Categories
Sexual Health

Oral and Genital Herpes: Causes, Symptoms and Treatments in Singapore

Oral & Genital Herpes: Causes, Symptoms and Treatments in Singapore

Herpes is one of the most common sexually transmitted diseases (STDs) in Singapore. There is currently no cure for herpes, so people who are infected have it forever.

However antiviral medications are available to treat sores, speed up the healing process, limit outbreaks and lower your chances of giving the virus to other people. And the good news is, outbreaks usually become less frequent over time, and even though herpes can sometimes be uncomfortable and painful, it’s not dangerous. People with herpes can have relationships, have sex and live totally normal lives.

In this article, we will discuss the:

  • Types of herpes (oral & genital herpes);
  • How do you get herpes;
  • Symptoms of herpes;
  • How to prevent herpes;
  • Available treatments for herpes in Singapore.

What Is Oral & Genital Herpes?

Herpes is a contagious viral infection caused by the herpes simplex virus (HSV). There are notably two members of this family: HSV-1 and HSV-2.

  • HSV-1: This type primarily causes oral herpes, characterized by cold sores or blisters inside of/around the mouth and on the face.
  • HSV-2: This type primarily causes genital herpes, which involves sores that appear on or around your genitals, anus, buttocks, and inner thighs. Sores can also develop inside the vagina.

How Do You Get Herpes?

Herpes spreads through close contact with a person who has the infection. The virus can be found in the skin and saliva. If you have herpes simplex, you are most likely to pass the virus to another person when you have sores. But you can infect someone else even if you have no symptoms (also known as asymptomatic viral shedding).

People may transmit or contract HSV-1, or oral herpes, through

  • Kissing.
  • Touching a person’s skin near the mouth.
  • Sharing food utensils, lip balm or razors.
  • If you receive oral sex from someone who has a cold sore, it may spread a herpes infection to your genitals.

People may transmit or contract HSV-2, or genital herpes, through

  • Intercourse, including anal, vaginal-penile and vaginal-vaginal.
  • Oral sex (giving or receiving) with someone who’s infected.
  • Skin-to-skin contact without ejaculation.
  • Touching open sores, including while breastfeeding.
  • Childbirth by a mother or gestational parent who has an active infection.

Symptoms Of Herpes

Most people infected with HSV may experience mild to no symptoms, leaving them in the dark about their infection, or even mistaking these signs as a skin condition instead. This is when transmission usually occurs as the individuals will dismiss the symptoms and leave the infection untreated while continuing to engage in sexual intercourse.

This is why it is useful to know the hallmarks of a herpes infection so that you can seek help as soon as possible. Here are some common signs that you can look out for:

  • Cold sores around lips, mouth or tongue. They may look crusty or like fluid-filled blisters;
  • Sores on their genitals, anal and surrounding areas;
  • Tingling, itching or burning;
  • Pain on urination;
  • Flu-like symptoms (headache, fever, muscle aches); and
  • Swollen lymph nodes in the groin area.

What Triggers A Herpes Outbreak?

Herpes infection is lifelong, and symptoms can recur over many years. A herpes outbreak may be triggered by:

  • Stress;
  • Menstruation;
  • Illnesses;
  • Surgery; or
  • A suppressed immune system (due to chemotherapy, AIDS, transplant etc.)

While some people may only have one outbreak during their lifetime, others may have several recurrences a year. Recurrent episodes are usually shorter in duration (usually 1 week) and less severe/painful than the initial episode. Though the virus will always be present in the body, the number of outbreaks often decreases over the years.

How To Prevent Giving Or Getting Herpes

The best way to avoid herpes is by practising abstinence (not engaging in sexual intercourse) but most people have sex at some point in their lives. Here are some ways that can help lower the risk of giving or getting herpes:

  • Always use protection like condoms and dental dams when having sex can lower your risk of giving or getting herpes.
  • Taking antiviral medication every day (preventive treatment) inhibits the activity of the virus, thereby lowering the risk of infecting partners.
  • Abstain from sexual activity when you feel a herpes outbreak coming or during a herpes outbreak, even with a condom. There may be sores on places the condom doesn’t cover (e.g. scrotum, butt cheeks, upper thighs, and labia).
  • Abstain from sexual activity sex until your sores are totally gone, and the scabs heal and fall off.
  • Avoid touching your sores and if you do, wash your hands with soap and water immediately.
  • If you have a cold sore on your mouth, don’t kiss anyone — especially babies, children, or pregnant women.
  • Always tell your sexual partners that you have herpes before you have sex, so you can work together to prevent it from spreading.
  • Encourage your sexual partner(s) to be evaluated and treated for any STDs as well.

Treatment For Herpes In Singapore

There is currently no cure for herpes but prescription antiviral medication (Acyclovir) can be used to stop the spread of the herpes virus in the body. This helps to lessen symptoms, speed healing of your infection, limit outbreaks and lower your chances of giving the virus to other people

Topical antiviralsOral antivirals
– Temporarily relieve the pain and discomfort and may help the sores (if any) heal faster
– Most effective when used at the start of an outbreak		– If you have frequent or severe recurrence, a daily dose will help to prevent them (suppressive therapy)
– If you have occasional outbreaks, start treatment when you feel one coming on (episodic therapy)
Prescription antiviral medication (Acyclovir) and how to use them

Where Can I Buy Antiviral Medication For Herpes In Singapore?

Topical and oral antiviral medications are only available with a prescription from a licensed doctor in Singapore. 

