Will you accompany me to get it?”

Don’t worry, it happens to the best of us! Whether it’s an accident or the heat of the moment, emergency contraception exists exactly for that reason. While it’s perfectly reasonable to ask for your partner’s emotional support (and split the cost as well as it takes two to tango!), there’s also a much easier way of getting your emergency contraception without having to head down to the clinic. Telemedicine platforms like Siena provide a range of emergency contraception at transparent and affordable pricing, and literally couriered to your doorstep incognito! While it might be called the morning-after pill, Siena also offers an emergency contraception pill that can be taken up to 120 hours after unprotected sex. That’s a 5 days window to quell the panic – but obviously don’t use this as an excuse to treat emergency contraception as a form of birth control. 

4. How do I introduce the idea of using sex toys with my partner?

Desired Outcome:  You don’t want to replace your partner but you’re interested in exploring using sex toys together so you can both enjoy different sensations and experiences. 


Conversation Starter: “So I’ve been reading about all these cool toys for the bedroom and I’m quite intrigued. Are you open to exploring these sex toys together with me? I think it’ll be fun to try something new and I’ll love to have that experience with you… ”

For some, the idea of sex toys and pleasure accessories may seem quite foreign or seen as ‘dirty’ because as a conservative Asian society, we’ve been conditioned to view sex as purely procreational. Pleasure hasn’t been placed in the forefront of conversations around sex so talking about owning, receiving and giving pleasure is still seen as taboo or weird.

The stigma around sex toys is also exacerbated by the misconception that a partner’s worth is also determined by how much they can give pleasure to their partner through just their genitals alone. (A.k.a if you have to use a toy in the bedroom, it means that you’re not sexually satisfied by your partner.) So when it comes (pun intended) to trying out sex toys to a partner who might be new to this world, we suggest emphasizing that it’s all about the shared experience, and mutually giving and receiving different types of pleasure as a fun way to strengthen your bonds. 

5. How do I bring up my kink/fetish with my partner?

Desired Outcome:  You are ready to share with your partner a sexual kink that you would like to experience with them. 


Conversation Starter: “I really love being with you and how much sexual chemistry we have. There’s been something I’ve wanted to share with you but since I felt quite vulnerable about it, I wanted to wait till we were closer. I’m actually quite turned on by BDSM and have wanted to explore it with someone I trust. Is this something you’ll be keen to explore with me? It’s ok to let me know if you’re not comfortable with the idea either. ”

Similar to our notes on introducing sex toys, be prepared that your partner might not initially know how to react if they’re not used to speaking openly about their sexual fantasies and pleasure preferences. Keep the dialogue open-ended and emphasize that while it might be your personal kink, they’re free to say a hard ‘No’ or that they can try it first but set up boundaries that they’re comfortable with. Remember that consent isn’t set in stone. While they may be open to trying it at first, they have the right to retract consent during play or afterwards if they’re uncomfortable and you should respect that decision.

6. How do I give constructive feedback about sex with my partner?

Desired Outcome:  Everything’s great except for that one thing in the bedroom! You want to speak to them after sex about how it can be better. 


Conversation Starter: “That was amazing! I really liked it when you did X. I wasn’t a fan when Y was happening but it felt really good when you switched it to X. ”

It’s often been called the ‘shit sandwich’ when it comes to delivering constructive feedback and it works even for sex! You’ll want to start by complimenting what you did enjoy during sex, then mentioning how it didn’t feel as good when they did the other act instead. Avoid accusatory negative comments like “You were pulling too hard” and rephrase it to focus on the act and how it felt (e.g. “It can get painful and intense when there’s a strong grip. I like it best when you focus on this part instead.”)

7. How do I tell my partner that this is my boundary?

Desired Outcome:  You gave consent previously but it’s now making you feel uncomfortable to engage further. You would like to stop and set a boundary to prevent it from happening again. 


Conversation Starter: “Can I speak to you about something important? I feel uncomfortable when X happens/you do Y. I know I’d initially said that I’ll like to give it a try but now I realize it’s not right for me. This is my boundary and I hope you respect that.”

For more tips on having the Talk® with your partner, do read the full article here.

Conclusion

We hope these scripts have given you some ideas on how to navigate those difficult conversations with your sexual partner. Keep it short, simple and direct. Don’t feel guilty or the need to apologize for putting up a boundary. You also shouldn’t feel the need to explain why it makes you uncomfortable – it’s a line you’ve drawn up and the only expectation on their end is to respect it. 

About Noorindah Iskandar
Noorindah is the founder and writer behind Shy & Curious – an online platform that explores sex and love without the fear of having to hide your Google search history! With honesty and humour, she writes articles and essays about sex, relationships and intimacy through personal stories and informed insights.

Categories
Birth Control Health Sexual Health

Generic versus Brand Name Birth Control: Everything You Need To Know To Decide Between The Two

When it comes to choosing your preferred choice of birth control pills, do you perceive brand name to be better than generic? Well perhaps, it’s time to rethink some of the criteria you typically use to evaluate whether one is better than the other! 

After all, both brand and generic birth control have to undergo rigorous review processes to establish their safety and effectiveness, before being approved for sale by the United States Food and Drug Administration (FDA). 

By the time you’re done with this article, you’ll hopefully get a better idea of their similarities, differences and why there’s no reason to worry no matter which type of birth control pills you’re prescribed. 

What Is A Brand Name Birth Control Pill? 

They’re the pioneers and innovators! Brand name birth control is exclusively protected under a 20-year patent before the generic version of the drug can be released. 

Some of the common brand names include Yaz, Yasmin, Microgynon 30, Mercilon and Diane 35. 

What Is A Generic Birth Control Pill? 

As the term suggests, they are the generic versions of brand name birth control. Once the patent expires, generics can enter the market to compete too. 

According to the FDA, generics are “copies of brand name drugs that have exactly the same dose, intended use, side effects, route of administration, risks, safety, and strength as the original drug.”

Liza, Estelle 35 and Drospera are a few examples of generic birth control pills. 

So You Might Be Wondering, What’s The Difference Between Generic And Brand Name Birth Control Pills? 

By law, trademark protection requires generic drugs to look different from their brand name counterparts despite having the same effects. Thus, they differ in terms of: 

  • Size 
  • Shape
  • Colour
  • Packaging 
  • Inactive ingredients (e.g. fillers, flavours, preservatives, binders) 

However, it’s important to note that these slight variations will not affect the efficacy of the birth control pills for pregnancy prevention although they may affect the type of side effects you experience (if any).

Some women may face breakthrough bleeding, mood changes, acne or other side effects when switching from one type of birth control to another. 

Birth control has many other benefits besides preventing pregnancy. It is often used to treat heavy menstrual bleeding, period cramps, and PMS. If you’re more sensitive to hormonal variations, you may also find brand name birth control more suitable compared to generics. 

One last differentiating factor between generic and brand name birth control is the cost. Generics are cheaper as they can cost up to 85% less than the branded version.

But ultimately, they work the same! 

