Menses & Fertility Problems – What Can You Do? (Nov 2018)
On 24th November (Saturday), SMG Women’s Health held a public forum for women, touching on common women’s problems such as abnormal periods and fertility challenges due to fibroids and adenomyosis. Our 2 speakers were experienced gynaecologists from Astra Women’s Specialists and Astra Laparoscopic & Robotic Centre for Women and Fertility.
A/Prof Fong Yoke Fai first shared on HIFU, also known as High-Intensity Focused Ultrasound, a new and non-invasive (non-surgical) way to treat fibroids and adenomyosis. In short, HIFU uses real-time ultrasound imaging and high-intensity ultrasound waves to generate localised heat, which specifically targets individual fibroids to destroy the cells. With this treatment, the fibroids will shrink over time, thereby alleviating the symptoms that women with fibroids experience. Some of these symptoms could include experiencing a mass in the abdomen and pressure, infertility, and heavy menses. It usually takes about 3 months for these symptoms to improve significantly.
As HIFU is a non-invasive, non-surgical procedure, there will be no need for any incision and hence no post-operative wounds and scars. The focused ultrasound also minimises disruption and damage to surrounding healthy tissues, and is made more precise and accurate with the whole procedure being computerised. It is a day surgery procedure requiring a short treatment time of about 2 hours, and patients can generally resume their normal daily activities after.
He also shared on other treatment options including the use of hormones, surgery (key-hole) and uterine artery embolisation (UAE). Depending on each woman’s condition and needs, the treatment offered will be customised.
Dr Cathryn Chan then touched on abnormal menstruation, and how women can generally detect abnormalities in their menstruation. For example, if they notice:
- a change in frequency (e.g. how often they menstruate)
- a change in the duration of menstruation
- a change in the flow during menses (e.g. getting heavier over time)
- a change in the intensity of pain experienced during menses (e.g. increasing pain)
Such changes potentially signify a need to go for a check with the gynaecologist, as they could be due to a variety of reasons, including pregnancy, hormone-related, growths in the womb e.g. polyps or fibroids, cancer, or the use of certain medications.
Dr Chan further explained that a typical gynae examination for a complaint of abnormal menstruation would include a detailed menstrual history taking, physical examinations e.g. pelvic examination with ultrasound, assessing for signs of anemia such as pale skin etc. After the initial assessment, further diagnostic tests might be performed, such as an endometrial biopsy, or hysteroscopy, where the gynaecologist inserts a scope to visualise the inside of the womb using the camera. Lastly, she touched on the potential treatment options, which are always customised based on the patient’s conditions and needs.