General
Gynaecology

There are many types of menstrual disorders including abnormal uterine bleeding, heavy menses (menorrhagia), intermenstrual bleeding, premenstrual syndrome (PMS), painful menses (dysmenorrhoea), infrequent menses (oligomenorrhoea) or absent menses (amenorrhoea). There are many causes and you should seek medical advice if you experience any of these symptoms. Treatment is dependent on the cause of the problem and may involve lifestyle modification to medical treatment or even surgery in some situations.

Menopause is the natural absence of menstrual periods and usually occurs between 49 to 52 years of age. Medical professionals often define menopause as having occurred when a woman has not had any vaginal bleeding for a year. It may also be defined by a decrease in hormone production by the ovaries. Common symptoms include hot flushes, insomnia, vaginal dryness, dry skin or mood changes. Sometimes the symptoms may affect the quality of life and medication may be needed to improve the symptoms. Furthermore, if bleeding occurs after menopause (PMB), it is considered abnormal and medical advice should be sought.

Uterine fibroids are non-cancerous growths that develop in the uterus (womb). They are common and do not cause symptoms in many women. However, depending on the size and location of the fibroids, they may cause menses problems, urinary or bowel movement problems. Rarely, fibroids can become cancerous (leiomyosarcoma). In most women treatment is not required though monitoring with ultrasound every 6 to 12 monthly would be useful to monitor the size of the fibroids. There are various treatment options depending on the symptoms, size and location of the fibroids and may involve surgery (myomectomy or hysterectomy), non-surgery methods (arterial embolization or high intensity focused ultrasound of fibroids) or medication.

Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus(endometrium) grows outside the uterus. Endometriosis most commonly involves the ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs. Endometriosis is often characterized by chronic pelvic pain that can impact women's daily activities. Symptoms include severe menstrual cramps, abdominal cramps, backache, heavy menses, painful sex, painful bowel or urination especially during menses and even difficulty in getting pregnant. Treatments usually include surgery or medication to manage symptoms.

Ovarian cysts are fluid filled sacs that develop in one of the ovaries. There are many types of ovarian cyst and in most cases, the cysts are painless and cause no symptoms. Most cysts are benign or functional and go away with time. However, some cysts do cause symptoms such as pain and bloating and may require treatment. An ultrasound scan can help determine the type, size and location of the ovarian cyst. In some instances, treatment may be needed either with medication or surgery.

There are many causes for a vaginal discharge. It can range from non-serious conditions such as vaginal atrophy, antibiotic/medication use to more serious conditions such as genital tract infections. Genital infections are caused by germs that ascend the female reproductive system after vaginal entry. Women may experience symptoms such as smelly vaginal discharge, itchiness, or pelvic discomfort/pain. Most infections occur in the lower genital tract and are easily treatable but sometimes the germs may affect the upper genital tract which affect the uterus and fallopian tubes. If no treated appropriately, upper genital tract infections may result in reduced fecundity and sterility.

The vulva is the external part of the woman’s genital area. Some women experience redness, itchiness, pain or swelling of the vulva. This may be due to various conditions including, infection, vulvar dystrophy, allergy, vulvodynia, Paget’s disease or even cancer. You should seek medical advice if you experience any vulvar symptoms.

Women who have had multiple pelvic surgeries or severe pelvic infections are at risk of dense pelvis adhesions(scarring) which increase the risk of surgical complications of the urinary tract or bowel system as well as haemorrhage. Also women with certain conditions such as severe pelvic endometriosis or fibroids in unusual location such as the cervix or broad ligaments also have higher surgical risks. At Timothy Lim Clinic, we have the necessary experience and expertise to deal with such complex pelvic surgery while minimising surgical complications.

This is a type of surgery that allows the surgeon to access the inside of the abdomen through small incisions (cuts). The advantages of laparoscopy surgery include faster recovery, shorter hospital stay, less pain, less infection risk and better cosmesis. It is frequently used in the surgical treatment of ovarian cysts, fibroids, uterus and even in some early cancers of the reproductive system. At Timothy Lim Clinic, we have the experience and expertise to perform such procedures for the benefit of our patients.