Clearing Your Misconceptions On Generic Birth Control

As you’ll see in this section, especially for those of you who are still wary about going on generic birth control, there’s no need to get worked up if you’re prescribed generics!

Generic birth control is as safe and effective as the original brand name birth control

Don’t you worry, both generic and brand name birth control have the same benefits and effects. Manufacturers have to prove that the drugs are bioequivalent, such that they work the same way and are proven to be equally effective. 

Generic drugs can only be FDA-approved if they meet all the same requirements that are also applied to brand name drugs. They also have to adhere to the same quality, strength and purity standards as branded birth control. 

Cheaper doesn’t mean it’s less effective 

You pay for what you get right? Yeah, we know what you might be thinking. 

But it’s different when it comes to birth control medications. The quality of your generic birth control pill is not at all compromised despite its lower cost! In fact, the majority of women also do well on generic birth control. 

The only reason why generics are less expensive is simply because they didn’t have to invest in actually creating the drug. New drugs are usually subjected to years of testing through clinical trials, research and development which can cost up to millions of dollars. 

But for pharmaceutical companies manufacturing generic birth control, all they need to do is manufacture the product and here’s the good news. They pass on these savings to customers like you!

What To Do If You Experience Problems With Your Birth Control Pills

Generally, as both generic and brand name birth control contain the same active ingredients, any side effects are likely to be similar even if you decide to opt for the latter. 

If you do experience problems, definitely seek professional advice from your doctor. If you recently changed your birth control, ask to be switched back to the one you’re used to, or even another generic version of the same formula.  

Should I Choose Branded or Generic Birth Control? 

It really depends on you. We’re just here to assure you that no matter which type of birth control you choose, they’re all safe and work the same!

But if cost is a factor for you when it comes to buying birth control, it might be worth trying generic birth control pills first.

And if you’re sensitive or possibly allergic to certain drugs or ingredients, have a look at the list of inactive ingredients before you decide. Although in most cases, you usually won’t be able to predict and know for sure how your body will react to the contraceptive pill till you try it.

Remember, be patient with yourself as it’s all about trial and error! Here at Siena, we’re ready to help you explore your options just so you can find the perfect birth control suitable for your unique bodies.

References: 

Categories
Health

Guide to Female Pattern Baldness (Androgenic Alopecia): Causes, Symptoms and Treatments in Singapore

causes of female pattern baldness and how to treat it
Image credit: The New York Times

What is Female Pattern Baldness? 

Female pattern baldness, also known as androgenic alopecia, is hair loss affecting women. Similar to male pattern baldness, it’s when a woman experiences unexpected, heavy loss of hair as it takes longer for new hair to begin growing. The only difference is that women lose their hair in a different pattern than men. 

Yes, balding isn’t just a characteristic of ageing men as much as you’d like to believe! In fact, it’s estimated that 50% of women will experience noticeable hair loss. 

How Much Hair Loss is Normal?

But you might be wondering what’s the norm. Generally, humans shed an average of 50 to 100 single hairs daily and this is perfectly normal! To reassure you, the average human head has about 100,000 hairs with a similar number of hair follicles. 

The only time you need to worry is when you begin to lose more than 100 strands of hair per day or 700 strands per week. These numbers are just a rough estimate and it ultimately varies from person to person. 

Hair loss in women is more common than you think 

Female pattern hair loss is actually a normal occurrence, and this is especially so once you age (i.e. 40s onwards). It’s experienced by about one-third of women at some point in their lives and two-thirds of women after menopause.

Although anyone can be affected by hair loss, it’s usually more common in women:

  • Older than 40 
  • Who just gave birth 
  • Who have undergone chemotherapy and/or are affected by other medications 
  • Women who often have hairstyles that pull on the hair (e.g. tight ponytails or tight braids) and/or use harsh chemicals on their hair 
  • Menopausal women

Fortunately, female pattern baldness is treatable 

Female pattern baldness is treatable but it can’t be reversed! That’s why it’s important to begin proper treatment as early as possible to stop the hair loss and potentially be able to regrow some of the hair you’ve lost. 

Treatments can take up to 12 months to start working and you’ll have to stay on them long-term to avoid losing hair again. 

What Does Female Pattern Baldness Actually Look Like? 

It’s important to keep a close eye on some of the early signs of hair loss because the earlier you’re aware, the more effective the treatment! It’s much easier to preserve the hair you already have than to regrow hair that’s been lost.

Early signs of hair loss: 

  • Seeing more hair falling out daily on your brush, on the floor, in the shower, on your pillows or in the sink 
  • Noticeable patches of thinner or missing hair, including a widening area on the top of your head 
  • Seeing scalp skin through your hair 
  • Having smaller ponytails 
  • Seeing hair break off

Male vs female pattern hair loss

Wondering what it’s like for a woman to lose hair compared to men? We get it, the imagery of a balding man is probably much easier to conjure in your mind.

Well, in men, hair loss starts at the front of the head before receding to the back until they go bald. For women, however, you’ll lose hair from all over your head, starting at the part line. Hair at the temples may also recede. 

The good news is women are less likely to become completely bald although their hair may start thinning drastically.  

Ludwig Scale: Stages of female pattern hair loss

To help you better understand female pattern hair loss, check out the Ludwig Scale!

It effectively categorises female pattern baldness into three different stages (according to severity). This allows you to understand the degree of your hair loss, the potential for additional hair loss in the future and lastly, the best course of treatment for you.

Image credit: The Treatment Rooms London

Type I: Mild 

  • Frontal hairline remains relatively unaffected although hair loss may occur on the top and front of the scalp 

Type II: Moderate 

  • May experience thinning, shedding, general decrease in hair volume and a widening centre parting 

Type III: Most extreme 

  • Hair becomes so thin you’ll have difficulty camouflaging your scalp 

Causes of Hair Loss in Females

Hair loss can happen at any age for a variety of reasons. 

1. Family history/Genes– Hereditary condition that happens with ageing
– Usually occurs gradually and in predictable patterns, like the thinning of your hair along the crown of your scalp
2. Hormonal changesThere are a variety of conditions that can cause permanent or temporary hair loss, such as pregnancy, childbirth, menopause and thyroid problems. 
3. Medications and SupplementsHair loss can also be a side effect of certain drugs (e.g. used for cancer, arthritis, depression, heart problems, and high blood pressure). 
4. Stress – Physical or emotional shock or trauma can also lead to the general thinning of your hair temporarily
– Caused by Telogen Effluvium: your hair is forced into the final phase of hair growth, thus resulting in hair loss and preventing new hair from growing and replacing it 
5. Hairstyles and Treatments – Excessive hairstyling or hairstyles that pull your hair tight (e.g. cornrows and pigtails) can cause a type of hair loss called traction alopecia
– Hot-oil hair treatments and permanents can cause your hair to fall out
– Hair loss can be permanent if scarring occurs 
6. Rapid weight loss – Experienced by those who engage in restrictive and unhealthy diets to lose weight quickly
– Your body may be depleted of iron, proteins and other dietary supplements
– Deprives hair of nourishment as healthy hair requires a healthy diet and balanced caloric intake 
7. Iron Deficiency– Low iron levels may indicate you’re anaemic which causes you to lose hair
– Possible reasons: intestinal disease, iron-deficient diet or your period 
Causes of female pattern baldness

