8 Common Gynaecological Conditions in SG: Treatments & FAQ

Gynaecological conditions play a crucial role in women's reproductive health and can greatly influence their overall well-being.

Here are eight common gynaecological conditions frequently encountered at Thomson Women’s Clinics, along with their treatments and FAQ:

#1: Menstrual disorders

There are mainly two types of menstrual disorders:

1. Dysmenorrhea (menstrual pain)

2. Menorrhagia (heavy menstrual bleeding)

What to reduce menstrual pain at home?

If you're experiencing menstrual pain, there are several effective home remedies you can try:

• Over-the-counter medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate menstrual pain.

• Apply heat: Applying heat to your lower abdomen using a hot water bottle or heating pad can provide significant relief.

• Relaxation techniques: Practices such as deep breathing, meditation, and yoga can help reduce pain.

• Regular exercises: Maintaining a regular exercise routine can also help manage and lessen menstrual discomfort.

When should I consider hormonal birth control for menstrual pain?

If over-the-counter pain relief measures are insufficient, hormonal birth control methods like birth control pills or patches can help regulate menstrual cycles and reduce pain. Consult with your gynaecologist to determine the most suitable option for you.

What are the treatment options for heavy menstrual bleeding (menorrhagia)?

Treatment options for heavy menstrual bleeding include:

• Hormonal contraceptives: Birth control pills and hormonal IUDs can help regulate menstrual cycles and reduce bleeding.

• Non-hormonal medications: Tranexamic acid can be used to reduce bleeding.

• Procedures for severe cases: In more severe cases, procedures such as endometrial ablation or hysterectomy may be considered. 

Consult with your healthcare provider to determine the best treatment for your condition.

#2: Pelvic pain

Pelvic pain may be caused by conditions such as endometriosis or Pelvic Inflammatory Disease (PID).

How is endometriosis managed?

Endometriosis is commonly managed through a combination of pain relief and hormonal therapies:

• Pain management: NSAIDs (nonsteroidal anti-inflammatory drugs) are often used to alleviate pain.

• Hormonal therapies: Birth control pills and progestin therapy can help regulate menstrual cycles and reduce symptoms.

• Laparoscopic surgery: This may be recommended for both diagnosis and treatment, especially if symptoms are severe or fertility is a concern.

What is the recommended treatment for pelvic inflammatory disease (PID)?

PID is typically treated with antibiotics to eradicate the underlying infection. Rest and pain management are also essential during the recovery period. Follow-up testing is crucial to ensure the infection has cleared.

#3: Infections

Common infections include:

1. Bacterial vaginosis (BV): 

   • Caused by an imbalance of bacteria in the vagina, leading to symptoms such as unusual discharge, odour, and itching.

2. Yeast infections (Candidiasis): 

   • Caused by the overgrowth of Candida fungus, leading to itching, discharge, and irritation.

How is bacterial vaginosis (BV) treated?

Antibiotics, either oral or topical, are prescribed to treat BV. It is important to complete the full course of medication. Additionally, avoiding douching and using scented products can help prevent recurrence.

What is the most common way to treat a yeast infection?

Yeast infections are commonly treated with antifungal medications, which are available as oral tablets or topical creams. Maintaining good hygiene practices and avoiding tight-fitting clothing can also help in recovery.

34: Sexually Transmitted Infections (STIs)

How are STIs treated?

The treatment for STIs depends on the specific infection and may involve antibiotics or antiviral medications. It is crucial to complete the prescribed course of treatment. Partner notification and testing are also important to prevent reinfection.

What preventive measures can be taken to avoid STIs?

Practicing safe sex, including consistent and correct use of condoms, getting vaccinated against preventable STIs like HPV, and regular screenings are key preventive measures.

#5: Polycystic Ovary Syndrome (PCOS)

PCOS is a common hormonal disorder affecting women of reproductive age. It is characterised by an imbalance of reproductive hormones, which can lead to a variety of symptoms and complications.

How is PCOS treated?

Treatment for PCOS focuses on managing symptoms and reducing the risk of long-term complications. Common approaches include:

1. Lifestyle modifications: Adopting a healthy diet and regular exercise routine to help manage weight and improve insulin sensitivity.

2. Hormonal contraceptives: Birth control pills, patches, or rings to regulate menstrual cycles, lower androgen levels, and alleviate symptoms such as acne and excess hair growth.

3. Medications for specific symptoms:

   • Metformin: Used to improve insulin resistance and lower blood sugar levels.

   • Clomiphene: To stimulate ovulation for women trying to conceive.

   • Anti-androgens: Such as spironolactone, to reduce androgen-related symptoms like excess hair growth and acne.

