Do you find yourself breaking out 1-2 weeks before your period every month?
It is likely to be hormonal acne, a flare-up of blemishes every month due to a fluctuation in hormonal levels in the body. These may present as large, painful, cystic acne around the chin and jawline.
Less commonly, hormonal acne may be due to an underlying medication condition such as Polycystic Ovarian Syndrome (PCOS).
Why does hormonal acne flare up before my period?
About 2 weeks before your period, the hormones estrogen and progesterone drop dramatically, while you will also experience a slight increase in testosterone.
The drop in estrogen and progesterone can trigger your sebaceous glands to secrete more sebum – an oily substance that lubricates your skin. This oil provides the perfect breeding ground for bacteria, and thus causes clogged pores, pimples and cystic acne (those somewhat painful bumps just under the skin) – usually around the chin and jawline.
While testosterone is thought of as the ‘male’ sex hormone, it exists in slightly differing amounts in everyone. The increase in testosterone can trigger acne by over-stimulating oil glands, which ultimately creates a fertile breeding ground for bacteria on the skin – resulting in clogged pores and period acne. They can also change the skin cells that line hair follicles, making them sticky and more likely to clog pores.
So what can you do about hormonal acne?
For acne that is related to your period, intervention treatment needs to be hormonal as well to work.
Birth control pills or patch
Hormonal birth control – including birth control pills and patches raise estrogen levels and reduce the effects of testosterone on women. Lower levels of testosterone reduce sebum levels, directly reducing breakouts and possible acne due to less oil and bacteria growth.
According to WebMD, hormonal birth control increase a protein known as “sex-hormone binding globulin” (SHBG) in the blood. In turn, SHBG acts like a testosterone sponge soaking up testosterone in your blood. In simple words, lesser testosterone equals lesser sebum which results in less acne.
Be patient when you first start hormonal birth control to control acne. Some women may experience increased breakouts for the first few months. However, this normally goes away as your body adjusts to the change in hormones.
Some birth control pills and patches are specifically useful for controlling acne, including Yaz and Evra Patch. Speak with your doctor before deciding if this is right for you!
Exercise and eat well (Non-hormonal)
Drink more water as the drop in estrogen and increase in testosterone can leave your skin dehydrated and thus susceptible to sebum build-up and clogged pores. Studies have shown dairy products and high glycemic (GI) foods can trigger acne as well, so stay off milk related products and processed foods to keep your skin healthy.
In Singapore, the male condom remains one of the most popular contraceptive options, experts say.
Yes, it happens.
Condoms do not break or slip often. In fact, it most commonly only happens when couples do not follow the recommendations on proper condom use.
Though infrequent, there is a chance that they might occur and being armed with the knowledge is crucial in the event you find yourself in such a situation.
How can you tell if a condom tears or breaks?
Obvious breakage
Sometimes condoms break in the packaging or while they’re being put in place, so it’s a good idea to quickly inspect the condom before putting it on.
If the breakage happens when you’re in the moment, you’ll probably feel (immediate change in sensation for the one wearing it) or see the damage when you or your partner pull away.
However, many people don’t notice that a condom broke until after they’re done having sex. That’s why it’s important that you check the condom when you remove it for any obvious holes or leaks.
Microtear
Microtears are tiny tears not usually visible to the naked eye but can also allow viruses and sperm to pass through. This is rare, especially if you’re using and storing the condom correctly.
In some cases, microtears can be a manufacturer defect, though that’s extremely rare. Manufacturers put condoms through a series of tests to monitor for breaks and defects before selling them.
More often, user error causes microtears. Common mistakes that could lead to microtears include:
using an expired condom
opening condom wrappers with your teeth
putting a condom on the wrong way, then flipping it and reusing it
using a condom that was stored in an unsafe place, like a wallet
using a condom that was exposed to large temperature shifts, moisture, or direct sunlight
using a condom without lubrication, which results in friction that could make the condom break
using oil-based lubes, such as Vaseline, lotion, or coconut oil, which can break down the material the condom is made of (latex or polyisoprene condoms)
How to prevent pregnancy if a condom is torn, broke or slipped?