Treatment and Hair Care

When it comes to treating your hair loss, early diagnosis is encouraged in order to potentially minimise future hair loss. Here are some ways to effectively treat female hair loss:

  1. Minoxidil 
    • The only topical medication approved by the U.S. Food and Drug Administration (FDA) to treat female pattern hair loss  
    • Actively promotes hair growth by shedding old hairs and replacing them with new, stronger ones
    • Available in 2%, 3% and 5%
  2. Spironolactone
    • Oral medication prescribed for female pattern hair loss that’s associated with the overproduction of male sex hormones
    • Works by slowing down the production of androgens (male sex hormones). Reduced production of androgens can slow down the progression of hair loss caused by androgenic alopecia. It can also encourage hair to regrow
  3. Ketoconazole 
    • Over-the-counter medicated products like Nitozol Shampoo can be used to treat dandruff, itchiness and flaking 
    • Used for the treatment and prevention of scalp and skin infection associated with the fungus Pityrosporum such as seborrheic dermatitis (a dry or greasy scaling of the scalp and other parts of the body) and dandruff (pityriasis capitis)

Lifestyle and dietary changes

For best practice, here are several things you should try to keep your hair on:

  • Avoid oily hair products that clog up your hair follicles and cause inflammation
  • Avoid hairstyles that pull on your hair 
  • Make changes to your lifestyle so that stress can be managed and minimised. Some ways to reduce stress include limiting your intake of stimulants (like nicotine and caffeine), exercising regularly and engaging in mindful meditation
  • Avoid drastic lifestyle changes (e.g. weight loss) or an unbalanced diet which may result in insufficient nutrients for your hair

Hair Loss No More 

If your hair is currently a cause of concern for you, you’ll be glad to know Siena can connect you to clinically proven treatments that will help with your hair loss/thinning problems. 

It’s time to make hair loss a thing of the past and look forward to discovering thicker, fuller and healthier hair!

References: 

Categories
Birth Control Health Period

Polycystic Ovary Syndrome (PCOS): Symptoms, Causes and Treatment

symptoms, causes and treatment for polycystic ovary syndrome (PCOS)
Image credit: Getty Images

Feel like you never get your periods? Or when you do get them, it seems like there’s no end to it? Well, you may be suffering from a condition called polycystic ovary syndrome (PCOS) that affects your hormone levels.

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a common hormonal disorder that affects approximately 10% of women who are of reproductive age. The infrequent or prolonged menstrual periods caused by excess male hormones or androgen levels are one of the most obvious signs of PCOS.

Those suffering from PCOS have an imbalance of female hormones that prevents their ovaries from releasing an egg monthly. As a result, the ovaries end up developing countless small collections of fluid sacs (follicles) and fail to regularly release eggs. Each sac contains an immature egg that is unable to mature enough to trigger ovulation. 

You may be wondering where the term “polycystic” comes from. As the unreleased eggs remain in the ovaries, these multiple small cysts contribute to the polycystic appearance of the ovaries.

Essentially, by also producing higher-than-normal amounts of male hormones leading to hormonal balance, this causes your body to skip menstrual periods and makes it harder for you to get pregnant.

Image credit: National University Hospital

Signs and Symptoms of PCOS

Signs and symptoms of PCOS often develop during puberty, around the time you go through your first menstrual cycle. However, PCOS can also develop at a later stage due to substantial weight gain. 

You’ll definitely want to pay attention to: 

  • Irregular periods: could be infrequent, prolonged or even absent 
  • Heavy bleeding 
  • Hair growth
  • Acne 
  • Weight gain
  • Male-pattern baldness 
  • Darkening of the skin
  • Headaches

If you think you have PCOS, you should observe and track your periods as they are usually the most common signs. 

Other symptoms that may be more obvious are associated with physical changes. These refer to excess facial and body hair, severe acne and male-pattern baldness as they signify the presence of excess androgen in your body. 

Severe symptoms usually arise if you’re obese.

Causes of PCOS 

So far, the exact cause for PCOS is unknown although it may be hereditary as research suggests genes also contribute to PCOS. 

But the most commonly cited reason is probably excess male hormones called androgen. Women normally produce androgen in small quantities but for those with PCOS, they produce an excessive amount which explains the male-pattern hair growth (i.e. on the chin, chest, inner thighs, etc) and the formation of acne. When your ovaries produce abnormally high levels of androgen, you can also gain weight both easily and quickly.

Some studies have also shown that excess insulin increases androgen production which contributes to PCOS. Insulin is the hormone produced in your pancreas allowing cells to use sugar and also acts as your body’s primary sugar supply. If your cells become insulin-resistant, your blood sugar levels can rise thus causing your body to produce more insulin. 

How is PCOS Diagnosed? 

A diagnosis of PCOS is made when you experience at least two of these signs: 

Irregular periods– Infrequent, irregular or prolonged menstrual cycles are the most common signs of PCOS.
– A good gauge would be: if you have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods. 
Excess androgen Elevated levels of male hormones (androgen) may cause physical changes like excess facial and body hair (hirsutism), occasionally severe acne and male-pattern baldness. 
Polycystic ovariesEnlarged ovaries that contain follicles surrounding the eggs. Thus, the ovaries may not be able to function regularly. 
Diagnosing PCOS

Other ways to diagnose PCOS:

  1. Hormonal blood tests
    • By analysing your blood to measure your hormone levels, you can then safely exclude other plausible causes like menstrual abnormalities or merely androgen excess mimicking PCOS. 
  2. Pelvic ultrasound scan
    • Examine the appearance of your reproductive organs and the thickness of your uterine lining. 

Targeted Treatments To Cope With PCOS

PCOS is not completely reversible but several treatments can help reduce or minimise uncomfortable symptoms, allowing you to better cope with the condition. 

Birth control for irregular periods and its related symptoms 

Already on birth control? Well, you may be killing two birds with one stone if you’re currently struggling with PCOS too. 

Combined hormonal contraceptives are usually prescribed to control various PCOS symptoms. Some examples are the combined birth control pill, patch and even the vaginal ring. The estrogen and progestin hormones present in the hormonal birth control help decrease androgen and regulate estrogen levels instead.

To treat irregular periods (a common PCOS symptom), combined hormonal contraceptives are also recommended to aid in fixing hormonal imbalance and regulating the menstrual cycle.

What’s more, regulating hormones can even lower your risk of endometrial cancer and correct abnormal bleeding, excess hair growth and acne! 

Clomiphene or surgery for infertility 

The irregular and infrequent ovulation caused by PCOS can make it difficult for you to conceive. So if you’re planning for a baby or if you intend to get pregnant in the near future, it’ll definitely be useful to know that ovulation can be artificially induced using medications. 