With MOH-approved telemedicine providers like Siena, you can now get your herpes treatments discreetly, conveniently, and inexpensively, all from the comfort of your home! Connect with one of our doctors via an online video consultation and if prescribed, we deliver your treatment plan right to your door in discreet packaging at $0.

References

Categories
Health Weight Loss

Duromine vs Panbesy: Which Is More Effective For Weight Loss?

Duromine vs Panbesy: Which Is More Effective For Weight Loss?
Image credit: Siena Health

Fat burners, calorie cutters, and appetite suppressants are just a few of the common claims made by the many weight-loss supplements on the market. It makes sense if you are hesitant to try them, especially if you are unsure about their success rates and side effects.

Fortunately, there are several FDA-approved, scientifically-proven prescription medications that can improve your chances of dropping those pounds — and keeping them off. Among them are two brands that are available in Singapore, Duromine and Panbesy.

So, what are their differences and which is better for weight loss? Read on to find out.

What Are The Similarities Between Duromine and Panbesy?

Duromine and Panbesy contain the same active ingredient, phentermine. 

Phentermine is an anorectic agent (an agent that suppresses appetite). It works by stimulating the release of chemical messengers or neurotransmitters (i.e. norepinephrine, serotonin, and dopamineare) in the brain. With the increase in the levels of these chemicals in your brain, you feel full and therefore eat less. Over time, this can lead to weight loss, especially if accompanied by a proper diet and exercise.

Who Is Duromine/Panbesy Typically Prescribed To?

Like other prescription weight-loss drugs, Duromine/Panbesy is intended to be used as part of an overall weight-loss plan. Use of prescription weight-loss medications is typically reserved for people who:

  • Have a BMI of 30 or greater (severe obesity); or
  • Have a BMI of 27 or greater (moderate obesity) with the presence of a weight-related disease or complication such as Type 2 diabetes, high cholesterol, or high blood pressure

It is indicated for people who are obese, and who have failed to lose enough weight with diet and exercise alone — not for people who want to lose just a few pounds.

How Much Weight Can You Lose On Duromine/Panbesy?

Several clinical studies have shown that Duromine/Panbesy can support meaningful weight loss.

One small study from South Korea showed that almost 86% of people who were overweight or obese taking phentermine for 14 weeks lost more than 5% of their body weight. Another South Korean study looked specifically at people who have obesity (not overweight) and used phentermine for a 12-week course. It found that almost 96% of them lost more than 5% of their body weight, and 62% of the same group lost more than 10% of their body weight.

While Duromine/Panbesy is FDA-approved for short-term use of fewer than 12 weeks, healthcare professionals often prescribe phentermine off-label for longer use. Doctors may prescribe it intermittently, meaning you take a break from the medication for a set period of time before resuming it.

What Are The Side Effects Of Duromine/Panbesy?

The most commonly reported side effects of Duromine/Panbesy are:

  • dry mouth
  • insomnia
  • dizziness
  • heart palpitations
  • skin flushing
  • fatigue
  • constipation
  • irritability
  • nausea
  • vomiting

Just like all other medications, not everyone will experience side effects after taking Duromine/Panbesy. The severity of the side effects differs among individuals as well.

What Is The Difference Between Duromine and Panbesy?

The main difference lies in how phentermine is present in the two products.

Each Duromine capsule contains phentermine enclosed in a complex, released continuously over a 10 to 14 hour period. Meanwhile, phentermine in Panbesy exists as an ion and is absorbed over 3 to 4.4 hours.

There will be a longer-lasting and equal appetite suppression throughout the day with  Duromine as phentermine is released more slowly. On the other hand, all of the phentermine present in a Panbesy capsule is released at once and appetite suppression will subside gradually with time, therefore its effect is not as long-lasting.

Since phentermine is slowly absorbed into your bloodstream in smaller amounts after taking Duromine, the risk of side effects is lower. There will be higher levels of phentermine in the bloodstream initially with Panbesy as everything is released at once. This translates to a higher risk of side effects when taking Panbesy.

Which Is Better, Duromine vs Panbesy?

Ultimately, both medicines are approved for weight loss in obese people who have other risk factors like controlled hypertension. They are two of the most established weight loss pills frequently prescribed by doctors. Duromine and Panbesy, based on the same active ingredient used, have similar effectiveness – more than 5% body weight lost in 12 weeks on average.

If you are looking for a medicine that has a longer-lasting effect in curbing your appetite, Duromine is definitely the more outstanding candidate.

Where To Buy Duromine Or Panbesy In Singapore?

Being obese puts you at risk for more health complications, like diabetes and heart disease. When you don’t see the desired weight loss results despite efforts to change your diet or lifestyle, seeking professional help may be necessary as reducing the risk of more serious health complications as soon as possible is the top priority.

There are many websites selling Duromine, Panbesy and other anti-obesity medications which may not be scientifically proven to be safe or effective. However, do not fall into the trap of convenience of purchasing these medicines from unreliable sites and sellers! Remember that you can only obtain such medications if a qualified doctor prescribes them to you and you should only take them according to his instructions.

If you’re looking for convenience and getting approved medications for weight loss, turn to Siena instead! Gone are the days when you have to wait in line to visit the doctor. With us, you can speak to an SG-registered doctor about your weight loss issues online via a teleconsultation. We’ll deliver the medicines to your home if prescribed, in discreet packaging and at no additional cost. Simply complete this online questionnaire to get started today!

