It’s important to be educated about our health so we can improve our quality of life. This is especially crucial for women as there are still areas of women’s health that are not fully understood or not given enough attention.
CNA Women explores five not so well-known facts about certain aspects of women’s health, from the effect of hormones to female-only conditions and misguided cures.
We often associate heart attacks with a pain in the chest but a woman may not present this common symptom.
Dr Sim Hui Wen, a consultant at Department of Cardiology, National University Heart Centre, Singapore (NUHCS), said that women can present typical symptoms similar to men, such as heaviness of the chest that can radiate to the left arm, neck or jaw, accompanied by cold sweat and nausea.
“However, women are more likely than men to present with atypical symptoms such as shortness of breath, light-headedness, indigestion, anxiety and unusual fatigue,” he said.
“This may lead to delayed diagnosis and treatment as patients may not know they are suffering from a heart attack. Also, doctors may miss the diagnosis due to the vague symptoms.”
Dr Sim noted that women tend to downplay their symptoms by attributing them to something less serious, like stress or exhaustion, or ignoring early warning signs, to see if symptoms improve on their own. Some women may fear being seen as overreacting or are worried that their concerns will be dismissed.
He advised women to communicate clearly with their healthcare providers of any symptoms, even if they don’t seem severe. “Awareness to these patterns can save lives by encouraging timely intervention,” he added.
Instead of downplaying possible heart attack symptoms, even if they are mild, women should see a doctor for advice. (Photo: iStock/FatCamera)
While many heart attack risk factors are shared by both sexes, some are unique to women. Examples include premature menopause, gestational diabetes, premature delivery, polycystic ovary syndrome and autoimmune disorders.
In fact, menopause itself is a significant risk factor for cardiovascular disease primarily due to the decline in oestrogen levels.
“Oestrogen protects women from heart disease by regulating good cholesterol levels and maintaining flexibility of blood vessels,” said Dr Sim. “After menopause, blood pressure, lipid and sugar control can worsen due to the loss of the protective effect from oestrogen.”
Dr Chuah Theng Theng, a consultant at the department of obstetrics and gynaecology at KK Women’s and Children’s Hospital (KKH), said that when oestrogen declines, fat can build up in the blood vessels, leading to narrowing and stiffening of the arteries.
“This will contribute to a rise in blood pressure as well as increase in cholesterol and blood sugar levels,” she added. “All these changes lead to an increase in heart diseases.”
She advised women to optimise their lifestyle habits and go for regular chronic diseases screenings to prevent heart disease.
KKH’s Dr Chuah said that women who became mothers before the age of 35 have a lower risk of breast and ovarian cancer as compared with mums who had kids after 35, and women who have never had children.
The culprit? Our hormones.
Women who have had children tend to have lower breast and ovarian cancer risks compared with women who never had children. (Photo: iStock/FatCamera)
Oestrogen can sometimes encourage breast cancer growth, so having less exposure to it, like when you’re pregnant, reduces this risk.
“During pregnancy, breast cells grow into a more ‘mature’ form to prepare for breast milk production; mature breast cells are less likely to become cancerous,” Dr Huang told CNA Women. “Pregnancy and breastfeeding reduce a woman’s lifetime exposure to oestrogen and hence offer more protection against breast cancer.”
Pregnancy and breastfeeding also stop ovulation temporarily. Dr Chuah pointed out that reducing ovulation lowers abnormal cell changes that trigger the development of ovarian cancer.
“While having children can reduce such risks, it does not make them disappear,” she added. “We still encourage all women to go for regular age-appropriate health screenings.”
These include, depending on their age, mammograms and screenings for gynaecological cancers. Women aged over 40 should also screen for chronic medical conditions such as diabetes, high blood pressure and high cholesterol.
The cervix is made up of millions of cells. When changes occur to these cells that are left untreated, cervical cancer can develop. The most common cause is persistent infection with the .
Cervical cancer can be caught in the pre-cancerous stage – it usually takes years for abnormal cells to develop into cervical cancer – through cervical smear tests, or Pap smears, where cells from the cervix are collected for testing.