If you had sex within the last 5 days, you can take an emergency contraception (morning-after) pill, which delivers a high dose of hormones to delay ovulation and prevent a fertilized egg from implanting in your uterus.
The two common types of morning-after pills in Singapore are:
Ulipristal acetate (Ella®)
has to be taken within 120 hours (5 days) after unprotected sex
lowers your chances of getting pregnant by up to 98% throughout the entire five-day window; and
Levonorgestrel (Postinor®-2)
works up to 72 hours after unprotected sex but is generally not recommended after 24 hours
lowers your chances of getting pregnant by 95% if taken within the first 24 hours after unprotected intercourse but this declines to 85% if taken between 25 – 48hours and 58% if taken between 48 – 72 hours after unprotected intercourse.
Generally, it’s important to remember that the EC pill works best the sooner you take it!
Where to get emergency contraception (morning-after) pills in Singapore?
In Singapore, emergency contraception is only available with a prescription.
Consult one of our female doctors via a video call and have youremergency contraception pill delivered to your door.
No waiting time, free 4-hour discreet delivery.
How to prevent HIV if a condom is torn, broke or slipped?
If you believe that you or your partner are at risk of contracting HIV, speak to a doctor immediately to access your situation and suitability for Post Exposure Prophylaxis (PEP) treatment.
PEP is a 28-day course of anti-retroviral medication that can prevent HIV from infecting your body. PEP is only effective within 72 hours after exposure to HIV, but the earlier you begin treatment, the more likely it is to work in full effect.
After which, you will likely need to take HIV tests to ensure the medication has worked.
The bottom line
Condom breakage or slippage can be a stress-inducing accident, but they’re pretty rare, especially if you follow the recommendations on proper condom use.
More often than not, you’ll know if the condom broke — and that means you can quickly take measures to protect yourself.
The morning-after pill, also known as emergency contraception (EC), is often an afterthought, something that comes to mind after accidents happen, or more colloquially “only when you need it”. Some couples though, do keep an extra pill at times because accidents do happen – condom broke during sex, you missed a birth control pill or no birth control was used.
If you’ve never taken emergency contraception before or have read up on it, it’s likely you’ll have lots of questions. What is it, how do you use it, are there any side effects (including fertility), how effective is it and how can I get it?
We understand it can get complicated, and we answer all these questions for you below.
What is the morning-after pill?
The morning-after pill is taken to prevent pregnancy for women who had sex without contraceptive protection – either they didn’t use birth control, they missed a birth control pill, they were sexually assaulted or their primary birth control method failed (e.g. condom broke during sex).
The pill works primarily by preventing or delaying the ovaries from releasing an egg (ovulation).
While the pill is an effective option for preventing pregnancy after unprotected sex, it is intended for backup contraception only, not as a primary method of birth control and offers no protection against sexually transmitted infections (STI).
Is the morning-after pill a form of abortion?
The morning-after pill doesn’t cause abortion or miscarriage. It is not the same as mifepristone or misoprostol, also known as the abortion pill. The abortion pill terminates an established pregnancy — one in which the fertilized egg has attached to the uterine wall and has begun to develop.
How do you use the morning-after pill and what can you expect?
The morning-after pill should be taken as soon as possible after unprotected intercourse. You can take morning-after pills anytime during your menstrual cycle. The contraceptive pill can be taken up to 5 days after unprotected sex, depending on the type of pill you take.
The morning-after pill does not offer lasting protection from pregnancy, do not have sex until you start another method of birth control. Having unprotected intercourse in the period after taking the morning-after pill exposes you to the risk of becoming pregnant.
Your period may be delayed up to a week. If you don’t get your period within 3 to 4 weeks of taking the morning-after pill, take a pregnancy test as soon as possible (you can purchase any test kit at pharmacies like Guardian or Watsons).
How effective is the morning-after pill?
The efficacy of the morning-after pill decreases the longer the period after unprotected sex and the time of taking the pill.