References

  • Ding H (2016). Modified-release drug products and drug devices. Shargel L, & Yu A.C.(Eds.), Applied Biopharmaceutics & Pharmacokinetics, 7e. McGraw Hill. Accessed December 17, 2021.
  • Kim, H. O., et al (2013, September). Postmarketing surveillance study of the efficacy and safety of phentermine in patients with obesity. Korean journal of family medicine, 34(5), 298–306. https://doi.org/10.4082/kjfm.2013.34.5.298 
  • MIMS. Phentermine: Indication, Dosage, Side Effect, Precaution.https://www.mims.com/singapore/drug/info/phentermine
Categories
Birth Control

EVRA® Transdermal Birth Control Patch: How It Works, Potential Side Effects And Where To Buy In Singapore

EVRA® Transdermal Birth Control Patch: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

Do you find it difficult to remember to take a pill every day? Do you have difficulty swallowing pills?

If you answered yes to any of the above questions, the birth control patch could be a viable option for you! Both birth control pills and patches use hormones to prevent pregnancy, but the way the hormones are delivered differs. You apply the patch to your skin once a week and forget about it.

In this article, we share all you need to know about the EVRA® Transdermal Patch. Read on to learn more about:

  • How it works;
  • How to use it; 
  • What to do if you missed a patch;
  • Potential side effects; and
  • How to buy EVRA® Transdermal Patch in Singapore.

What Is EVRA® Transdermal Patch? 

The EVRA® Transdermal Patch is a small, beige sticky patch that contains 2 hormones:

  • Progestin (6mg norelgestromin); and
  • Estrogen (0.6mg ethinyl estradiol).

The patch works by releasing hormones into your body through your skin to prevent pregnancy.

The patch is mainly used as contraception to prevent pregnancy. However, women using the EVRA® Transdermal Patch may also benefit from the non-contraceptive effects of estrogen such as:

How Does EVRA® Transdermal Patch Work? 

After the patch is in place, it delivers a steady dose of hormones through your skin and into your bloodstream.

EVRA® Transdermal Patch prevents pregnancy by:

  • Inhibiting ovulation, the release of an egg from the ovary;
  • Thickening the cervical mucus (the fluid in the vaginal tract), such that it is hard for the sperm to reach the egg to fertilise it;
  • Thinning of the uterine lining, such that even if an egg is fertilised, it will be unable to attach to the uterus. The fertilised egg will instead be passed out of the body.

How Effective Is EVRA® Transdermal Patch?

When used perfectly, EVRA® Transdermal Patch is more than 99% effective in preventing pregnancy. It is typically 91% effective (in events of missed applications or improper storage etc.), according to a report by the Centers for Disease Control and Prevention.

Birth control patches are generally more effective than male condoms in preventing pregnancy — male condoms are 98% effective when used perfectly, and 82% effective in typical use. However, it is important to note that birth control patches do not protect women against sexually transmitted infections (STIs), unlike male condoms.

Therefore, it is recommended to use dual protection of condoms and non-barrier contraceptives such as birth control patches during any sexual activity.

How To Use EVRA® Transdermal Patch?

Each pack of EVRA® Transdermal Patch contains 3 patches. Apply your first patch and wear it for 7 days. On day 8, change the patch to a new one. Change the patch every week for 3 weeks, and then have a patch-free week.

During your patch-free week, you’ll get a withdrawal bleed, like a period, although this may not always happen.

After 7 patch-free days, apply a new patch and start the 4-week cycle again. Start your new cycle even if you’re still bleeding.

Where to put the patch:

  • ​Always put your patch on clean, dry and hairless skin.
  • Put it on the buttock, abdomen, upper outer arm or upper back.
  • Put it on places where it won’t be rubbed by tight clothing.
  • Do not put on the breast or waistline, and on any open wounds, cuts or irritated skin.
  • Do not use adhesive or wraps to hold the patch in place.
  • Do not use creams, oils, lotions, powder or other skin care products on the application site. The patch may not stick well.

How to open the patch:

  • Open the foil sachet by tearing it along the edge with your fingers.
  • Peel away half of the clear protective covering without touching the sticky surface.

How to put the patch:

  • Put the patch on your skin and remove the other half of the protective covering.
  • Press down firmly on the patch with the palm of your hand for 10 seconds, making sure the edges stick well.

What To Do If The Patch Becomes Loose, Lifts At The Edges Or Falls Off?

Usually, the patch remains sticky, even if you get sweaty while exercising or take a shower. On rare occasions where the patch loosens (less than 3% of patches) or falls off (less than 2% of patches), you can follow the below steps to ensure you are still protected against pregnancies.

For less than 48 hours:

  • Try to put the same patch on again or put on a new patch immediately if:
    • it is no longer sticky;
    • it has become stuck to itself or on another surface or material; or
    • it is the second time it has become loose or has fallen off.
  • Change your patch on your normal change day.
  • You’re protected against pregnancy if you’ve used your patch correctly for the past 7 days (and the 7 days before your patch-free week, if you’re in week 1).

For 48 hours or more, or if you are unsure of the duration:

  • Put on a new patch immediately.
  • If you’re in week 1 or 2 of your patch cycle, change your patch on your normal change day.
  • If you’re in week 3, you need to start a new patch cycle (this is now day 1 of your new cycle) and skip your usual patch-free week.
  • Consider taking emergency contraception if you had unprotected sex in the last 7 days.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.

What To Do If I Forget To Change My Patch?

If you forget to change your patch for one to two days (up to 48 hours): 

  • Put on a new patch as soon as you remember.
  • Change your patch on your normal change day.
  • A barrier method of contraception is not needed.

