This is the prime period of a woman’s life, where she has outgrown the awkwardness of puberty and established her sense of self as a young adult. Some of the gynaecological needs or concerns affecting young women in their 20s and 30s are listed below:
Young Adulthood
Enter into Your Prime: 20 – 34 years
Endometriosis
Endometriosis is a gynaecological condition in which the endometrium, or tissue lining the uterus, grows outside the uterus and in other locations such as the ovaries, fallopian tubes and ovarian ligaments. This tissue thickens and subsequently breaks down during every menstrual cycle. Severe pain during menstruation or chronic pain in the pelvic region is a common symptom of endometriosis. Women with endometriosis may also experience pain during sex, painful urination or bowel movements, and may struggle with infertility later on.
Do I Have Endometriosis?
Your doctor can check for clues of endometriosis during a pelvic exam or ultrasound. However, a laparoscopy or keyhole surgery will be able to determine with certainty if endometriosis is present. Treatment may be in the form of pain relief medication, hormonal therapy to control the build-up of endometrial tissue, or a laparoscopic surgery to remove the tissue.
Fibroids
Fibroids are non-cancerous growths consisting of muscle and fibrous tissue. Around 1 in 3 women will develop fibroids in their lifetime. They vary in size and may develop in or around the uterus, usually during a woman’s reproductive years, often shrinking after menopause.
Do I Have Fibroids?
Most small fibroids are asymptomatic and no treatment is required. However, depending on their location and size, fibroids may cause certain symptoms which interfere with daily life, such as:
Excessive bleeding with passage of blood clots during menstruation
- Pelvic pressure or discomfort
- Increased frequency of urination
- Pelvic and/or lower back pain
- Difficulty or pain during bowel movement
Upon diagnosis, your gynaecologist may treat symptoms with medication to reduce the occurrence of menorrhagia or shrink the size of the fibroids. Fibroids may also be treated surgically, either through complete removal of the uterus (hysterectomy) or removal of the fibroids with the uterus in place (myomectomy). This procedure may be done via an abdominal surgery or a keyhole surgery (laparoscopy).
Ovarian Cysts
Ovarian cysts are fluid-filled sacs which develop on a woman’s ovary. A large majority of ovarian cysts are harmless and will naturally disappear without presenting any symptoms (physiological or functional cysts). However, in some cases, an ovarian cyst may be a tumour, and if the cyst is large, may develop complications.
Do I Have Ovarian Cysts?
Your gynaecologist will be able to detect an ovarian cyst during a pelvic examination and ultrasound. Sometimes blood tests such as tumour markers may be performed. If your cysts are persistent, symptomatic or possibly malignant, your doctor may speak to you on the removal of cysts via an abdominal surgery or laparoscopy.
Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a condition which affects up to 27% of women during their childbearing years. It is characterised by the presence of multiple small ovarian cysts (due to egg follicles that failed to grow, mature or be released), higher levels of male hormones and irregular periods. Women with PCOS may also experience symptoms like hair growth or balding, weight gain and acne. PCOS is a common cause of infertility in women.
Do I Have PCOS?
Other than a suggestive history, hormonal blood tests and an ultrasound scan is necessary to aid in the diagnosis of PCOS. PCOS can be managed with oral contraceptive pills to regulate the menstrual cycle or with fertility drugs to improve fertility.
Family Planning
Contraception
Understanding The Various Birth Control Options
A wide variety of birth control options are available for women nowadays. They range from oral contraceptive pills (OCPs) , to hormonal injections and even hormonal implants under the skin and intra-uterine contraceptive devices (IUDs).
Oral Contraceptive Pills |
Hormonal Injections |
Hormonal Implants |
Intra-Uterine Devices (IUD) |
|
Description |
Contains synthetic female hormones either singly or in combination |
Injectable hormones |
A small, silicone tube containing a progesterone hormone that is placed in the arm just below the skin |
A small device that is placed in the womb in the clinic. Can be coated with hormone e.g. Mirena or can be without (copper) |
Benefits |
Can also help regulate menstrual cycle, lighten the flow and reduce cramps |
Convenient as it is administered every 3 months only |
Convenient as it needs to be changed only in 5 years |
Convenient as it needs to be changed only in 3 years. Hormonal IUD can help to reduce heavy menstrual flow |
Disadvantages |
Effective only if taken consistently according to instructions |
May sometimes cause irregular menstrual cycles, weight gain and mood swings |
Can cause scarring and may result in irregular menstrual cycles at the start |
May experience some weight gain or irregular menstruation at the start |
While reliable in preventing an unwanted pregnancy, these birth control methods do not protect against sexually transmitted infections, and should be used in conjunction with condoms during sex.
Selecting the most suitable birth control method should begin with a discussion together with your partner and doctor. The appropriate method will vary with individuals depending on your medical history, lifestyle, duration of contraception use, usage compliance and level of effectiveness.
Fertility
A woman’s highest chances of getting pregnant are in her 20s. Women below 30 have a 20% – 25% chance of conceiving every month. At this age, you also have lower chances of miscarriage, pregnancy complications and foetal abnormalities. However, women in their 20s are not immune from fertility problems. If you have been having regular, unprotected sex for a year without getting pregnant, you or your partner may be facing fertility issues.
Vaginal Infection and Discharge
Vaginal discharge is a normal and regular occurrence in women. It is usually white or clear and watery. During ovulation, you may sometimes observe discharge that is clear and stretchy like mucus. Towards the end of your period, it is also normal to experience brown or bloody discharge. However, vaginal discharge that is abnormal in colour, consistency, odour or accompanied by other symptoms may indicate an infection or even sexually-transmitted diseases (STDs) such as gonorrhoea, chlamydia and HPV.
Do I Have a Vaginal Infection?
A vaginal infection usually presents with abnormal vaginal discharge, and sometimes accompanied by itch, pain or even fever.
- A white and thick discharge accompanied by vaginal itchiness or swelling is a sign of vaginal yeast infection or candidiasis, a common condition.
- A yellow or green discharge with a foul smell is a sign of trichomoniasis, a sexually-transmitted infection. It may be accompanied by pain and vaginal itchiness.
- Increased vaginal discharge, which has a foul and fishy odour, may be caused by bacterial vaginosis, a common bacterial infection which also occurs during pregnancy.
These infections can be easily diagnosed by a doctor and treated with medication, creams and ointments.
Vaccinations and Screening for Women
Under the Ministry of Health’s recently-established National Adult Immunisation Schedule (NAIS), it is recommended for expecting or young adult women to undergo the following vaccinations:
Vaccines |
Recommended Groups |
Schedule |
Why is vaccination important? |
Human Papillomavirus (HPV) |
Women aged 18-26 years |
3 doses (0, 1-2, 6 months) |
Some types of HPV infection may lead to cervical cancer. Maximize the benefits of HPV vaccinations by going for vaccination before the start of sexual activity, where HPV exposure occurs. |
Tetanus, Diphtheria and Pertussis (TDAP) |
Pregnant women (between 16-32 weeks) |
1 dose per pregnancy |
Pregnant mothers vaccinated against TDAP can pass on the protection to their babies for a short-term as newborns will not receive vaccinations immediately upon birth. |
Influenza |
Women at all stages of pregnancy |
1 dose annually |
Protects mothers and newborns against influenza |
