Consult Doctors. FREE.
Real Doctors, Expert Answers
Connect with Facebook Connect with Google For Doctors
By creating an account, you are indicating that you have read and accepted the DoctorXDentist Terms of Use.
Consult Doctors. FREE.
Real Doctors, Expert Answers
By creating an account, you are indicating that you have read and accepted the DoctorXDentist Terms of Use.
Registration Progress
Step 1: Indicate Topics of Interests
Step 2: Follow Relevant Doctors
Complete!
What are your interests?
Please select at least 3 interests.
NEXT
NEXT
Registration Progress
Step 1: Indicate Topics of doctors
Step 2: Follow Relevant Doctors
Complete!
Follow your favourite doctors
We found some doctors you may like. Click continue to follow them.
CONTINUE
CONTINUE
Consult Doctors. FREE.
Real Doctors, Expert Answers
Continue with Facebook Continue with Google

or

OOPS!

SOMETHING WENT WRONG.

PLEASE TRY AGAIN.

OOPS! SOMETHING

WENT WRONG.

PLEASE TRY AGAIN.

Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

Continue with Facebook Continue with Google

Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

YOUR QUESTION HAS BEEN

SUCCESSFULLY SUBMITTED.

YOUR QUESTION

HAS BEEN

SUCCESSFULLY

SUBMITTED.

YOUR ANSWER HAS BEEN

SUCCESSFULLY SUBMITTED.

YOUR ANSWER

HAS BEEN

SUCCESSFULLY

SUBMITTED.

YOUR QUOTE REQUEST HAS BEEN

SUCCESSFULLY SUBMITTED.

OUR DOCTORS WILL GET BACK TO YOU SHORTLY!

YOUR QUOTE REQUEST

HAS BEEN

SUCCESSFULLY

SUBMITTED.

OUR DOCTORS WILL GET

BACK TO YOU SHORTLY!

YOUR THREAD HAS BEEN

SUCCESSFULLY CREATED.

HEAD OVER TO FORUM PAGE NOW

TO JOIN THE DISCUSSION

YOUR THREAD

HAS BEEN

SUCCESSFULLY

CREATED.

HEAD OVER TO THE FORUM PAGE NOW

TO JOIN THE DISCUSSION!

YOUR REVIEW HAS BEEN

SUCCESSFULLY SUBMITTED.

THANK YOU.

YOUR REVIEW

HAS BEEN

SUCCESSFULLY

SUBMITTED.

THANK YOU.

OOPS!

THERE IS SOMETHING

WRONG WITH YOUR EMAIL.

PLEASE TRY AGAIN.

OOPS! THERE IS

SOMETHING WRONG

WITH YOUR EMAIL.

PLEASE TRY AGAIN.

YOUR EMAIL HAS BEEN

SUCCESSFULLY SUBSCRIBED.

THANK YOU.

YOUR EMAIL

HAS BEEN

SUCCESSFULLY

SUBSCRIBED.

THANK YOU.

YOUR CONSULTATION HAS BEEN

SUCCESSFULLY SUBMITTED.

OUR DOCTORS WILL

GET BACK TO YOU SHORTLY.

YOUR CONSULTATION

HAS BEEN

SUCCESSFULLY

SUBMITTED.

OUR DOCTORS

WILL GET

TO YOU

SHORTLY.

MESSAGES TO

Women's Health

A DxD Session with Dr Michelle Chia


Now Answering until Thu Feb 28 2019
Live | Now answering questions
Have a question to ask?

Get Dr Michelle Chia's opinions on your questions! Only approved questions are displayed.

Top Answers


I am sorry to hear that these symptoms have been so troubling for you and affecting your quality of life. 

Chronic fatigue syndrome is usually diagnosed when no other medical conditions or causes can be found for a person's symptoms of excessive tiredness/fatigue. This sounds like it may be consistent with the symptoms you are going through.

Very often, chronic fatigue syndrome can affect a person's quality of life and day to day activities, which becomes very frustrating for the affected person.

To address your question with regards to the link between menopause and chronic fatigue syndrome, the relation between the 2 conditions has actually not been extensively studied as of yet. 

However, studies have shown that the majority of women affected by chronic fatigue syndrome are in their late 40s to 50s, which also correspond to women in their peri-menopausal or menopausal years.

In addition, menopause itself can lead to symptoms of fatigue, tiredness, mood swings or lower energy levels due to the lower level of female hormones in the body. As such, having menopaused may in turn be an additional factor for the symptoms you are experiencing as well.

Hope this addresses your concerns and hope you feel better soon.