If you forget to change your patch for more than two days (48 hours or more): 

  • Start a new four-week cycle as soon as possible.
  • Consider taking emergency contraception if you had unprotected sex in the last 7 days.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.

If you forget to take off your patch (at Week 4): 

  • Take it off as soon as you remember.
  • Start your next cycle on your normal “Patch Change Day”, the day after Day 28.
  • A barrier method of contraception is not needed.

If you forget to take off your patch (after Week 4):

  • Take it off as soon as you remember.
  • Put on the first patch of your new cycle as soon as you remember.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.
  • You now have a new “Patch Change Day” and new Day 1.

What Are The Potential Side Effects Of EVRA® Transdermal Patch?

Women who just started using EVRA® Transdermal Patch may experience some of the following side effects:

  • Nausea and bloating. Taking the medication after food may help reduce these side effects. 
  • Headache. Taking over-the-counter painkillers such as Paracetamol may help manage the pain.
  • Vaginal bleeding between periods (spotting).
  • Breast soreness.
  • Mood changes.

These symptoms vary among individuals and normally subside within 2-3 months as your body starts to get accustomed to the changes in hormone levels. Do inform your doctor if you experience any of these symptoms for longer than expected or if they are bothering you.

How To Buy EVRA® Transdermal Patch In Singapore?

Birth control patches are prescription-only medicines in Singapore. You would need to consult a doctor in person before you can get started on any birth control.

With Siena, you can have access to affordable birth control without leaving home. Simply complete an online questionnaire, and speak with a doctor online. If prescribed, your medication will be delivered to you in discreet packaging and at no additional charge.

References

Categories
Skin

Isotretinoin for Acne: How It Works, Potential Side Effects And Where To Buy In Singapore

Isotretinoin for Acne: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Gabriella Cetrulo

Acne is a common skin condition that affects over 80 percent of people at some point in life. 

While over-the-counter acne treatments are usually successful for light acne breakouts, many products that are great for milder forms of acne are almost totally ineffective against severe or persistent pimples. 

Commonly known by its original brand name Accutane, Isotretinoin is a potent drug that is U.S. Food and Drug Administration (FDA) approved in 1982 for hard-to-treat acne.

Read on to find out:

  • What is Isotretinoin;
  • How does Isotretinoin works;
  • How effective is Isotretinoin;
  • How to take Isotretinoin;
  • What to do if you missed a dose;
  • Potential side effects;
  • Pregnancy precautions; and
  • Where to buy Isotretinoin in Singapore.

What Is Isotretinoin?

Isotretinoin is available in capsule form and is a vitamin-A derivative (retinoid). Originally created to treat cancer, it is increasingly prescribed for the treatment of acne.

What Are The Requirements For Taking Isotretinoin?

Isotretinoin is typically used for patients with:

  • Severe, nodular acne or cystic acne; or 
  • Moderate to severe acne that has not responded to other acne treatments (such as over-the-counter treatments, topical benzoyl peroxide, topical clindamycin or oral antibiotics for acne); or 
  • Physical or emotional scarring.

What Is Moderate And Severe Acne?

In moderate acne, individuals present with more widespread blackheads and whiteheads, with many papules and pustules. Papules are small red bumps that may feel tender or sore. Pustules are similar to papules but have a white tip in the centre, which is a collection of pus.

In severe acne, individuals present with lots of large, painful papules, pustules, nodules or cysts; you might also have some scarring. Nodules present as large painful bumps and can be red or skin-coloured. Cysts are the most severe forms of acne. They are large and painful and often look like boils. Compared to nodules, cysts feel softer and are pus-filled.

What Is The Right Isotretinoin Dosage?

In Singapore, oral isotretinoin is available as 10 mg and 20 mg capsules (Acnotin® brand). Depending on your acne presentation and body weight, the dosage and treatment period required to treat the acne may vary among individuals. Many doctors start their patients on a graduated plan to help mitigate side effects and allow the body to adjust.

Which Brand Of Isotretinoin Is Better?

There are 4 brands of isotretinoin available in Singapore – Acnotin®, Nimegen®, Oratane® and Roaccutane®.

While the brand names are different, all of them contain isotretinoin as the active ingredient and are used for the treatment of moderate to severe acne, which has shown to be successful. They may differ slightly in the inactive ingredients but have little to no impact on the effectiveness of treatment.

How Does Isotretinoin Work?

Isotretinoin works by:

  • Reducing the size of oils glands in the skin and the amount of oil produced
  • Reducing the amount of bacteria in the skin
  • Slowing down the production of skin cells inside pores, preventing clogging of pores
  • Reducing skin inflammation

Unlike spot treatments, the drug addresses acne all over the body, including back, neck, and chest.

How Effective Is Isotretinoin?

First approved in 1982, Isotretinoin remains the most clinically effective prescription anti-acne treatment available that can clear acne and produce long-term remissions.

Isotretinoin is shown to be about 90% effective in reducing acne within 6 weeks of use. Most patients on Isotretinoin will be free of acne by the end of 4 – 6 months of treatment, depending on the dose administered.

How To Take Isotretinoin?

Follow these steps when you are taking Isotretinoin capsules:

  • Isotretinoin is usually taken twice daily for 15-20 weeks, or as directed by your doctor.
  • Swallow the capsule whole with a glass of water.
  • Do not chew or crush the capsule.
  • Take this medication with or after food.

What To Do If I Missed My Isotretinoin Capsule?