A common drug used to induce ovulation is clomiphene (Clomid) which has to be taken orally for five days. If the tablet fails, you may need to consider hormone injections to stimulate the ovaries. But of course, this depends on the recommended treatment plan based on professional advice and guidance from your doctor or specialist. 

If you find that your body is unresponsive to medical treatment, there’s also the option for surgery. Laparoscopic ovarian drilling is typically used to trigger ovulation by using electrocautery or a laser to destroy parts of the ovaries. This corrects hormonal imbalance and restores normal ovulation. 

Hair removal medications for excessive hair growth

Excess hair may be something you’re not used to and find frustrating when you experience PCOS symptoms. Several fuss-free and convenient techniques include depilatory creams, shaving, waxing, bleaching, plucking and electrolysis. However, these methods have to be sustained or repeated in order to manage hair growth.

Suppression of male hormone production with tablets like the oral contraceptive pill or anti-male hormone drug may also reduce excessive hair growth if used for at least nine months. 

Lastly, you can also consider laser hair removal as it’s the most effective long-term method to help tackle the problem of excess hair. However, it’s probably one of the most expensive options as well. 

Lifestyle changes 

As substantial weight gain has also been attributed to PCOS, paying attention to your diet and regularly exercising to reduce excess weight may help to improve symptoms by restoring normal hormonal balance. 

To do so, you can also limit your intake of carbohydrates to increase insulin levels, or opt for food high in complex carbohydrates (e.g. whole grains and vegetables) to gradually raise your blood sugar levels. 

The Bottom Line 

If you suspect you have PCOS, it’s really important to seek timely and appropriate treatment to prevent further complications. That said, always seek help from your doctor first to figure out the best approach or course of treatment for your body and lifestyle.

Considering birth control? Here at Siena, we also want to help you find a solution to help you manage your PCOS symptoms. If you’re considering birth control, don’t hesitate to reach out and book a consult with one of our female doctors to explore your options! 

References: 

Categories
Birth Control Health

Why You May Be Bleeding Or Spotting While On Hormonal Birth Control

causes of breakthrough bleeding

Perplexed as to why you’re finding bloodstains on your underwear or pad even though you’re not on your period? Or worse still, you freak out thinking of the worst-case scenario. 

More often than not, however, you may just be experiencing breakthrough bleeding.  

What is Breakthrough Bleeding? 

It refers to any type or amount of bleeding that occurs outside of your normal menstrual period or even during pregnancy. This could be spotting or heavy bleeding that may even require you to wear a pad or tampon.

Spotting is easily recognisable by tiny pink or red spots and usually lasts for a few days. It also isn’t as serious compared to heavy or continuous breakthrough bleeding. 

Some may also find that they simultaneously experience lower abdominal cramps (similar to menstrual cramps) a few days before or during breakthrough bleeding.

Breakthrough bleeding is usually painless and mostly harmless although of course, it can be an unpleasant and uncomfortable feeling. Here’s more of the science and facts behind it so you understand why it happens if you ever experience it. 

A Potential Side Effect of Hormonal Birth Control 

Breakthrough bleeding is a common side effect that some birth control users experience within the first three to four months after starting hormonal birth control. In that case, this includes any contraception method containing hormones as they’re all likely to cause breakthrough bleeding:

Why do hormonal birth control cause breakthrough bleeding? 

This happens because your body has to take time to adjust to the new hormones. As you experience changing hormone levels, it also alters the endometrial lining in your uterus which thus, causes a change in or disruption of your usual period cycle. Ultimately, this leads to breakthrough bleeding. 

If you’re on oral contraceptives, there’s another reason why you may be experiencing breakthrough bleeding.

When you take a break in between pills (i.e. skipped a dose, frequently forgetting to take your pills on time or you’re on the inactive pills for a week), breakthrough bleeding can also occur. This is a reaction to your body’s attempt in detecting and responding to fluctuating hormone levels which then causes the premature shedding of part of your uterine lining before your period’s due date. 

Spotting is a pretty clear indication that your body hasn’t yet adjusted to the hormones in your birth control or that you missed your pill. Typically, breakthrough bleeding should stop after a few months of consistent use.

But if it does persist, it’s highly recommended you consult a doctor. This could mean your current birth control method might not be the most suitable for you and you may want to consider another method, or it could also be a sign of another bleeding disorder. 

Other Possible Factors That Cause Breakthrough Bleeding

Besides hormonal birth control, there are other reasons which may explain your breakthrough bleeding. 

1. Age

If you’re in the early and developing stages of puberty, you’re more likely to experience breakthrough bleeding after starting your period. Your body requires time to go through several cycles before establishing one and balancing your hormones. 

Women who go through menopause may also experience spotting and irregular periods once they’re no longer in their reproductive years. During perimenopause (also known as a menopause transition preceding menopause by several years), some women may be more susceptible as well. 

2. Sexually Transmitted Infections (STIs) 

Specifically, chlamydia and gonorrhoea can cause excessive bleeding due to the irritation of your cervix, or neck of the uterus. This in turn can lead to unscheduled bleeding.

3. Pregnancy

Breakthrough bleeding can also happen when a fertilised egg attaches itself to your uterine lining, also known as implantation bleeding. But unfortunately, it can also be a sign of an impending miscarriage or an ectopic pregnancy.

4. Other conditions 

The following are several conditions that may also cause unscheduled bleeding: 

  • Cervical cancer — bleeding between periods and especially after sex
  • Endometriosis — a painful condition in which the endometrium grows outside the uterus, thus causing spotting and other painful symptoms
  • Endometrial hyperplasia — overly thick uterine lining that causes bleeding 
  • Polycystic ovary syndrome (PCOS) — a hormonal disorder due to lack of ovulation that produces small cysts in the ovaries and diminishes progesterone levels; excess estrogen causes thickening of the uterus 
  • Uterine fibroids and polyps — benign growths that can cause spotting in between periods, or even after a woman has gone through menopause

Recommendations to Manage Bleeding or Spotting 

It’s unlikely you can stop or avoid breakthrough bleeding once it happens BUT you may be able to decrease the likelihood of even experiencing it though this is dependent on the cause of your bleeding.

For instance, if you know for sure your hormonal birth control pill is the cause for your irregular bleeding, simply ensure that you stick to a consistent schedule by taking the pill around the same time each day without missing a dose. 

If you’re new to birth control, remember it’s normal and breakthrough bleeding should stop after three months. But if the bleeding is frequent, heavy or often accompanied by pain, it might be a warning sign you should attend to as early as possible.

Easing Your Worries

Spotting is common and is usually no huge cause for concern. As a precaution, you may find it useful and important to keep track of when spotting or bleeding occurs and take note of how light or heavy the bleeding is, as well as the frequency of your breakthrough bleeding. 

But of course, if you’d rather be on the safe side, definitely speak with a doctor to rule out more serious health conditions. Or if you simply want to know more about your birth control options, you can comfortably do so at Siena where you can connect with any one of our female doctors from the privacy of your own home! 

