18 Questions answered

What other tests should I take to find the cause of intermenstrual bleeding if Pap Smear and Ovarian Tumour Marker results are negative?

Intermenstrual bleeding has a number of possible causes including infections, hormone changes, ovulatory dysfunction, polyps, fibroids or other structural growths. A detailed consultation to find out about your menstrual, sexual, past medical and family history, followed by a physical examination will guide your doctor on the investigations needed to further evaluate this unscheduled bleeding. This includes vaginal swabs, STI tests, pelvic ultrasound, blood tests such as thyroid function and hormonal profiles and other procedures to examine the uterus.

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Answered By

Human

Why are menstruation products marketed gender-specificly, i.e. “feminine wash”?

By labeling products as "feminine wash", this is a polite way of describing washes specifically designed to cleanse the female genital areas. These washes are meant to restore the natural vaginal pH to a mildly acidic environment. The better quality washes have probiotics (friendly bacteria) incorporated into them. These probiotics help to maintain the natural mildly acidic environment and therefore prevent lower genital tract infections from occurring because bacterial and fungal organisms do not propagate in an acidic environment.

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Answered By

Dr Christopher Ng

Gynaecologist

Why are women more prone to developing gallstones?

Gallstone formation is found to be 2 to 3 times more common in females as compared to males [1]. This difference is observed starting puberty and throughout childbearing age. This is because females have higher levels of estrogen which promotes gallstones formation. Gallstones are caused by hardened digestive fluid deposits. In most cases, they are primarily composed of cholesterol. Estrogen level is a risk factor because estrogen increases biliary cholesterol secretion causing cholesterol supersaturation of bile [2]. References: 1. Novacek G. Gender and gallstone disease.

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Answered By

Dr Stephen Chang

General Surgeon

In cases of cryptic pregnancy, can women still have periods?

A cryptic pregnancy is one in which one does not know that they are pregnant until they are in labour. If the pregnancy is very smooth-going and no problems encountered, then there would not be any reason to experience bleeding during this time until the onset of spontaneous labour in which case the "show" (dislodging of the mucus plug from the cervical opening) would occur. If, however, there was an instance of threatened miscarriage, then there would be unexpected per vaginal bleeding and this may or may not be accompanied with pelvic pain.

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Answered By

Dr Christopher Ng

Gynaecologist

What are the ways to regulate my irregular menstrual cycle?

Provided the cause of your irregular menstrual cycle is because of hormonal imbalance, this can be very easily regulated with hormonal therapy. The most popular and convenient way would be oral hormones either with the oral contraceptive pills (if pregnancy prevention is also wanted) or hormonal pills with no contraceptive benefits. These oral tablets need to be taken on a daily basis so for women who are very forgetful, there is an alternative intramuscular hormonal injection which would last up to 3 months and a repeat injection is then planned 3 months later.

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Answered By

Dr Christopher Ng

Gynaecologist

When is abnormally heavy menstrual flow that contains clots a cause for concern?

Normal menstrual flow occurs every 21 to 35 days, lasts three to seven days and the total blood loss is about 30 to 80 mls (2 to 5 1/2 tablespoons). Every woman’s menstrual cycle is different. Menorrhagia or heavy menses affects 9-14% of menstruating women and is defined as menstruation at the expected intervals but with duration lasting longer than 7 days or excessive flow with more than 80 mls (> 5 1/2 tablespoons) of blood loss during each menstrual cycle.

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Answered By

Dr Christopher Ng

Gynaecologist

Why do I get diarrhoea at the start of my menstrual cycle, and how can I relief it?

Menstruation occurs when an ovum failed to get fertilised. This shedding of the womb's inner lining is related to the release of a special class of hormones known as prostaglandins. Prostaglandins cause the smooth muscles of the womb to contract which help to shear off its inner lining. This contraction is also the reason for the painful menstrual cramps that most of us are familiar with. When there is an excessive release of these hormones during menstruation, the smooth muscle in the intestines may respond in a similar manner resulting in more frequent stools or diarrhoea.

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Answered By

Dr Wai Leong Quan

Gastroenterologist

When will my period arrive if I am on the combined birth control pill?

The oral contraceptive pill that you have been prescribed (Mercilon) is a 21 day pill with a 7 day pill-free break. This means that you have to consume 1 oral contraceptive pill daily for 21 days and then have a 1 week break (7 days) before starting a new pack. During this 7 pill-free days, your period should come. If it comes exactly 7 days after your last active pill, this means that your cycle is a 28 day cycle like the majority of women who are on Mercilon. if it comes 5 days after your last active pill, you then have a 26 day menstrual cycle.

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Answered By

Dr Christopher Ng

Gynaecologist

When is dark menstrual blood a cause for concern?

Thank you for asking this interesting question Hazel, I am sure many patients are keen to know as well. If you remembered some chemistry from your school days, iron oxidises, or rusts. So the longer the iron or the lining has been in your body, the more likely it will "rust" inside. It is absolutely normal to have brownish or even black colour menses on the first few days. But of course if you are worried, you can see a GP or Gynae to have it checked. Take care!

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Answered By

Dr Paul Ang

General Practitioner

How does an abnormal sleep pattern affect periods?

Thank you for asking such a fascinating question. What you describe is called the delayed sleep phase syndrome, a form of sleep disorder that involves the circadian rhythm or body clock. Most people sleep at 11-12 midnight and then wake up at 5-7 am. You sleep late and wake up late, and that is what delayed sleep phase means. In terms of hours of sleep, 6 hours sound fairly decent for an adult but for a teenager it may not be enough. The important question would be whether you feel refreshed or rested when you wake up naturally.

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Answered By

Dr Beng Yeong Ng

Psychiatrist

Could thick green vaginal discharge before my period be a sign of a yeast infection or BV?

Yeast infections tend to be thick white and clumpy, while bacterial vaginosis tends to be a grey watery discharge with a "fishy" odour. It would certainly be a good idea to get retested for STDs to be sure that you are not infected.

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Answered By

Dr Christopher Ng

Gynaecologist

Why do I have urine incontinence?

Sorry to hear about your incontinence problem. Urinary incontinence is a socially embarrassing problem, with many patients not seeking help for it. There are many different types of urinary incontinence. Here are 3 types that I learnt as a medical student 1. Stress incontinence - Stress incontinence is the leakage of urine when you cough or sneeze or laugh. This is due to decrease muscle control over the bladder neck (which in turn is due to various reasons) resulting in urine leaking whenever the abdominal pressure increases. 2.

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Answered By

Dr Heap Yong Seah

General Practitioner

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* This profile has been last updated on January 8.