If you have forgotten to take a dose of Isotretinoin, take it as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and take the next one at the usual time.

Do not take two doses to make up for the missed dose.

What Are The Potential Side Effects Of Isotretinoin?

As with all medications, Isotretinoin comes with its own set of side effects. These side effects may vary among individuals and tend to subside when you stop taking the medication.

Here are some of the common side effects associated with Isotretinoin:

  • Worsening of acne during the first few weeks before improvement
  • Red, cracked and sore lips. This can be managed by applying lip balm frequently.
  • Irritated and dry eyes. Apply eye drops or artificial tears to relieve the dryness. Do not use contact lenses if irritation persists.
  • Dry skin, sometimes with peeling. Apply moisturiser regularly.
  • Dry mouth. You may drink more water or suck on sweets.
  • Dry nose. In severe cases, nose bleeding may occur. Apply white soft paraffin to the lining inside of your nose. If unresolved, consult your pharmacist or doctor about decreasing the dose of Isotretinoin.
  • Increased risk of sunburn. Avoid direct sun exposure for long durations and wear protective clothing if exposed to direct sunlight. Use a broad-spectrum sunscreen product with a Sun Protection Factor (SPF) of at least 30.

Do not take vitamin A or any vitamin supplement containing vitamin A while using Isotretinoin, unless otherwise directed by your doctor. Doing so may increase the chance of side effects.

If these side effects are persistent or severe, stop treatment immediately and consult your doctor.

Pregnancy Precautions

Isotretinoin can cause very serious birth defects in humans if taken during pregnancy.

Women of childbearing years should rule out pregnancy by taking a pregnancy test before starting treatment. 

For women who are sexually active, it is recommended to use 2 forms of effective birth control while on treatment and at least 4 weeks after stopping Isotretinoin. The most effective forms of birth control are birth control pills, patches, shots, implants or IUD. One of these forms of birth control should be combined with a condom, a diaphragm, or a cervical cap.

Avoid breastfeeding during treatment as it’s unclear if the drug passes to your baby through breast milk.

Blood donation by males and females on Isotretinoin is not allowed in case the blood is used for a pregnant woman.

Where To Buy Isotretinoin In Singapore?

In Singapore, Isotretinoin can only be obtained with a valid doctor’s prescription. 

While extremely effective, Isotretinoin can come with some serious side effects. It is important to use Isotretinoin under the supervision of a doctor. 

At Siena, a MOH-approved digital health clinic, we carry a wide range of acne treatments ranging from topical cream/gel, oral antibiotics, birth control pills to Isotretinoin (Acnotin®). Find out the root cause of your pimples and get a personalised, ongoing acne treatment care plan by connecting with one of our friendly doctors online. Click here to get started!

References

Categories
Emergency Contraception

Ella® or Postinor®-2: How Are They Different and Which Emergency Contraception Is Better?

Ella® or Postinor®-2- How Are They Different and Which Emergency Contraception Is Better?
Image credit: Siena Health

Accidents happen, like the condom broke during sex, or you missed a birth control pill. This is when the morning-after pill, also known as emergency contraception, comes to mind. 

We all want our medications to work but many factors can affect the effectiveness of our medications. With emergency contraception, we will understandably be more concerned as the stakes are much higher.

Emergency contraception is available in two types: Ella® and Postinor®-2 (also known as Plan B). Some questions may then surface: What is the difference between Ella® or Postinor®-2? Which one is better at preventing pregnancy after sexual intercourse? Which one is more suitable for me?

In this article, we will discuss the main differences between Ella® and Postinor®-2.

Differences Between Ella® and Postinor®-2

There are 3 main differences between Ella® and Postinor®-2:

  1. Effectiveness and when they are most effective;
  2. Active ingredient; and
  3. Body Mass Index (BMI)

Effectiveness and when they are most effective

The key difference between Ella® and Postinor®-2 is the effectiveness at preventing pregnancy and when they should be taken after sexual intercourse to experience the maximum benefit.

Ella® is 98% effective at preventing pregnancies up to 120 hours (5 days) after unprotected sex and does not lose effectiveness over that time.

Postinor®-2 is only effective up to 72 hours (3 days) after unprotected sex and is less effective the later you take it in that 72-hour window:

  • 95% effective if taken within first 24 hours
  • 85% effective if taken within between 24-48 hours
  • 58% effective if taken within between 48-72 hours

Ella® reigns superior in terms of effectiveness and longevity. In comparison, Postinor®-2 is most effective only when it is taken within 24 hours after sexual intercourse.

Nevertheless, it is still recommended to take emergency contraceptive pills as soon as possible after sexual intercourse, to reduce the likelihood of pregnancy as much as possible.

Active Ingredient

The greatest difference between the two pills is the active ingredient used. Though using different modes of action, both pills ultimately prevent pregnancy.

The active ingredient present in Ella® is ulipristal acetate, a Selective Progesterone Receptor Modulator (SPRM). It suppresses the release of progesterone, a hormone involved in the menstrual cycle, for an extended duration. This results in a delay or inhibition in the release of an egg (ovulation). During this period, sperms which have entered the woman’s body will die. Over time, when the effects of Ella® wane and progesterone levels increase to release an egg, there is no remaining sperm to fertilise it.

On the other hand, levonorgestrel in Postinor®-2 is the active ingredient that prevents pregnancy. Levonorgestrel is a progestogen, which mimics the effects of progesterone. With higher levels of progesterone, effects include:

  • Inhibiting implantation of the fertilised egg on the uterine lining;
  • Stimulating the motility of the fallopian tube;
  • Increasing the viscosity of the cervical mucus, preventing the sperm from reaching the egg.

