Elective egg freezing is now available in Singapore. Learn more here.
CALL USBook Appointment
YouTube
Instagram
Astra Women's Specialists Logo
Women Wellness

Gynaecology

Gynaecology is the field of women’s health medicine that looks at the clinical care of the female reproductive system. This not only includes the management of clinical problems but also preventive management such as vaccinations and screenings to keep your reproductive health at an optimal state.

Most women are aware of their reproductive health changes during puberty. But as she moves through adolescence to young adulthood, and subsequently her middle age and golden years, life’s priorities may cause her to de-prioritize her reproductive health.

Book Appointment

We manage gynaecological problems for all ages

Adolescence (10-19 years)
Young Adult (20-34 years)
Adult (35-50 years)

Adolescence (10-19 years)

This period marks the transition from childhood to womanhood, with physical changes starting around age 10. Puberty includes growth in height and weight, breast development, body hair, acne, and menstruation. Many gynecological issues in adolescence are linked to hormonal imbalances during this stage.

Young Adult (20-34 years)

Young Adult (20-34 years)

This is the prime period of a woman’s life, where she has moved past the challenges of puberty and developed a strong sense of self as a young adult.

Adult (35-50 years)

Adult (35-50 years)

This period focuses on managing hormonal changes, addressing common concerns like irregular periods, menopause, and pelvic health, and ensuring overall reproductive wellness.

Gynaecological problems that we manage:

  • Fibroids

    Non-cancerous growths consisting of muscle and fibrous tissue.

  • Endometriosis

    A condition where the uterine lining (endometrium) grows outside the uterus, affecting areas like the ovaries, fallopian tubes, and ovarian ligaments.

  • Polyps

  • Gynaecological cancers (endometrial, cervical and ovarian cancer)

    Refer to various cancers which develop in a woman’s reproductive organs.

  • Vaginal laxity and dryness

    After childbirth, women may experience vaginal dryness and laxity due to muscle strain during delivery. Those with difficult or multiple deliveries are more prone to these changes.

  • Ovarian Cysts

    Ovarian cysts are fluid-filled sacs that develop on the ovary. Most are harmless and resolve on their own (physiological cysts), but in some cases, they may be tumors or cause complications if large.

Follicular Cyst
Benign Ovarian Cysts (Non-Cancerous Cysts)

Follicular Cyst

The most common cyst. This is a normal development in an ovulatory cycle. After ovulation, the cyst will become a corpus luteal cyst. If pregnancy does not occur, the corpus luteal cyst will resolve and disappear. These cysts are usually asymptomatic. However, some women do experience some ‘mid-cycle’ pain around ovulation. Occasionally the corpus luteal rupture can rupture and cause bleeding in the abdomen.

Benign Ovarian Cysts (Non-Cancerous Cysts)

a) ENDOMETRIOTIC CYST
These cysts are filled with brownish stale blood and are also called ‘chocolate cysts’. They are usually associated with endometriotic spots in the pelvis and sometime, pelvic adhesions. Endometriosis can cause infertility, pain during menses, pain on defecation and painful sexual intercourse.

b) DERMOID CYST
Dermoid cysts are filled with thick yellow fluid, sebum. Structures such as skin tissues, hair, teeth, brain tissues can also be present.

c) MUCINOUS AND SEROUS CYSTS
These cysts are filled with mucoid and watery clear serous fluid respectively.

d) MALIGNANT CYST (CANCEROUS CYST)
Usually these cysts do not present with symptoms until at a late stage. These cysts may be multi-septated with some solid areas. Ascites (fluid in the abdomen) may be present. CT Scan assessment is needed.

Preventive Management Services for Women:

1. Female Cancer Screening

PAP Smear for Cervical Cancer
Endometrial Cancer (Inner lining of the womb)
Ovarian Cancer

PAP Smear for Cervical Cancer

Who should do it?

Once a woman becomes sexually active. After age 69, Pap smears are less essential, especially if previous smears have been negative.

Women are at increased risk of cervical cancer if they had sexual intercourse at an early age, have multiple sexual partners, had sexually transmitted infections, smoke, are immuno-compromised or are HIV-positive.

When to do it?

Optimally to be done once a year if not at least once every 3 years. Annual screening would have a higher detection rate as compared to every 3 years.

How is it done?

There are 2 forms of PAP smears presently available. The conventional dry smear and the liquid based cytology. The latter has higher detection for cervical cancer. HPV DNA is used in conjunction with Thin prep Pap smear to diagnose the presence of high risk HPV.

Endometrial Cancer (Inner lining of the womb)

At present there is no effective means of screening. Women who have abnormal bleeding should see their doctors early and consider hysteroscopy / endometrial biopsy for evaluation.
Risk factors for endometrial cancer:

  • Infertility
  • Never been pregnant
  • Overweight
  • Diabetes
  • Hypertension (high blood pressure)
  • Late onset of menopause
  • Taken drugs such as Tamoxifen or unopposed estrogens.

Ovarian Cancer

Women with a family history of ovarian or breast cancer would be at increased risk. There is at present no effective screening for women at average risk. They would be advised to see their doctors if they feel bloated or have pain in the abdomen, indigestion, frequent urination, back pain, loss of weight and appetite. Those with increased risk may consider a transvaginal ultrasound scan and CA 125 serum testing.

2. Colposcopy

Colposcopy is a diagnostic procedure where a colposcope is used to closely examine the cervix and vagina. The colposcope magnifies the area with light, similar to a microscope for the womb.

3. Hysteroscopy to assess the uterine cavity

4. Vaccinations e.g. HPV vaccination for protection against cervical cancer

The HPV vaccine protects against common cancer-causing HPV strains. There are three types of vaccines, and completing the course with one is sufficient.

5. Menopause Management

Menopause marks the end of menstruation and occurs in all women. While many transition smoothly, some face discomfort. With proper knowledge and care, symptoms can be managed effectively.

Book Appointment

What to Know About Menopause

Menu