In Singapore, it is highly recommended for females aged nine to 26 to get the HPV vaccine. Dr Grace Huang, a general practitioner at DTAP Clinic, said, in some cases, women aged up to 45 may benefit from it, such as if they have new sexual partners.
As long as they understand that the vaccine may not be as effective as if they had taken it before age 26 and before becoming sexually active, they can have a discussion with their doctor to understand what would best suit their needs, she added.
“The age limit of 26 years is because the assumption is that most people would have been sexually active by that age and thus already been exposed to HPV,” said Dr Huang. “The vaccine affords best protection if someone has not been exposed to HPV yet.”
It is highly recommended that females between nine and 26 years old get the HPV vaccine, to protect themselves against cervical cancer. (Photo: iStock/DragonImages)
The bad news is, you’ll still have to get cervical smear tests.
“Cervical cancer screening in the form of Pap smears and/or HPV tests is still necessary because the vaccine does not cover all types of HPV that can cause cervical cancer,” Dr Huang told CNA Women. “Also, you may have been exposed to HPV before vaccination. And, finally, the vaccine does not treat existing infections – it only prevents future ones.”
Regardless of whether you’ve had the HPV vaccine, you should get a Pap smear every three years if you’re aged 21 to 29. For women aged between 30 and 65, Dr Huang advised to do it every three years, or a Pap and HPV co-test every five years, or HPV testing alone every five years.
“Screening helps detect abnormal cells early, allowing for early treatment before cancer develops,” she said.
Urinary tract infections (UTIs) are common in women – one in five females aged 20 to 65 experience it at least once a year. It occurs when there’s a significant amount of bacteria in the urinary tract and, if left untreated, it can spread to the kidneys.
If you’ve been reaching for cranberry juice to cure your UTI, you might want to stop.
“While cranberry juice can’t treat UTIs, some studies suggest cranberry products may help prevent them,” said Dr Huang.
“A substance in cranberries, A-type proanthocyanidins (PACs), has anti-adhesion properties that can prevent harmful bacteria (including E. coli, which is commonly associated with urinary tract infections) from sticking to the walls of the urinary tract,” she added.
The only cure for UTIs is antibiotics, which have to be prescribed by a doctor. If you have UTI symptoms such as painful urination, urgency or cloudy urine, Dr Huang recommended you see a healthcare provider for proper diagnosis and treatment.
If you suffer from severe menstrual cramps, you might have what’s known as ‘the missed disease’ – endometriosis.
Endometriosis is known as “the missed disease” because it is often underdiagnosed. (Photo: iStock/Charday Penn)
KKH’s Dr Chuah explained that endometriosis is a condition where the tissue of womb lining responsible for menstruation is found outside of the womb. It affects about 10 per cent of women and as many as 30 per cent of women who complain of severe menstrual pain suffer from endometriosis.
“However, the condition is often under diagnosed as it may also exist in women with symptoms unrelated to periods or those who experience minimal discomfort,” Dr Chuah added. “This elusive condition can also cause inflammation, scarring and adhesions of tissues in the pelvis, resulting in infertility and debilitating pain.”
Pelvic ultrasounds are commonly used to look for signs of endometriosis, such as cysts on the ovaries or nodules. Dr Chuah
Dr Chuah urged women to seek help from a gynaecologist when menstrual pain affects their day-to-day activities and quality of life.
While it’s common to take paracetamol for menstrual cramps, DTAP Clinic’s Dr Huang said that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and mefenamic acid are more effective as they reduce inflammation.
You could also ease cramps by applying heat. Dr Huang suggested a heating pad or warm bath as they can relax muscles and reduce pain. Dietary changes help too – reducing caffeine, salt and processed foods may lessen bloating and discomfort.
Also, drinking plenty of water can reduce bloating and ease cramps, she added.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.
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CNA Women explores five not so well-known facts about certain aspects of women’s health, from the effect of hormones to female-only conditions and misguided cures.