Regards,

Dr Michelle Chia

15 Jan 2019

I am sorry to hear that your symptoms have been so worrying for you. 

Firstly, your symptoms sound like what we refer to as Intermenstural bleeding.

In a young person of reproductive age like yourself, the main thing to always rule out is always a pregnancy whenever you experience irregular spotting or bleeding that is out of the ordinary.

However, if you have not been sexually active, then there can also be many other causes of intermenstural bleeding such as cervical polyps, infections or even hormonal imbalance.

My main advice for you is to go see a doctor regarding your symptoms so that we can better investigate the cause of the symptoms to ensure this is not caused by something serious!

Hope this helps!

Regards,

Dr Michelle Chia

14 Jan 2019

There could be several reasons for a missed period. The causes for it will depend on factors such as your age, lifestyle factors and whether you are sexually active or not.

You have correctly done the right thing when you missed your period which was to perform a urine pregnancy test. That would be the most important thing to rule out with a delayed period.

If the urine pregnancy test is negative and your period is still not here in a few weeks, you may consider repeating the test to ensure that the negative test was not done too early.

Other than pregnancy, a delayed period can also be caused by lifestyle factors such as stress or any changes in your recent lifestyle. However, it would be good for you to consult a doctor if your period is delayed for a prolonged period of time (eg several weeks) or if this becomes a persistent problem.

Hope this helps!

Regards,

Dr Michelle Chia

21 Jan 2019

The purpose of taking folic acid prior to conceiving and during the first trimester of your pregnancy is to significantly reduce the risks of neural tube defects in the baby.

According to guidelines, the recommended dose of folic acid recommended for any woman who is trying to conceive is at least 400micrograms. 

However, in certain situations, the required amount of folic acid is much higher eg: 5mg 

For example, people with:

1. Pre-existing diabetes

2. Personal history, partner's history or family history of neural tube defects

3. Personal history of medications that may increase the risk of neural tube defects eg anti-epileptic medications etc

Whilst it would be useful to keep a balanced diet rich in folate rich food such as beans, grains etc, diet alone is insufficient to meet the requirements and most women actually take folic acid supplements before they conceive or during their first trimester.

The Thorne Research Basic B Complex that you have shown seems to be primarily a multivitamain that contains vitamin B.

I would recommend taking a pure folic acid supplement to ensure you get the adequate amounts of folic acid you need before conceiving.

Regards,

Dr Michelle Chia

21 Jan 2019
Hi,


Progesterone pills are commonly given as one of the management options for patients with PCOS. 

These pills are usually taken for a week every 3 months of not having your natural period.

Many girls affected by PCOS may not get their periods for many months, and the main purpose of a progesterone pill such as Norcolut is mainly to induce a withdrawal bleed once every 2-3 months. This is to maintain a healthy endometrial lining.

However, if you are trying to conceive, then taking a progesterone such as Norcolut may not be the most suitable. You may be advised by your doctor to switch to a different type of progesterone pill such as Duphaston which is more suitable for someone who is trying to conceive.

With that being said, it is expected for someone with PCOS to face some challenges while trying to conceive, and it would be good to see a doctor early for more timely treatment if required.

Regards,

Dr Michelle Chia


25 Jan 2019

Thank you for your question.

Fibroids are very common in women,especially those in the reproductive age group. They are usually mostly benign growths that grow mostly within the uterus.

A 8.7cm x 7.4cm x 7.8cm sized fibroid is relatively significant in size, and is actually of a size whereby surgical removal may be recommended.

The concern with having a large and fast growing fibroid is the rare chance of it being malignant,when it becomes a leiomyosarcoma. Of course, the only way to definitely know for sure is only with histology when the fibroid is removed.

Large fibroids can also cause other complications such as external compression on the bladder causing urinary retention or frequency. Some people can also experience heavier periods with fibroids, or abdominal pain if the fibroid undergoes degeneration.

 Given that you are only 30 years old, you have to also consider other factors such as: how this fibroid can affect your pregnancy if you do get pregnant (it can significantly grow much bigger during pregnancy), and also the chances of this fibroid coming back even if you choose to remove it with surgery.

In your situation, surgery will be the most effective way to remove the fibroid. Other considerations can include hormonal injection to try to reduce the size but this may not be effective or suitable for you since you are still quite young.

Ultimately, the important thing to note is that you have to weigh your own risks and benefits of choosing to go for surgery to remove the fibroid or choosing to closely monitor it. An honest and detailed discussion with your gynaecologist can help guide you in making your decision.

Hope this helps!