There are two main types of morning-after pills prescribed by doctors:
Ulipristal acetate (Ella®) has to be taken within 120 hours (5 days) after unprotected sex and it lowers your chances of getting pregnant by up to 98% throughout the entire five-day window; and
Levonorgestrel (Postinor®-2) works up to 72 hours after unprotected sex but is generally not recommended after 24 hours. Postinor lowers your chances of getting pregnant by 95% if taken within the first 24 hours after unprotected intercourse but this declines to 85% if taken between 25 – 48 hours and 58% if taken between 48 – 72 hours after unprotected intercourse.
What stops the morning-after pill from working?
If you vomit within 2-3 hours of taking the morning-after pill, it is likely not to work.
What are the side effects of the morning-after pill?
Please make sure you’re not pregnant before using ulipristal as the effects of ulipristal on a developing baby are unknown. If you’re breastfeeding, ulipristal isn’t recommended as the effect on newborns/infants has not been studied.
The levonorgestrel emergency contraceptive pill is safe to take at any time after having a baby. It will not affect your breast milk.
If you notice spotting that lasts longer than a week or develop severe lower abdominal pain 3-5 weeks after taking the morning-after pill, speak to your doctor. These can indicate a miscarriage or that the fertilized egg has implanted outside the uterus, usually in a fallopian tube (ectopic pregnancy).
Side effects of the morning-after pill, which typically last only a few days, might include:
Nausea or vomiting
Dizziness
Fatigue
Headache
Breast tenderness
Bleeding between periods or heavier menstrual bleeding
Lower abdominal pain or cramps
Does the morning-after pill affect fertility?
Misinformation about the morning-after pill is often spread unwittingly.
The 2020 Fact Not Fiction survey in the UK found that 51% of the respondents said they believed you shouldn’t take emergency contraception more than once in the same cycle and 40% of respondents believed the morning-after pill can make you infertile if you use it too many times (fiction).
The reality is using emergency contraception will not affect your future fertility and won’t stop you from getting pregnant in the future.
How to get the morning-after pill in Singapore?
In Singapore, emergency contraception is only available with a prescription and any woman, regardless of age, can get the drug from a doctor or GP subject to a consultation.
At Siena, we provide online emergency contraceptionconsultation with one of our female doctors so that you can get access to the care you need from the comfort and privacy of your home. If prescribed, we deliver your emergency contraception right to your doorstep in a discreet packaging, in 4 hours.
Birth control, also known as contraception, anti-conception, and fertility control, is a method or device used to prevent pregnancy. Although birth control has been used since ancient times, effective and safe contraception methods only became available in the 20th century.
Birth Control in Singapore
One of the most commonly practised birth control methods in Singapore is the rhythm method (sex only while you’re not ovulating) and withdrawal (pull out) method, which is not super effective. After all, sperm can be extremely tricky – they can live inside the vagina and the rest of the reproductive tract for up to around six days.
Another common method is male condoms. Condoms can be readily bought at any convenience store or supermarket and offer protection against sexually transmitted infections (STIs). However, they are only about 85 percent effective in preventing pregnancies (one of the lowest). The effectiveness of condoms depends on when and how it is put on and there is also a risk of condoms tearing during sex.
There are other birth control methods that have higher success rates – but they can cost more money, take more discipline to use or require more commitment. All require a doctor’s prescription after a thorough consultation.
Types of Birth Control Methods
These contraception options can be split into 2 major categories – Temporary and Permanent.
Contraception
Temporary (Reversible)
Permanent
Method
Hormonal birth control (Short-acting) – Birth control pill – Birth control patch – Contraception injection
Intrauterine device (Long-acting)
Tubal ligation
To help you along, we discuss the common contraceptive methods in Singapore, their mode of action, effectiveness, pros and cons. Here’s what every responsible man and woman should know.
1. Birth control pill
Birth control pill
What is birth control pill?
Birth control pills are medications you take by mouth to prevent pregnancy. Hormones in the pills prevent pregnancy by:
stopping or reducing ovulation (the release of an egg from an ovary)
thickening cervical mucus to keep sperm from entering the uterus
thinning the lining of the uterus so that a fertilized egg is less likely to attach
Effectiveness:
Used perfectly, most birth control pills are 99 percent effective at preventing pregnancy. In “real life” conditions (e.g. occasional missed or late dose), the birth control pills are about 91 percent effective.