Fact #1: Women have different heart attack symptoms and additional risk factors
We often associate heart attacks with a pain in the chest but a woman may not present this common symptom.
Dr Sim Hui Wen, a consultant at Department of Cardiology, National University Heart Centre, Singapore (NUHCS), said that women can present typical symptoms similar to men, such as heaviness of the chest that can radiate to the left arm, neck or jaw, accompanied by cold sweat and nausea.
“However, women are more likely than men to present with atypical symptoms such as shortness of breath, light-headedness, indigestion, anxiety and unusual fatigue,” he said.
“This may lead to delayed diagnosis and treatment as patients may not know they are suffering from a heart attack. Also, doctors may miss the diagnosis due to the vague symptoms.”
Dr Sim noted that women tend to downplay their symptoms by attributing them to something less serious, like stress or exhaustion, or ignoring early warning signs, to see if symptoms improve on their own. Some women may fear being seen as overreacting or are worried that their concerns will be dismissed.
He advised women to communicate clearly with their healthcare providers of any symptoms, even if they don’t seem severe. “Awareness to these patterns can save lives by encouraging timely intervention,” he added.
Instead of downplaying possible heart attack symptoms, even if they are mild, women should see a doctor for advice. (Photo: iStock/FatCamera)
While many heart attack risk factors are shared by both sexes, some are unique to women. Examples include premature menopause, gestational diabetes, premature delivery, polycystic ovary syndrome and autoimmune disorders.
In fact, menopause itself is a significant risk factor for cardiovascular disease primarily due to the decline in oestrogen levels.
“Oestrogen protects women from heart disease by regulating good cholesterol levels and maintaining flexibility of blood vessels,” said Dr Sim. “After menopause, blood pressure, lipid and sugar control can worsen due to the loss of the protective effect from oestrogen.”
Dr Chuah Theng Theng, a consultant at the department of obstetrics and gynaecology at KK Women’s and Children’s Hospital (KKH), said that when oestrogen declines, fat can build up in the blood vessels, leading to narrowing and stiffening of the arteries.
“This will contribute to a rise in blood pressure as well as increase in cholesterol and blood sugar levels,” she added. “All these changes lead to an increase in heart diseases.”
She advised women to optimise their lifestyle habits and go for regular chronic diseases screenings to prevent heart disease.
Fact #2: Not having children increases your risk of breast and ovarian cancers
KKH’s Dr Chuah said that women who became mothers before the age of 35 have a lower risk of breast and ovarian cancer as compared with mums who had kids after 35, and women who have never had children.
The culprit? Our hormones.
Women who have had children tend to have lower breast and ovarian cancer risks compared with women who never had children. (Photo: iStock/FatCamera)
Oestrogen can sometimes encourage breast cancer growth, so having less exposure to it, like when you’re pregnant, reduces this risk.
“During pregnancy, breast cells grow into a more ‘mature’ form to prepare for breast milk production; mature breast cells are less likely to become cancerous,” Dr Huang told CNA Women. “Pregnancy and breastfeeding reduce a woman’s lifetime exposure to oestrogen and hence offer more protection against breast cancer.”
Pregnancy and breastfeeding also stop ovulation temporarily. Dr Chuah pointed out that reducing ovulation lowers abnormal cell changes that trigger the development of ovarian cancer.
“While having children can reduce such risks, it does not make them disappear,” she added. “We still encourage all women to go for regular age-appropriate health screenings.”
These include, depending on their age, mammograms and screenings for gynaecological cancers. Women aged over 40 should also screen for chronic medical conditions such as diabetes, high blood pressure and high cholesterol.
Fact #3: Getting the HPV vaccine doesn't mean no more Pap smears
The cervix is made up of millions of cells. When changes occur to these cells that are left untreated, cervical cancer can develop. The most common cause is persistent infection with the .
Cervical cancer can be caught in the pre-cancerous stage – it usually takes years for abnormal cells to develop into cervical cancer – through cervical smear tests, or Pap smears, where cells from the cervix are collected for testing.