Body Mass Index (BMI)

Another important factor to consider when deciding between Ella® and Postinor®-2 is BMI. Differences in treatment effectiveness are significant for women with higher BMI.

Evidence has shown that, in general, the risk of pregnancy is much greater in obese women with BMI above 30 as compared to women with normal BMI. Comparing Ella® and Postinor®-2 in obese women, the risk of pregnancy is greater for those taking Postinor®-2.

Which Emergency Contraception Is Better?

There is no definite answer to this question.

Though both Ella® and Postinor®-2 are effective at preventing pregnancy, it is important to consider your circumstances, needs and preferences to decide which emergency contraceptive pill is better suited for you.

How To Get Emergency Contraception In Singapore?

In Singapore, regardless of age, women can only obtain emergency contraception with a valid prescription by a doctor (usually a general practitioner can help).

Need emergency contraception? As a MOH-approved digital health clinic, Siena offers online emergency contraception consultation with one of our friendly doctors, all from the comfort and privacy of your home. If prescribed, the emergency contraception will be delivered in discreet packaging to your doorstep, in 4 hours.

No more rushing, no more panicking!

References

Categories
Birth Control

Yaz® Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore

Yaz® Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

From birth control pills and patches, to condoms and intrauterine devices (IUD) — have you ever been at a crossroad, debating about which contraceptive to use? If you decided to take “the pill”, then have you ever wondered which one is most suitable for you out of so many brands available?

With a myriad of contraceptive methods available in Singapore, we will be sharing more about some of the more commonly used ones. In this article, we share more about Yaz®:

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Yaz® in Singapore.

What Is Yaz®? 

Yaz® is a brand-name combination birth control pill containing 2 hormones:

  • Progestogen (3mg drospirenone); and
  • Estrogen (0.02mg ethinylestradiol).

Drospera® is a generic version of the brand-name drug Yaz®.

On top of preventing unwanted pregnancies, Yaz® is also FDA-approved to:

  • Treat moderate acne in women who are at least 14 years old and have started having menstrual periods, and who wish to start on birth control pills; and
  • Manage symptoms of premenstrual dysphoric disorder (PMDD).

Some women also take Yaz® for other non-contraceptive purposes such as to:

How Does Yaz® Work? 

Yaz® prevents pregnancy by:

  • Inhibiting ovulation, which is the release of an egg from the ovary;
  • Thickening of the cervical mucus (the fluid in your vaginal tract) which serves as an impedance for the sperm making its way to the egg for fertilisation; and
  • Thinning of the uterine lining, which prevents the fertilised egg from attaching to the uterus, and it would be passed out of the body instead, preventing pregnancy.

How Effective Is Yaz®?

A report by the Centers for Disease Control and Prevention shows that Yaz® is more than 99% effective in preventing pregnancy when used perfectly. However, missed pills and improper storage may occur day-to-day. Hence, in typical use, Yaz® is around 91% effective. 

This shows that birth control pills are more effective than male condoms in preventing pregnancy, with male condoms being 98% effective when used perfectly, and 82% effective in typical use. However, birth control pills do not protect against sexually transmitted infections (STIs), which male condoms do.

Therefore, always use dual protection of condoms and non-barrier contraceptives such as birth control pills during any sexual activity.

How To Take Yaz® Birth Control Pills?

Yaz® contains a total of 28 tablets: 24 pink (active) tablets and 4 white (inactive, hormone-free) tablets. You should take one tablet daily for 28 days in a row, preferably at the same time every day after food, in the correct sequence as indicated on the packaging.

The next pack of Yaz® is immediately started after the last tablet of the previous pack. Withdrawal bleeding (menses) usually starts during the week when you are taking the white tablets.

What To Do If I Missed My Yaz® 30 Birth Control Pill?

It is considered a missed dose, if:

  • you missed a dose for more than 24 hours after your usual time when a tablet is supposed to be taken; or
  • vomiting or diarrhoea occurs within 3 to 4 hours following pill taking.

Missed white film-coated tablets can be disregarded. However, you must follow the steps below if you miss any 24 pink (hormone-containing) tablets to ensure that the contraceptive effect is not reduced.

If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill:

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately.
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day).
  3. Take the 4 inactive pills.
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle.
  5. No additional contraceptive protection (e.g. condoms) is needed.

If you missed two or more active pills (48 hours or more):

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day. 
  2. Discard any earlier missed pills.
  3. If the missed pill is within: 
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take the 4 inactive pills
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 24): 
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the 4 inactive pills
      • Begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days.
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days.

What Are The Potential Side Effects Of Yaz®?

With all medications, you may experience some side effects when you first start taking Yaz® such as:

  • Nausea. Take Yaz® after food to reduce these side effects. 
  • Headache. Can be managed by taking over-the-counter painkillers such as Paracetamol.
  • Spotting between your periods during the first few months of taking oral contraceptives.
  • Breast tenderness
  • Weight changes due to fluid retention, mood swings. Take Yaz® at the same time every day to avoid huge changes in the hormone levels in your body.

These symptoms may vary among individuals. As your body gets accustomed to the changes in hormone levels, these symptoms may subside within 2-3 months. However, do consult your doctor if you experience any symptoms for longer than expected or if they are bothering you.

If you missed 2 menstrual periods in a row (or 1 menstrual period if the pill has been incorrectly used), contact your doctor for a pregnancy test.