References: 

Categories
Birth Control Health Period

Things You Should Know About Endometriosis: Definition, Symptoms, Treatments & Medications

endometriosis and birth control
Image credit: iStock

Endometriosis, a painful condition affecting 1 in 10 women of reproductive age. That’s about 190 million women globally. More often than not, endometriosis causes severe pain and can contribute to other problems like poor wellbeing and even infertility. And that’s why it’s important to address it, starting from this blog article.

Just last month (June 2021) in Singapore, it was reported that there’s a rising trend in the number of people diagnosed with endometriosis. From 70 to 80 patients per month in 2019, the National University Hospital’s endometriosis clinic saw 100 to 110 patients a month this year, with more than half being severe cases. (Source: CNA)  

Endometrial pain can also be extremely unbearable for most women, thus some may choose to opt for telehealth services like Siena where they can access birth control to help relieve the pain. We’ll delve into that in a bit. 

What is Endometriosis? 

It is a condition where tissue similar to the lining of the uterus grows outside the uterus instead. The tissue attaches itself to other pelvic and abdominal organs like the ovaries and fallopian tubes, which causes scarring, adhesions and cysts. 

Every month, your uterus grows the endometrial lining in preparation for a fertilised egg. If the fertilised egg doesn’t implant itself in the lining within a month, your hormone levels will fall, prompting the lining to shed. 

For women with endometriosis, however, after the lining sheds, the endometrial cells that grow outside the uterus liquefy, bleed and touch other organs or body tissues. This then causes irritation, inflammation and pain. 

There is currently no cure for it although you can seek treatment to help with the symptoms.

Common symptoms

  • Severe premenstrual/menstrual cramps (marked by having to change more than five to six sanitary pads a day) 
  • Pain during and/or after sex 
  • Painful and frequent bowel movements 
  • Pain in the abdomen, lower back or thighs often lasting throughout the cycle 
  • Heavy periods 
  • Spotting between periods 
  • Difficulty getting pregnant (40 to 50% of patients with endometriosis are diagnosed with infertility)

If you’re experiencing menstrual cramps that are currently (or have been) affecting your quality of life (e.g. unable to get out of bed or having to take medical leave to get through your cycle), it’s a sign that you could have endometriosis. 

Due to the condition’s painful and uncomfortable symptoms, women may also develop depression.

However, some who suffer from endometriosis may not display any symptoms at all.

Likely causes

Most people diagnosed with endometriosis are in their 30s and 40s. But you may be more vulnerable if: 

  • You’ve never given birth 
  • Your periods last more than seven days 
  • You have short menstrual cycles (your period comes every 27 days or less) 
  • You have a family history of endometriosis 
  • You’re suffering from a health problem that keeps blood from flowing out of your uterus when you’re on your period

Ways to Manage Endometriosis 

As there is currently no cure, it’s good to know about the available treatments out there to help you better manage your symptoms. It can be treated with medicine or surgery. 

How hormone medications can help 

In most cases, doctors tend to prescribe specific types of birth control ranging from the combined contraceptive pill to the contraceptive patch and GnRH analogues. This is because birth control can help reduce pain and bleeding.

As these hormone medications act as both contraception and treatment for endometriosis, they’re especially useful if you don’t plan on getting pregnant anytime soon.

Method Function
Combined hormonal contraception like birth control pills and patches (containing both estrogen and progestin hormones) – Pain relief
– Help you experience lighter, shorter and more regular periods
– Continuous use (skipping the inactive pills or last week of a 4-week pack) of the pill prevents menstruation. Thus, this stops endometrial cells from shedding and causing inflammation and irritation.
– Monophasic birth control that releases a continuous, steady dose of hormones each day of the month is also useful in alleviating symptoms. 
Gonadotropin-releasing hormone (GnRH) agonists medications– Trigger a temporary menopause-like state by stopping the production of certain hormones
– Prevent ovulation, menstruation and the growth of endometriosis and its related pain and symptoms
Progesterone and progestin medications like the mini pill, injection or intrauterine device (IUD) – Improve symptoms by reducing or skipping periods, on top of preventing pregnancy
– These hormones reduce menstrual flow without causing the uterine lining to grow, thus reducing endometriosis-related pain 
How hormone medications alleviate symptoms of endometriosis

As with all hormonal treatments, symptoms can return after you stop taking or using them.

Other methods to ease symptoms of endometriosis 

For milder symptoms that are still tolerable, you can consider painkillers or anti-inflammatory medications which may be enough to keep away the pain. This may include over-the-counter pain relievers or even stronger painkillers prescribed to you. 

If you want to get pregnant but you’re unable to do so or if you experience severe and extreme symptoms, surgery is another option you may want to go for. Going through with surgery will require you to remove the growths outside of your uterus or just patches of endometriosis tissue, relieving the pain and making it easier for you to get pregnant. Sometimes, the growths do come back after surgery so you may have to take medication. 

Some women also opt for hysterectomy (surgical removal of the uterus) to remove part or all of the affected organs like the uterus, fallopian tubes and ovaries. Keep in mind that this is permanent and it’ll be impossible to become pregnant in future. 

Increasing awareness

Even though access to early diagnosis and effective treatment of endometriosis is essential, it remains lacking. A significant problem associated with endometriosis is the delayed or under-diagnosis of the condition. Worldwide, diagnosis for endometriosis is typically made seven to 10 years after the onset of symptoms, which is a considerably long time. 

This suggests there’s low awareness among not just the patients, but also the general population and even doctors. Endometriosis shouldn’t be brushed off as merely normal period pain but rather, it’s important to be able to recognise and treat the condition to greatly improve patients’ quality of life.

The current priorities laid out by the World Health Organization includes the need for more research and awareness globally to “ensure effective prevention, early diagnosis and improved management of the disease”. Healthcare also plays an important role in screening, identifying and offering basic pain management to cope with endometriosis. 

In Singapore, there are a few great initiatives and outreach programmes you can support, such as the Endometriosis Awareness Campaign launched in 2012 and the Singapore Endometriosis Support Group. 

How Siena Can Help You Cope With Endometriosis 

If you think you may be suffering from endometriosis, birth control is definitely an option you can consider to help manage your symptoms. By hindering the growth of the endometrial tissues, birth control essentially relieves the pain and other symptoms associated with endometriosis. 

With that, don’t hesitate to seek help from any of our female doctors at Siena. With nine brands to choose from, you can also take comfort in knowing that we prescribe safe and effective hormonal birth control to help you alleviate symptoms of endometriosis. 

Summary

What is endometriosis?

It is a condition where tissue similar to the lining of the uterus grows outside the uterus instead. The tissue attaches itself to other pelvic and abdominal organs like the ovaries and fallopian tubes, which causes scarring, adhesions and cysts.

What are the symptoms of endometriosis?