Pros:
you don’t need to use the pill every time you have sex in order to stay protected, unlike condoms
fertility returns immediately when you stop taking it
lower risk of ovarian and endometrial cancer
non-contraceptive benefits such as:
helping to regulate the menstrual cycle;
manage acne; and
improve PMS symptoms.
Cons:
not for those who hate popping pills
have to take the pill every day for it to work properly
not suitable for women with certain existing health problems, or medications
2. Birth control patch
Birth control / contraceptive patch
What is birth control patch?
The birth control patch is a thin skin patch that is worn anywhere on the abdomen, thigh, buttocks or arm and changed weekly. The patch releases a daily dose of hormones (estrogen and progestin) through the skin into the bloodstream to prevent the ovaries from releasing eggs each month (ovulation). It also thickens the cervical mucus, which keeps sperm from getting to the egg. (Source: MayoClinic)
Effectiveness:
Used perfectly, most birth control patches are 99 percent effective at preventing pregnancy. In “real life” conditions (e.g. forget to replace the patch or patch is not stuck properly), the birth control patches are about 91 percent effective.
Pros:
good alternative for people who find pill-popping a hassle
Cons:
the patch is not transparent
might be uncomfortable due to Singapore’s hot and humid weather
some women get insecure because they are unsure if it will fall off
3. Contraceptive injection
Contraceptive injection
What is contraceptive injection?
The contraceptive injection is a shot of hormones given by your GP or gynae to prevent ovulation and has to be repeated every 90 days.
Effectiveness:
Used perfectly, most contraceptive shots are more than 99 percent effective at preventing pregnancy. In “real life” conditions (e.g. missed or late shots), the contraceptive shots are about 94 percent effective.
Pros:
good alternative for people who find pill-popping or changing patches a hassle
suitable for breastfeeding mums
light or possibly no periods after a year
Cons:
weight gain and irregular bleeding in the first three months are possible as your body adjusts
takes 6 to 12 months to regain fertility after you stop the injections
4. Intrauterine device (IUD)
Intrauterine device (IUD)
What is IUD?
An IUD, or the coil, is a small T-shaped device that is inserted and left in your uterus to prevent pregnancy. Some IUD types work by releasing small amounts of hormones, while others use copper to trigger your immune system to prevent pregnancy.
Effectiveness:
More than 99 percent effective at preventing pregnancy
Pros:
can be left in the womb for up to five years
fertility returns immediately once you remove it
Cons:
may cause irregular bleeding or spotting
usually not recommended as the first choice for anaemic women or those who have heavy periods
there is a small risk that the IUD may fall out and cause an infection during the insertion (in rare instances)
difficulty in removing the device.
5. Tubal ligation
Tubal ligation
What is Tubal Ligation?
During a tubal ligation (female sterilization), the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy. Tubal ligation prevents an egg from travelling from the ovaries through the fallopian tubes and blocks sperm from travelling up the fallopian tubes to the egg. (Source: Mayo Clinic)
Effectiveness:
More than 99 percent effective at preventing pregnancy
Pros:
a good option for women who are certain that they no longer want more children
does not affect your hormone levels and you’ll still have periods
Cons:
irreversible
small risk of complications as with any surgery, such as internal bleeding, infection or damage to other organs
Which Birth Control Method Is Right for Me
When it comes to birth control, you have options and there are no bad options.
What suits you will depend on factors such as your age, frequency of sexual activity, family history regarding certain illnesses, comfort level when using a particular method, and level of desire to be pregnant in the future.
And remember, you don’t have to figure it out all on your own. Before settling on any option, do your own research or speak with your doctor to figure out which contraceptive will work best for you.
At Siena, you can speak to one of our female doctors in the privacy and comfort of your home, order your contraceptives online and get them delivered to your door in discreet packaging. Feel free to reach out!
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