Can lifestyle changes help manage PCOS symptoms?

Yes, lifestyle modifications such as maintaining a healthy diet, regular exercise, and stress management can help manage PCOS symptoms, particularly those related to insulin resistance and weight.

What medications are commonly used for PCOS management?

Hormonal contraceptives to regulate menstrual cycles, anti-androgen medications to address symptoms like acne and hirsutism, and insulin-sensitising drugs like metformin may be prescribed.

#6: Fibroids

Fibroids, also known as uterine fibroids or leiomyomas, are non-cancerous growths that develop in or on the uterus. They are composed of muscle and fibrous tissue and vary in size from very small to large masses that can distort the uterus.

How are fibroids monitored and treated?

Fibroids require monitoring and treatment based on their size, location, and associated symptoms.

Monitoring

1. Regular Check-ups: Periodic visits to the healthcare provider to assess symptoms and fibroid growth.

2. Imaging studies: Ultrasounds or MRIs to track the size and number of fibroids.

Treatment options

1. Medications:

   • Pain relievers: Over-the-counter or prescription pain medications to manage discomfort.

   • Hormonal therapies: Birth control pills, GnRH agonists, or progestin-releasing IUDs to help regulate menstrual cycles and reduce bleeding.

2. Surgical options:

   • Myomectomy: Surgical removal of fibroids while preserving the uterus, recommended for women who wish to maintain fertility.

   • Hysterectomy: Complete removal of the uterus, considered for severe cases or when other treatments have failed.

You can consult your gynaecologist to determine the most appropriate monitoring and treatment plan for your specific condition.

Can fibroids affect fertility?

Yes, fibroids can sometimes affect fertility. They may impact the ability to conceive or maintain a pregnancy. If fertility is a concern, it is advisable to consult a fertility specialist to explore potential treatment options and strategies.

#7: Cervical Abnormalities

Cervical abnormalities refer to changes in the cells on the surface of the cervix, which can range from mild to severe and may potentially lead to cervical cancer if not monitored or treated appropriately. These abnormalities are often detected through routine screening tests such as Pap smears or HPV tests. If your results are abnormal, further tests like colposcopy and biopsy might be required.

What are the treatment options for cervical abnormalities?

Treatment for cervical abnormalities depends on the severity of the condition:

1. Watchful waiting: 

   • For mild abnormalities, regular monitoring with repeat Pap smears or HPV tests may be sufficient.

2. Cryotherapy: 

   • Freezing abnormal cells to destroy them.

3. Laser therapy: 

   • Using a laser to remove or destroy abnormal tissue.

4. Loop Electrosurgical Excision Procedure (LEEP): 

   • Removing abnormal tissue using a thin wire loop heated by an electric current.

5. Cone biopsy: 

   • Removing a cone-shaped piece of tissue from the cervix, including abnormal cells.

#8: Infertility

Treating infertility involves a comprehensive approach to identify and address the underlying causes. Here are the key steps:

1. Assessment of underlying causes through testing

2. Preconception Counselling

3. Addressing lifestyle factors (diet, exercise, stress management)

4. Fertility treatments (ovulation induction, intrauterine insemination (IUI), IVF)

When should I seek help for infertility?

If you have been actively trying to conceive for a year without success, it is advisable to seek consultation with a fertility specialist. Earlier evaluation may be recommended if there are known fertility issues or age-related concerns.

What are common fertility treatments?

Fertility treatments may include ovulation induction medications, intrauterine insemination (IUI), and assisted reproductive technologies (ART) such as IVF. The specific treatment plan will depend on the underlying cause of infertility.

FAQ

Are ovarian cysts common, and do they always require treatment?

Ovarian cysts are common and often resolve on their own without treatment. Treatment may be considered if the cyst is large, causing pain, or if it persists over several menstrual cycles. Surgical intervention is rare and typically reserved for complex or problematic cysts.

What symptoms may indicate the presence of ovarian cysts?

Symptoms can include pelvic pain, bloating, changes in menstrual patterns, and pain during intercourse. However, many ovarian cysts are asymptomatic and discovered incidentally during routine pelvic exams or imaging studies.

What is considered normal vaginal discharge, and when should I be concerned?

Normal vaginal discharge is usually clear or white and may vary in consistency throughout the menstrual cycle. Changes in color, consistency, or the presence of a strong odour may indicate an infection and should be evaluated by a gynaecologist.

Can birth control methods affect vaginal discharge?

Yes, hormonal birth control methods can sometimes alter the cervical mucus, leading to changes in vaginal discharge. If there are concerns or persistent changes, it is advisable to consult with a gynaecologist.