Regards,

Dr Michelle Chia

3 Feb 2019

The surgical considerations for treatment of fibroid include:

  1. Mode of surgery - Laparoscopic vs Open Surgery
  2. Extent of surgery - Myomectomy (removal of fibroid only) vs Hysterectomy (removal of the entire womb)

The type of surgery recommended for fibroids will depend on a few factors such as:

  • a patient's age
  • prior abdominal surgeries before (including caesearean section)
  • reproduction desire
  • whether your family is completed
  • the size, location and number of fibroids
  • if there are any other symptoms or problems associated with it
  • patient's own medical history and condition

Whether you are suitable for a laparoscopic myomectomy will depend on what you want, your expectations as well as the expertise of your operating surgeon.

In general, a 8.7cm can usually be removed via laparoscopic myomectomy (again, depending on the surgeon). However, you must be aware of the risks vs benefits of a laparoscopic vs open approach and weigh the options yourself before deciding.

The benefits of laparoscopic surgery include much smaller scar and faster recovery time post op. 

However, laparoscopic myomectomy carries the risk of morcellation (surgically cutting the fibroid into smaller pieces to remove through the key hole port). 

The concern with morcellation is the rare risk of potentially spreading abnormal cells around the abdominal cavity if the cells in the fibroid turn out to be bad. 

Again, the main thing is for you to have a detailed discussion with your gynaecologist so that you can weigh your options carefully before making a decision that you are comfortable with.

Regards,

Dr Michelle Chia

3 Feb 2019

Hi there,

It is good to know that you are taking birth control pills for contraception. Birth control pills are a very reliable form of contraception if taken correctly.

Your next course of action will depend on when in the pack the missed pills were, eg: week 1, 2 or 3.

However,if you had missed taking 2 consecutive pills, the birth control effect would have been lost during that period. The fact that you also had unprotected intercourse during this period would mean that you do have an increased risk of pregnancy.

In general, missing pills would mean additional protection is required and the contraceptive effect of the pills only return after 7 consecutive days of proper consumption of the pill.

You should see a doctor for a consultation to get advice on what is the next best thing to do, and do a pregnancy test if you do have a suspicion of any possible pregnancy.

If you have a tendency to forget the pills, then perhaps an alternative form of contraception may be more suitable for you.

Regards,

Dr Michelle Chia

10 Feb 2019

Hi there,

Missed periods and its relation to osteoporosis are only in specific situations whereby the levels of Estrogen in your body is low, eg premature menopause.

There can be several reasons why you could be experiencing amenorrhea, and the best advice for you is to seek a doctor's opinion as soon as possible to find out what the underlying cause is.

The answer to your question will depend on many other factors such as your age, medical history, medications etc.

Bone mineral density test is usually recommended for surveillence for women who have menopaused or who have premature menopause/ovarian failure as well as other risk factors for osteoporosis.

Again, do see a doctor early to find out the reason behind your amenorrhea before doing a BMD.

Regards,

Dr Michelle Chia

10 Feb 2019

Hi there,

Your symptoms sound like they way be related to some form of nipple eczema or dermatitis. Especially since the symptoms worsen with sweating and is associated with intense itch.

What you should do is to see a doctor for a consultation as only when a doctor examines the area of concern can we form a better clinical diagnosis and help you treat your condition better.

Hope this helps.

Regards,

Dr Michelle Chia

15 Feb 2019

It would be important for you to get a work up of the irregular periods first before you resume your Yasmin.

Resuming birth control pills is ideally done with the first day of your period, but this should only be after other causes of your irregular periods have been excluded.

Hope this helps.

Regards,

Dr Michelle Chia

13 Feb 2019

Hi there,

The answer to your question will depend on what your menstural pattern was before yasmin and how irregular your periods have become now.

Your periods on Yasmin would have been very regular because of the monthly withdrawal bleeding.

However, if you have since stopped the medications and find that your periods have become irregular, it would be good for you to go for further checks to ensure that this irregular periods is not due to some other underlying cause.

Regards,

Dr Michelle Chia

13 Feb 2019

Top Questions


I'm 33 and trying to conceive. I have undergone endometrial scratching to try to improve my fertility. I was wondering if endometrial scratching is effective at improving fertility?

I have several fibroids, the largest is about 6cm. Specialists have been monitoring my fibroids, and deemed it to be stable. I was wondering how fibroids may affect my periods? 

I’m 21 years old and pregnant. I've suffered from a toothache for almost 3 weeks. Are there any considerations to take note of for treatment of my toothache?

Is there any risk of permanent damage (especially to my reproductive system) if I suffer from recurrent vaginal yeast infections? These happen before ovulation every month.

I've heard that giving birth is very painful. What are my anesthesia options during delivery in Singapore?