Health

Dysmenorrhea (period pain / menstrual cramps / menstrual pain)

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Dysmenorrhea refers to lower abdominal pain felt during menstruation. It is divided into two broad categories, which are primary and secondary dysmenorrhoea.

  1. Primary dysmenorrhea refers to the presence of pain during menses without any obvious gynaecological disease that could account for these symptoms. The pain is typically recurrent, crampy pain that starts just before or with the onset of menses and then gradually reduces over the next 24 to 72 hours. It is more often seen in adolescents and young females. Physical examination and an ultrasound scan of the pelvis is usually normal.
  2. Secondary dysmenorrhea refers to the pain before and/or during menstruation in females with a gynaecological disease that could explain the symptoms. These could be endometriosis, adenomyosis, or uterine fibroids. The cramping pain can be in the lower abdomen, lower back or radiates to the inner thighs. The pain may even persist after menstruation has stopped.

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Stress and hormonal imbalance in women

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Life is full of stress. It is common to everyone. Some people are able to handle stress better than others while many cannot cope with the stress that comes with everyday modern living. Stress can affect the well-being of both one’s physical and mental health. Physical stress occurs when a person does not have enough rest, engaging in exercises to the extreme limit of bodily endurance, has a poor diet, or suffers from illness and disease. Mental stress may arise from worries about matters such as money, jobs, retirement, marriage, or the death of loved ones. Sometimes the stress that arises is subtle, and a person may not even realize she is experiencing it. For example, one may feel tired and overwhelmed after a hard day’s work. This fatigue may be a result of either physical or mental stress or a combination of both. Either way, the body is taxed to some degree.

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Vulval Care

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The female external genitalia area (also called the vulval area) is particularly susceptible to skin disorders since this area is warm, sweaty, and moist. The wearing of undergarments in this type of condition can predispose the area to constant irritations and possible infections. Many types of irritants can aggravate the skin such as vaginal and menstrual discharge, use of sanitary pads or panty liner, synthetic undergarments, and vaginal lubricants. Chemicals used in the manufacturing of the undergarments, sanitary pads, and panty liners may act as irritants and sensitizing allergens. In postmenopausal women, lack of oestrogen can cause atrophy of the skin, with gradual loss of subcutaneous fat and skin elasticity. The labia fold (external skin fold at the side) will also shrink in size. This thinning of the skin will predispose to irritation and may lead to various skin disorders.

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Sunscreen – what you need to know……..

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Article contributed by:
Dr Ch’ng Chin Chwen
Consultant Dermatologist
Subang Jaya Medical Centre

1. Why is applying sunscreen important?

Sunscreen is the most important skincare product. If you can only afford one skincare product, choose a good sunscreen. Sunscreen protects our skin from harmful sun rays and reduces skin cancer risk. It reduces the flare-up of most skin problems from acne, eczema to rosacea. Not to mention when skin damage is reduced, we are reducing pigmentation, wrinkles and skin sagging.

2. Do I still have to apply sunscreen while indoors?

Yes, particularly if you have large windows or indoor fluorescent lighting.

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Menopausal Hormone Therapy (MHT)

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Menopause is the permanent cessation of menstruation. It can occur as early as age 40 or as late as nearly age 60s. The average age of menopause is usually about 49 to 51. It is normally diagnosed in females after 1 year of absent menstrual flow. Menopause does not occur suddenly. It is a slow transition and peri-menopause usually begins a few years before the last menstrual period. Menopause is only one event in the transition period involving changes in the female body between the mid or late 40’s, when the production of female hormones (estrogen and progesterone) begins to decline. Most of the signs and symptoms of menopause arise from this decrease in estrogen production. Therefore, MHT (referring to both the EPT and ET) is often given to women who have significant symptoms that have an impact on their daily activities.

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Contraception – Male condom

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The main purpose of contraception (or birth control) is to prevent an unplanned pregnancy. You should know and understand the different types of methods available to you, the risks and benefits of each, and any possible side effects, so that both you and your partner can able to make an informed choice. Contraception can be broadly divided into:

  1. Temporary or permanent methods – permanent birth control is accomplished through sterilization (tying or removal of the fallopian tubes) or hysterectomy (removal of womb / uterus). The rest of the methods are classified as temporary or reversible.
  2. Short term or long-term methods – short term methods are condoms and oral pills. Long term methods are injectables, intrauterine device and hormonal implants.

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First visit to the gynaecologist – what you should know

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Health screening as a person ages is especially important. It should be your top priority even if you are healthy. In women, this will include a visit to the gynaecologist’s clinic and will help in identifying if the woman has increased risks for developing a disease or already has the disease or condition that was not previously known about. Early identification of risks factors can help in counselling and instituting remedial or preventive measures to reduce that risk. This may in fact help to prevent the disease from occurring. Likewise, early detection of disease and starting treatment as soon as possible will results in a better outcome and lower the risks of complications. For example, many women with ovarian cancer do not have symptoms until it is too late. However, prompt diagnosis at an early stage of ovarian cancer will give excellent outcome with surgery alone and may not even need chemotherapy at all.
Many women feel nervous or even afraid to see the gynaecologist, especially if it is their first visit. Seeing a gynaecologist is just like seeing any other doctor in other specialities such as your dentist or general practitioner. They are there to help you and you should take this as an opportunity to seek their help in taking care of your health.

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Bone mineral density testing (BMD)

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This test is done to measure the density of bones and this is able to predict the risk of fractures. Bone density decreases in both men and women with age, but in women, the decrease is more rapid and more severe following menopause when the ovaries stop producing the oestrogen hormone. BMD testing can show whether there is significant bone loss, resulting in low bone mass. This is a major cause of osteoporosis and of bone fractures (partic­ularly the hip, spine or forearm) in men and women over the age of 40.

Osteoporosis is a reduction in the amount of bone mass resulting in the loss of bone strength. This will predispose it to fracture. Osteopenia refers to a decrease in bone mineral density and is less severe form compared to osteoporosis. Eventually, it is likely to lead to osteoporosis if no treatment is given.

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