Where To Buy Yaz® In Singapore?

Birth control pills cannot be obtained over-the-counter in Singapore — you’ll need to get a prescription from a general practitioner or gynaecologist if you wish to get your hands on birth control pills like Yaz®. 

Conventionally, that will mean taking time off work to travel to a physical clinic. With a MOH-approved digital women health clinic like Siena, you can get an online prescription for your birth control needs without leaving home! 

Simply complete an online medical questionnaire and our doctor will video call you at a time of your convenience for a tele-consult. If prescribed, your medication will be delivered to you in discreet packaging at no additional charge.

References

Categories
Birth Control

Microgynon® 30 Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore

Microgynon® 30 Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

If you’re concerned about becoming pregnant, the birth control pill (better known as simply “the pill”) is one of the safest, most reliable forms of contraception available.

In this article, we share all you need to know about one of the popular birth control pill brands in Singapore, Microgynon® 30:

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Microgynon® 30 in Singapore.

What Is Microgynon® 30? 

Microgynon® 30 is a brand-name combination birth control pill. It contains 2 hormones:

  • Progestogen (0.15mg levonorgestrel); and
  • Estrogen (0.03mg ethinylestradiol).

Microgynon® 30 is mainly used as contraception to prevent pregnancy. However, women taking Microgynon® 30 may also benefit from the non-contraceptive effects of estrogen such as:

How Does Microgynon® 30 Work? 

Microgynon® 30 prevents pregnancy by:

  • inhibiting ovulation, which is the release of an egg from the ovary
  • thickening the cervical mucus (the fluid in your vaginal tract). This makes it hard for the sperm to reach the egg to fertilise it.
  • thinning of the uterine lining, so that even if an egg is fertilised, it will be unable to attach to the uterus. The fertilised egg will instead be passed out of the body.

How Effective Is Microgynon® 30?

According to the Centers for Disease Control and Prevention, when used perfectly, Microgynon® 30 is more than 99% effective in preventing pregnancy. However, possibly due to missed pills or improper storage, Microgynon® 30 is typically around 91% effective. 

Birth control pills are generally more effective than male condoms in preventing pregnancy — male condoms are 98% effective when used perfectly, and 82% effective in typical use. However, it is important to note that birth control pills do not protect women against sexually transmitted infections (STIs), unlike male condoms.

Therefore, always use dual protection of condoms and non-barrier contraceptives such as birth control pills during any sexual activity.

How To Take Microgynon® 30 Birth Control Pills?

Microgynon® 30 contains 21 pills. This means that you need to take a pill at the same time every day, for 21 days. You should swallow each pill whole with water. Do not chew the pill.

The back of the pill strip states the days of the week (Monday – Sunday). Start your course by taking a pill marked with the correct day of the week and follow the direction of the arrows on the strip. This is followed by 7 days where no pills are taken.

A few days after taking the last pill from the strip, you will experience a withdrawal bleed, similar to having your period. During the 7 pill-free break, you do not need to use extra contraception such as condoms, as long as you have taken your pills correctly and start the next strip of Microgynon® 30 on time.

What To Do If I Missed My Microgynon® 30 Birth Control Pill?

A regular routine of taking your birth control pills at the same time every day during the 21 days regimen is desirable. This is because taking a pill late or missing doses may affect the effectiveness of the pill in preventing pregnancy.

Microgynon® 30 is considered “missed” if you:

  • don’t take it for 24 hours or more after you were supposed to; or
  • vomit or suffer from diarrhoea within 3 to 4 hours of pill-taking.

Follow these steps below if you have forgotten to take a pill:

​​If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill:

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately.
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day).
  3. Take the 7-day pill-free break as prescribed or if you’re on an everyday pill, take the inactive pills.
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle.
  5. No additional contraceptive protection (e.g. condoms) is needed.

If you missed two or more active pills (48 hours or more):

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day. 
  2. Discard any earlier missed pills.
  3. If the missed pill is within: 
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take a 7-day break
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 21): 
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the pack
      • Don’t take the 7-day break, begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days.
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days.

What Are The Potential Side Effects Of Microgynon® 30?

Women who just started taking Microgynon® 30 may experience some of the following side effects:

  • Nausea and bloating. Taking the medication after food may help reduce these side effects. 
  • Headache. Taking over-the-counter painkillers such as Paracetamol may help manage the pain.
  • Vaginal bleeding between periods (spotting)
  • Breast soreness
  • Mood changes. To avoid huge changes in the hormone levels in your body, it is recommended to take Microgynon® 30 around the same time every day.

These symptoms vary among individuals and normally subside within 2-3 months as your body starts to get accustomed to the changes in hormone levels. Do inform your doctor if you experience any of these symptoms for longer than expected or if they are bothering you.

Where To Buy Microgynon® 30 In Singapore?

Birth control pills are prescription-only medicines in Singapore. You would need to consult a doctor in person before you can get started on any birth control.

With Siena, you can have access to affordable birth control from the comfort of your home. Simply complete an online questionnaire, and speak with a doctor online. If prescribed, your medication will be delivered to you in discreet packaging and at no additional charge.

References

Categories
Birth Control

Yasmin® Birth Control: How It Works, Potential Side Effects & Where To Buy In Singapore

Yasmin® Birth Control: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

Contraceptives come in many different forms — birth control pills and patches, condoms, intrauterine devices (IUD). 