– Severe premenstrual/menstrual cramps (marked by having to change more than five to six sanitary pads a day) 
– Pain during and/or after sex 
– Painful and frequent bowel movements 
– Pain in the abdomen, lower back or thighs often lasting throughout the cycle 
– Heavy periods 
– Spotting between periods 
– Difficulty getting pregnant (40 to 50% of patients with endometriosis are diagnosed with infertility)

What causes endometriosis?

You may be more vulnerable if: 
– You’ve never given birth 
– Your periods last more than seven days 
– You have short menstrual cycles (your period comes every 27 days or less) 
– You have a family history of endometriosis 
– You’re suffering from a health problem that keeps blood from flowing out of your uterus when you’re on your period

References: 

Categories
Birth Control Emergency Contraception Health Sexual Health

Preventing Unintended Pregnancies: What You Should Know About Having Safe Sex

preventing unplanned pregnancies
Image credit: Freepik

Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception.

In Singapore, the Ministry of Health revealed that there were 10,960 abortions in 2012 whereby roughly one in four pregnancies were terminated. Furthermore, a 2018 study by KK Women’s and Children’s Hospital’s Clinic for Adolescent Pregnancy revealed that nearly one in three girls and young women even had successive pregnancies before the age of 21, suggesting a need to improve care for pregnant adolescents. 

Aside from teenage pregnancies, this article still stands even if you’re a 35-year-old mom with two kids, and perhaps you know it’s more than you can ever handle. Or if you and your partner have already decided that right from the get-go, having kids is a definite no in your lifetime.

And that is why knowing how to prevent unintended pregnancies can be so important, no matter your age, background or individual differences.

Causes of Unintended Pregnancies 

Unintended pregnancies can happen for many reasons. It could be due to last-minute accidents or emergencies, carelessness and for some, even the lack of sexual education. In order to take the necessary steps in planning for when (or if) you want to conceive, it’ll probably be useful to first understand the likely causes of unintended pregnancies. 

Accidents or ineffective use of birth control

Although birth control can help prevent pregnancy, it won’t do you any good if you aren’t taking it on time or changing it as needed. And birth control methods, even when used correctly, can fail. Globally, an estimated 33 million unintended pregnancies are the result of incorrect use or contraceptive failure.

If you prefer to only rely on the rhythm method (abstaining from sex only during your most fertile days) or withdrawal (pull out) method, it’s important to note that you’re essentially using the least effective of birth control methods. They are less reliable mainly because it’s harder to control several important factors involved.

For instance, pre-cum may also contain sperm such that even if the other party pulls out every single time, there’s still a higher chance of pregnancy. And, if you’ve been nailing your ejaculation timing perfectly, remember that even just one slip up can potentially cause pregnancy. 

Also, although male condoms are easily accessible and offer protection against sexually transmitted infections (STIs), they’re only about 85 percent effective in real-life conditions for pregnancy prevention (one of the lowest). The efficacy of condoms depends on when and how it’s worn while there’s also a risk of condoms tearing and breaking during sex. 

Having sex without using any birth control 

Studies have found that among couples who have regular sex without contraception, 84% get pregnant within a year and 92% within two years. Several plausible reasons for not using birth control could be due to personal preference, lack of access to birth control, or cultural and religious norms and beliefs. 

If you’re one of those who don’t use birth control regularly or not at all, this might increase your chances of getting pregnant. This is especially so for couples who are fertile and also frequently have sex. 

Unaware of your fertility status 

For some women, they may be unaware they’re capable of getting pregnant if they:

  • Have prior experience struggling with infertility
  • Do not have regular periods 
  • Are going through perimenopause (menopause transition which occurs several years before menopause)

Although the above factors usually suggest a decrease in fertility, it is still possible to conceive. Thus, some women face unintended pregnancy when they least expect it. 

Non-consensual sex

Unintended pregnancies can also be a result of rape or forced pregnancy. This is a severe reproductive health risk that usually always leads to negative consequences for victims. 

Youths are at a higher risk of being exposed to non-consensual sexual experiences due to individual factors like financial need and alcohol consumption, and also environmental factors like poverty, early marriage and gender inequality. 

Ways You Can Prevent Unintended Pregnancies 

It all begins with you and most importantly, your knowledge and understanding of your own sexual and reproductive health. Hence, you may find it beneficial to keep the following guidelines in mind!

Practise safe sex

A really basic rule! Don’t be afraid to take charge of your own safety when it comes to your sexual health. You should take all precautions such as using condoms to prevent transmitting or getting STIs, and even hormonal birth control to prevent unintended pregnancies. 

Compared to the rhythm and withdrawal methods, hormonal contraceptives have much higher success rates. What’s more, there are many types of birth control you can choose from if you decide to go on hormonal birth control, ranging from the birth control pill, patch and vaginal ring. It all depends on what suits you the best in terms of your own preference and lifestyle.

If used perfectly, these methods are at least 99 percent effective at preventing pregnancy! With that said, if you’re not on any form of hormonal birth control, remember to use protection (i.e. condoms) every time you’re engaged in any form of sexual encounter. 

Still can’t wrap your head around your options? Before settling on a decision, you might want to do some research or speak with a doctor to figure out which contraceptive works well for you. 

Communicate with your partner

It’s important to be transparent about your sexual past, personal preferences and even your decisions about sex and pregnancy. Besides being able to learn about potential STIs and each other’s thoughts on having kids (especially for long-term couples), it’ll definitely help to maintain open communication with one another. 

Emergency contraception to the rescue 

Got caught up in the heat of the moment? Simply forgot about protection because you weren’t exactly in a sober state? Never expected your trusty condom to fail on you? 

We get it. Accidents happen. 

But that’s what emergency contraception is for! Also known as the morning-after pill, you take it to prevent pregnancy if you’ve had sex without contraceptive protection. The pill will then work to prevent or delay your ovaries from releasing an egg (ovulation). It should be taken as soon as possible after unprotected sex.

But do note emergency contraception is intended for occasional use, not as a primary form of birth control.

Consider long-acting reversible contraceptive methods 

Research has shown that long-acting contraception like the intrauterine device (IUD) and implants are essential in reducing unwanted pregnancy rates, abortion and even repeat abortion. Overall, they’re likely to have a positive impact on women’s ability to take control of their reproductive health. 

In comparison with other methods that depend on user adherence, these long-term contraceptive methods are more reliable, cost-effective and also offer better prevention against unintended pregnancies. 

Abstain from sex

This might be an unfavourable option but hey, it’s something that works and is definitely 100% effective for both pregnancy and STIs prevention. If you ever come to this decision, it’ll definitely help to share your feelings with your partner so both of you are agreeable and understanding of the situation. 

To Sum It Up

Educating yourself on the strategies and precautions needed to prevent unintended pregnancies is really important for quality family planning. I mean, what’s not to love about enjoying both great sex and child-free days especially when you’re not yet ready?

Being able to gain access to effective contraception with minimal barriers (or even stigma) can make a huge difference. And it’s really all you need in order to learn how to prevent unintended pregnancies. 

With Siena, you can speak to our female doctors via a tele-consult, purchase your contraceptives online and await your discreet package in the comfort of your home at no extra cost! 