In Singapore, it is highly recommended for females aged nine to 26 to get the HPV vaccine. Dr Grace Huang, a general practitioner at DTAP Clinic, said, in some cases, women aged up to 45 may benefit from it, such as if they have new sexual partners.
As long as they understand that the vaccine may not be as effective as if they had taken it before age 26 and before becoming sexually active, they can have a discussion with their doctor to understand what would best suit their needs, she added.
“The age limit of 26 years is because the assumption is that most people would have been sexually active by that age and thus already been exposed to HPV,” said Dr Huang. “The vaccine affords best protection if someone has not been exposed to HPV yet.”
It is highly recommended that females between nine and 26 years old get the HPV vaccine, to protect themselves against cervical cancer. (Photo: iStock/DragonImages)
The bad news is, you’ll still have to get cervical smear tests.
“Cervical cancer screening in the form of Pap smears and/or HPV tests is still necessary because the vaccine does not cover all types of HPV that can cause cervical cancer,” Dr Huang told CNA Women. “Also, you may have been exposed to HPV before vaccination. And, finally, the vaccine does not treat existing infections – it only prevents future ones.”
Regardless of whether you’ve had the HPV vaccine, you should get a Pap smear every three years if you’re aged 21 to 29. For women aged between 30 and 65, Dr Huang advised to do it every three years, or a Pap and HPV co-test every five years, or HPV testing alone every five years.
“Screening helps detect abnormal cells early, allowing for early treatment before cancer develops,” she said.
Fact #4: No, cranberry juice does not cure UTI
Urinary tract infections (UTIs) are common in women – one in five females aged 20 to 65 experience it at least once a year. It occurs when there’s a significant amount of bacteria in the urinary tract and, if left untreated, it can spread to the kidneys.
If you’ve been reaching for cranberry juice to cure your UTI, you might want to stop.
“While cranberry juice can’t treat UTIs, some studies suggest cranberry products may help prevent them,” said Dr Huang.
“A substance in cranberries, A-type proanthocyanidins (PACs), has anti-adhesion properties that can prevent harmful bacteria (including E. coli, which is commonly associated with urinary tract infections) from sticking to the walls of the urinary tract,” she added.
The only cure for UTIs is antibiotics, which have to be prescribed by a doctor. If you have UTI symptoms such as painful urination, urgency or cloudy urine, Dr Huang recommended you see a healthcare provider for proper diagnosis and treatment.
Fact #5: Don't brush off bad period pains – it could be endometriosis
If you suffer from severe menstrual cramps, you might have what’s known as ‘the missed disease’ – endometriosis.
Endometriosis is known as “the missed disease” because it is often underdiagnosed. (Photo: iStock/Charday Penn)
KKH’s Dr Chuah explained that endometriosis is a condition where the tissue of womb lining responsible for menstruation is found outside of the womb. It affects about 10 per cent of women and as many as 30 per cent of women who complain of severe menstrual pain suffer from endometriosis.
“However, the condition is often under diagnosed as it may also exist in women with symptoms unrelated to periods or those who experience minimal discomfort,” Dr Chuah added. “This elusive condition can also cause inflammation, scarring and adhesions of tissues in the pelvis, resulting in infertility and debilitating pain.”
Pelvic ultrasounds are commonly used to look for signs of endometriosis, such as cysts on the ovaries or nodules. Dr Chuah
Dr Chuah urged women to seek help from a gynaecologist when menstrual pain affects their day-to-day activities and quality of life.
While it’s common to take paracetamol for menstrual cramps, DTAP Clinic’s Dr Huang said that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and mefenamic acid are more effective as they reduce inflammation.
You could also ease cramps by applying heat. Dr Huang suggested a heating pad or warm bath as they can relax muscles and reduce pain. Dietary changes help too – reducing caffeine, salt and processed foods may lessen bloating and discomfort.
Also, drinking plenty of water can reduce bloating and ease cramps, she added.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.
Continue reading...