In this article, we share all you need to know about one of the most common birth control pill brands in Singapore — Yasmin®: 

  • How it works;
  • How to take it; 
  • What to do if you missed a dose;
  • Potential side effects; and
  • Where to buy Yasmin® in Singapore.

What Is Yasmin®? 

Yasmin® is a brand-name combination birth control pill that contains 2 hormones: 

  • Progestogin (3mg drospirenone); and 
  • Estrogen (0.03mg ethinylestradiol).

Liza® is a generic version of the brand-name drug Yasmin®.

Besides preventing unwanted pregnancies, Yasmin® can also help to:

How Does Yasmin® Work? 

Yasmin® prevents pregnancy by inhibiting ovulation, the release of an egg from the ovary. 

Besides preventing ovulation, Yasmin® also thickens cervical mucus (the fluid in your vaginal tract) making it hard for sperm to reach the egg to fertilise it. 

Yasmin® also causes thinning of the uterine lining, so that even if an egg is fertilised, it will be unable to attach to the uterus, and instead be passed out of the body. 

How Effective Is Yasmin®?

According to the Centers for Disease Control and Prevention, Yasmin® is more than 99% effective in preventing pregnancy when used perfectly. However, in typical use (due to missed pills or improper storage), Yasmin® is around 91% effective. 

Birth control pills are more effective than male condoms in preventing pregnancy — male condoms are 98% effective when used perfectly, and 82% effective in typical use. However, birth control pills will not prevent or protect you and your partner from sexually transmitted infections (STIs) unlike male condoms. 

Therefore, it is still important to practice dual protection for safer sex — use both birth control pills and condoms.

How To Take Yasmin® Birth Control Pill?

Yasmin® contains 21 active pills. You should take one pill at the same time every day for 21 days, followed by 7 days where you take no pills. During the pill-free days, a withdrawal bleed usually occurs that is similar to having your period. After the 7-day pill-free interval, start on a new pack of Yasmin® whether or not you have any menstrual bleeding.

You should swallow each pill whole with water. Do not chew the pill. The back of the pill strip states the days of the week (Monday – Sunday). Start your course by taking a pill marked with the correct day of the week and follow the direction of the arrows on the strip.

What To Do If I Missed My Yasmin® Birth Control Pill?

You should establish a regular routine of taking your birth control pills at the same time every day during the 21 days. This is because taking a pill late or missing pills may affect the effectiveness of the pill in preventing pregnancy. 

Yasmin® is considered “missed” if you:

  • don’t take it for 24 hours or more after you were supposed to; or
  • vomit or suffer from diarrhoea within 3 to 4 hours of pill-taking.

If you forget to take a pill, here’s what you should do: 

​​If you are late (less than 24 hours) or missed (24 to 48 hours) an active pill

You’re still protected against pregnancy if you missed 1 pill anywhere in the pack or started a new pack 1 day (24 hours) late. 

Follow these steps:

  1. Take the late or missed pill immediately
  2. Continue taking the remaining pills at the usual time (even if it means taking two pills on the same day)
  3. Take the 7-day pill-free break as prescribed or if you’re on an everyday pill, take the inactive pills 
  4. Emergency contraception is not usually needed but can be considered if hormonal pills were missed earlier in the cycle or in the last week of the previous cycle
  5. No additional contraceptive protection (e.g. condoms) needed

If you missed two or more active pills (48 hours or more)

When this happens, it greatly increases your chances of ovulation. In this case, when you missed 2 or more active pills anywhere in the pack or started a new pack only after 2 days (48 hours) or more, you may not be protected against pregnancy. 

What you should do:

  1. Take the last pill that you missed immediately even if it means taking 2 pills a day 
  2. Discard any earlier missed pills 
  3. If the missed pill is within: 
    • Week 1 (pills 1 to 7) or Week 2 (pills 8 to 14) of the pack:
      • Continue to take the active pills in your current pack daily
      • Take a 7-day break
      • Begin a new pack the next day
    • Week 3 of the pack (pills 15 to 21): 
      • Continue to take the active pills in your current pack daily
      • When you have finished taking all the active pills, discard the pack
      • Don’t take the 7-day break, begin a new pack the next day
  4. Consider taking emergency contraception if you missed 2 or more pills during the first week of a pack and/or had unprotected sex in the last 7 days
  5. Use extra contraception (i.e. condoms) or abstain from sex for the next 7 days 

What Are The Potential Side Effects Of Yasmin®?

Women who just started taking Yasmin® may experience some of the following side effects:

  • Nausea, vomiting, bloating and stomach cramps. Take Yasmin® after food to reduce these side effects. 
  • Headache. Can be managed by taking over-the-counter painkillers such as Paracetamol.
  • Spotting between your periods during the first few months of taking oral contraceptives.
  • Breast tenderness
  • Weight changes due to fluid retention, mood swings. Take Yasmin® at the same time every day to avoid huge changes in the hormone levels in your body.

Side effects vary widely among individuals and usually ease within 2–3 months of starting to take the pill as your body adjusts to the hormones. Inform your doctor if the side effects last for a long time (more than 3 months) or bother you.

How To Buy Yasmin® In Singapore?

Birth control pills are only available with a prescription, so you need to consult a doctor. Conventionally, this means you would need to carve out time to go down to a clinic for a doctor’s consultation before you can get started on birth control. 

Siena is a digital health clinic that offers you easy and affordable access to birth control. Simply complete an online questionnaire, and speak with a doctor online from the comfort of your home. If prescribed, we deliver your birth control to you in discreet packaging at no additional charge.

References

Categories
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.

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 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.