@sienahealth

Unboxing a #Siena package with your birth control needs & a lil surprise✨ #singapore #tiktoksg #fyp #womenshealth #sexualhealth #birthcontrolcheck

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References: 

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Birth Control Health Period

Period Hacks: 9 Ways You Can Embrace Self-Care During That Time of the Month

period hacks: 9 ways to embrace self-care during your period

Periods can be tough. Most of us learn (the hard way) that it’s pretty much impossible to avoid both the physical and emotional symptoms of your menstrual cycle. From painful menstrual cramps to bloating, fatigue and irrational mood swings, there are seriously tons of reasons validating that dreadful feeling you get when you’re on your period. 

But you’re definitely not alone. Approximately 80 percent of women experience period pain (dysmenorrhoea) in their lifetime and in 5 to 10 percent of women, the pain can be so severe that it disrupts their daily life. While some of those who experience dysmenorrhea rely on over-the-counter painkillers, others may also seek longer-term remedies like birth control to help reduce the pain associated with menstrual cramps. 

Looking for an everyday solution that’s more convenient and perhaps even free? Try these easy period hacks that can help you cope better during that time of the month! 

Dietary Changes

Image credit: Freepik

Snuggling in bed with junk food on both hands, Netflix and a pint of ice-cream waiting by your bedside. Yes, I’m sure we’ve all been there in one way or another. It can get really tempting to just wait out your period in the most comforting (yet unhealthy) manner possible. 

1. Stay away from simple carbs, sugar and salt

Of course, along with your period also comes the time you’re most likely to indulge in food high in carbohydrates, sugar and salt. Mostly because you feel like it. However, they can actually cause energy levels to crash whilst intensifying mood swings and bloating due to higher water retention. 

Instead, try to consume protein-rich foods and those with healthy fats and high fibre which can help to stabilise your blood sugar levels and decrease inflammation. Or you could also consider having more complex carbs found in wholegrain food as they keep you full longer, thus reducing your food cravings and irritability.

2. Hydrate

Drink up (water, not alcohol)! Having plenty of water helps with digestion, hormone regulation and hydration. Research has shown that staying hydrated (at least 1600ml a day) can decrease the duration of menstrual bleeding and the severity of menstrual pain.

If you’re usually reliant on that cup of espresso to kickstart your days or plenty of nights with at least one glass of wine, it might be a better idea to avoid them around the time of your period. Both caffeine and alcohol have the potential to enhance premenstrual syndrome (PMS) symptoms such as irritability, restlessness and tension.

3. Don’t forget your daily nutrients/supplements

Calcium is a key dietary intake that can help relieve PMS symptoms like depression and fatigue. In the week leading up to your period, you might want to consider stocking up on milk, other dairy products and even cereal. 

When taken together, magnesium and vitamin B-6 are most effective in helping you cope with symptoms like depression, anxiety, bloating and food cravings. Vitamin B-6 is commonly found in fish, chicken and fruits while you can also expect to have magnesium in your leafy greens like spinach, and in whole grains and nuts. 

Lifestyle Recommendations

Image credit: Freepik

Dating back to your teenage years, you might already be accustomed to a certain routine or way of life when it comes to your period. Good on you if it’s been working well for you so far! But for those of you still on the lookout for ways to improve your period health, it’s best to re-evaluate your current lifestyle and learn from some of the tips below. 

1. Get up and get moving

No matter how much you feel like it, don’t let yourself become a couch potato! 

Be it hiking, jogging, biking, dancing or even as simple as taking a stroll, any kind of exercise for at least 30 minutes a day can do you good. As long as it gets your heart pumping, the release of mood-boosting endorphins is a great way to improve PMS symptoms like fatigue, poor concentration and depression. 

2. Quality sleep 

Feel like you’re getting enough hours of sleep but can’t fathom why you still wake up feeling grouchy and moody? Well, here’s a plausible explanation.  

As you may find it harder to fall asleep at night whilst enduring your period symptoms, any disruption to your sleep pattern can also increase your irritability and even cause menstrual migraines. To tackle this, try sticking to a sleep routine where you head to bed at the same time each night and wake up at the same time in the morning.

Turn in earlier by reducing your screentime in bed so that you’ll also have the full, minimum eight hours of sleep. This will not only help to rejuvenate you, but it also stabilises your hormones. 

3. Break your habit 

Smoking can lead to more severe PMS symptoms and menstrual problems like cramping and irregular periods. This happens because it alters your hormone levels and even lowers plasma vitamin D levels which potentially increases the incidence and/or severity of PMS.

At-Home Care and Relaxation Techniques

Image credit: Freepik

Sometimes, all you really need during the few days of menstruation is to relax and forget about your troubles and worries. That’s all there is to it, period.

1. Therapeutic care

It can be stressful juggling your life’s commitments and daily activities, alongside your period. But fret not, there are so many relaxation techniques you can adopt to wind down and give yourself the self-care you deserve. 

Yoga is one effective activity for your stress management as the combination of gentle movements and deep breathing techniques help to relax your muscles and improve blood supply to the pelvic area. A study found that doing regular yoga exercises actually improved PMS bloating, cramps and sore breasts, hence decreasing premenstrual distress. 

Alternatively, a back and stomach massage could also be another solution for you to calm your nerves and anxiety around the time of your period, as well as to ease physical discomfort. An hour of massage can reduce your cortisol levels — a hormone triggered in times of stress — and produce a feel-good chemical, serotonin. This boosts your body’s ability to deflect pain, anxiety and negative emotions.  

2. Turn up the heat

Warm-anything is the way to go during your period! They help relax the muscles of your uterus causing period cramps and also boost circulation in your abdomen.

These are some simple and effective ways to ease tension and for pain relief:

  • Soak in a warm bath with aromatherapy oils 
  • Use a heating pad, patch or wrap 
  • Hug a hot water bottle 
  • Enjoy a cup of hot ginger tea 

3. Stay positive 

More often than not, taking care of your mental health may be just the thing to beat the period blues (emotionally at least). And these are probably the most basic of tips that some of you may have overlooked! 

We cannot emphasise enough how important rest is. Periods are obviously exhausting so don’t feel guilty for taking all the rest you need to recharge. 

If you’re tucked in bed feeling lonely and horrible, try listening to audiobooks and podcasts, or simply reach out to a friend or loved one to chat about what’s on your mind. 

And if you’re up for it, why not learn something new or invest your energy into a task you’ve been wanting to take on? Make yourself a new smoothie recipe, spend a few minutes on the piano or simply rearrange your bookshelf if it makes you feel better. You’ll probably feel the tiniest sense of accomplishment and satisfaction while getting a whole lot of inspiration in time for your post-period activities! 

Should You See A Doctor?

With plenty of period hacks to choose from, you’ll hopefully get better at managing your next and subsequent menstrual cycles! While they may not work for everyone, your period problems will most likely be more tolerable whenever the dreaded time of the month rolls around. Just remember to stick to the ones that work best for you and don’t be afraid to experiment. 

