STI: Ask the experts

March 5, 2009

Ask the experts

 

PERIOD PAIN FOR 20 YEARS

 

Q: I have suffered terrible period pains for more than 20 years. It became worse after childbirth.

 

I have tried taking painkillers two days before and after the start of my period but it does not help much.

 

I understand that there is a procedure whereby a flexible band is inserted into the womb to stop the menses totally.

 

My colleague said she underwent this procedure six years ago. I would like to know if it works and whether it is recommended for all women with my problem.

 

A: Painful periods are common and can be very distressing if severe. Usually the periods become less painful after childbirth. As this is not so in your case, it is important to exclude any pelvic organ pathology like endometriosis or fibroids, which may be causing the pain.

 

Endometriosis is a condition in which tissue from the lining of the uterus is found outside the uterus, such as in the ovaries or pelvis. This tissue still responds to monthly changes in hormones and also breaks down and bleeds. This bleeding, which occurs outside the uterus, can cause pain.

 

Fibroids are non-cancerous tumours or growths in the muscle wall of the uterus which can cause pain and heavy periods.

 

I would advise you to consult a gynaecologist who will do an internal examination and an ultrasound scan to detect any fibroids or endometriotic cysts in the ovaries. Other procedures, like a laparoscopy, may be necessary. The treatment will need to be tailored to the condition.

 

If small fibroids or mild endometriosis are found, then a trial of oral contraceptive pills may be worthwhile. The flexible band that you mentioned may be an option.

 

It is an intra-uterine hormone containing a contraceptive device called Mirena. It thins the lining of the womb and makes the periods stop temporarily or become lighter and much less painful. The device works for about five years and can be inserted easily at the clinic.

 

However, for certain types of fibroids and severe endometriosis, surgery may be the best option.

 

Dr Anupriya Agarwal is an associate consultant in the department of obstetrics and gynaecology at the National University Hospital.

 

 

LOW LIBIDO DESPITE GOOD HEALTH

 

Q: I am a 50-year-old Chinese male. Although my work involves sitting in front of a computer for many hours, I try to jog two or three times a week.

 

My Body Mass Index (BMI) is about 21.33, and I have no high blood pressure. I feel healthy but I have had low libido for more than 10 years now.

 

A few months ago, I had a prostate gland screening and the result was normal. I can hold my urine to a full bladder when necessary. However, whether or not my bladder is full, my urine flow is always weak.

 

Sometimes the final few drops of urine are difficult to pass. Can traditional Chinese medicine help improve my condition? Or is there any other solution?

 

A: Your low libido may be psychological; perhaps you have a busy work schedule. Regular exercises should help. Your BMI is not high, so obesity is not a contributing factor.

 

As for your dribbling, this is due to physiological reasons: The bladder behaves like a balloon. Once it is overstretched, the muscle power and elasticity drops, hence the difficulty in emptying the last few drops and dribbling at the end.

 

You should also try not to hold your bladder until it is so full. At 50 years, it is unlikely that prostate enlargement is the cause. So rather than rely on TCM, it is a matter of correcting your bladder habits.

 

Dr Chin Chong Min is an urologist at the Mount Elizabeth Hospital