However, if your PMS symptoms are seriously unbearable and extreme such that it severely disrupts your daily life, consider seeking professional help from a doctor. With Siena, all you have to do is fill up a questionnaire to schedule a tele-consult with one of our female doctors to discuss the complications and find relief from your PMS symptoms — all from the privacy and comfort of your own home. 

Summary

How To Relieve Period Cramps?

  1. Dietary Changes

    Cut down on simple carbs, sugar and salt, constantly hydrate and don’t forget your daily nutrients & supplements.

  2. Lifestyle Recommendations

    Exercise, have sufficient quality sleep and stay away from bad habits like smoking.

  3. At-Home Care and Relaxation Techniques

    Indulge in therapeutic care such as yoga and massage, use heat pads or take a warm bath while staying positive.

References: 

Categories
Sexual Health

Premature Ejaculation (PE): Symptoms, Causes, Treatments in Singapore

Remember the proverb, “slow and steady wins the race”? Whether or not you actually heed this advice in your daily life, I’m sure you’ll agree that this proverb holds potent truth in bed. Indeed, coming too fast in bed often ruins the mood and can be extremely distressing for both you and your partner.

With 1 in every 3 men aged between 18 and 59 years old experiencing premature ejaculation (PE) at some point, PE is more common than you think.  

What is premature ejaculation (PE)?

Premature ejaculation occurs when:

  1. A man orgasms and ejaculates sooner than he or his partner would like.
  2. A man orgasms with very little stimulation.

How soon is too soon?

There is no clearly defined time period of what constitutes PE. The time frame can vary across individuals, depending on what he or his partner constitutes as “too soon”. International guidelines often cite that a man has PE if he ejaculates within 1 minute of entering your partner. Once again, this isn’t a hard-line definition, and it really depends on you and your partners’ preferences and feelings. 

What if it happens only occasionally?

It’s okay to have some disappointing nights, you can’t always have it all. However, if the problem occurs almost every time for more than 6 months and causes you significant distress, then you may have PE. 

Types of premature ejaculation

Also, did you know that not every PE is the same? Here, we break down the 2 different types of PE for you.

  • Lifelong PE (primary PE): These men have been experiencing PE ever since their first sexual encounter. 
  • Acquired PE (secondary PE): These men have previously had normal ejaculations, but later developed PE.

Lifelong PE is often caused by psychological factors, whereas acquired PE can be caused by a mixture of both psychological and biological factors. Moving on, let’s explore the different reasons for PE. 

Causes of premature ejaculation

PE may be due to psychological factors or physical factors, or a mixture of both. It’s good to know the common causes of PE so that you can identify which ones have led to your PE. 

Psychological factors

Anxiety is one of the leading factors of PE. This usually comes in the form of performance anxiety, where a man is concerned about his sexual performance. However, anxiety and stress about other aspects of life, such as work or relationship problems, can also play a part in PE. Other psychological factors that cause PE include depression, guilt, low self-confidence and unrealistic expectations about sex. 

Think back about your teenage years. If you recall masturbating hurriedly for fear of getting caught by your parents or others, that might have caused a lasting effect and led to your PE today. Besides that, traumatic sexual experiences at a young age or strict upbringing that frowns upon sex as shameful can lead to PE. 

Biological factors

Ever heard of serotonin, the happy hormone? Not only does serotonin boost your mood, but it is also the controller of your sexual desires and erection. The higher the serotonin levels in your brain, the longer it takes for you to ejaculate, allowing more satisfactory and happier sex. However, when serotonin levels are low, the time to ejaculation is shortened, causing PE. Not so happy anymore.

Besides serotonin imbalance, other medical conditions can also lead to PE. These include erectile dysfunction (ED), diabetes, an overactive thyroid and some prostate-related conditions. Genetics or simply an overly sensitive penis may even be at blame. 

Medical treatment for premature ejaculation

Oral medication

A common way to treat PE is using selective serotonin reuptake inhibitors (SSRIs). This is a class of drugs that increases the level of serotonin, hence prolonging the time it takes to ejaculate. They may also help increase your sense of control over ejaculation. If deemed medically appropriate, Siena can prescribe you an SSRI medication known as Priligy®, which contains dapoxetine. 

In men who have both PE and erectile dysfunction (ED), ED pills can help. These include sildenafil (Viagra®), also known as the blue pill, as well as avanafil (Spedra®) and tadalafil (Cialis®). These pills improve blood flow to the penis, which is necessary for an erection. 

Not sure if you have ED? Check out our previous blog article to learn more about ED.

Sprays and creams

Some men may find that local anaesthetic sprays and creams help reduce penile sensation, increasing the time to ejaculation. These sprays or creams should be applied onto the head of the penis up to 30 minutes before sex. You should wash the spray or cream off your penis 5 to 10 minutes before sex or put on a condom to prevent absorption of the spray or cream by your partner. Otherwise, it may cause vaginal numbness in your partner during vaginal sex. The condom also helps reduce your penile sensation, ultimately prolonging your time to ejaculation. 

Other tips and tricks to combat premature ejaculation

There are several natural ways to combat premature ejaculation. These include behavioural therapy, psychological therapy, lifestyle changes and even switching up your sex positions and techniques. We’ll save those for the next blog post, so do keep a close lookout for it!

Our final tip to all men with PE is to talk to your partner and seek treatment. Keep in mind that PE does not only affect you, but it can also lead to frustration and feelings of hurt from your partner. This may, of course, be a difficult topic to approach. However, your partner can be a great pillar of emotional support, and an open discussion with your partner will help to pave the way for mutual understanding. 

Lastly, remember that PE can be easily treated. That’s fortunate, but it means nothing if you shun away from seeking treatment. We know that visiting the clinic for treatment can be embarrassing and daunting, and that’s where we step in to help you. At Siena, simply fill up a questionnaire to answer the awkward questions and connect with one of our doctors for a video consultation, all from the comfort and privacy of your own home. 

References

  • What are the DSM-5 diagnostic criteria for premature ejaculation (PE)? Latest Medical News, Clinical Trials, Guidelines – Today on Medscape. (2021, June 4). https://www.medscape.com/answers/435884-30677/what-are-the-dsm-5-diagnostic-criteria-for-premature-ejaculation-pe. 
  • Nazario, B. (2020, July 7). Premature Ejaculation: Symptoms, Causes, Treatment, & Prevention. WebMD. https://www.webmd.com/men/what-is-premature-ejaculation. 
  • NHS. (2019, July 24). Ejaculation problems. NHS Choices. https://www.nhs.uk/conditions/ejaculation-problems/. 
  • Premature Ejaculation. Premature Ejaculation: Causes & Treatment – Urology Care Foundation. (2020, July 16). https://www.urologyhealth.org/urology-a-z/p/premature-ejaculation. 
  • Lowy, M. (2018). Premature Ejaculation Fact Sheet. Healthy Male (Andrology Australia). 
  • Urology Care Foundation. (2020). Premature Ejaculation Patient Guide.