This article was contributed by Dr Kanika Chaudhuri   For ladies who are not ready for a child yet, common contraception options that come to mind are usually condoms or birth control pills. However, due to medical advances, ladies actually have a wider range of contraception options. Dr Kanika from Astra Women’s Specialist Centre in Toa Payoh, Singapore answer some frequently asked questions on the various contraceptive devices, especially Intrauterine Contraceptive Devices, which are gradually gaining popularity. What Are IUCDs and What Types of IUCDs Are There? Intrauterine Contraceptive Devices (IUCDs), which are also referred to as Intrauterine Devices, are a form of birth control device that is inserted into a woman’s uterus. There are 2 main types of IUCDs — copper (non-hormonal) and hormonal.   1. Copper IUCD The copper IUCD, an example being Nova-T, is a small device that is only about 2 cm in size. It prevents pregnancy by preventing the implantation of the embryo in the uterus lining. The life span is about 5 years, after which, a new IUCD can be inserted by your gynaecologist.   2. Hormonal IUCD The hormonal IUCD, an example being Mirena, is also a small device that is only about 2cm. However, unlike a copper IUCD, it is coated with a hormone. Apart from its contraceptive function, Mirena can also help ladies with a very heavy menstrual flow to reduce their menstrual blood flow (this usually takes 3-4 months to happen). The lifespan of Mirena is about 3-5 years.   What are the Benefits of IUCDs? They are long-acting, with life spans of 3-5 years. Hence, once inserted, you do not need to be troubled with contraceptive methods until the lifespan of the device ends. This contraceptive action is reversible – at any point in time where you would like to start trying for a child, the IUCD can be removed and the contraceptive effect will also be removed. The insertion process is simple and relatively painless. IUCDs are typically inserted at the gynaecologist’s clinic via a short procedure that does not require anaesthesia. After insertion of the IUCD, you will only need to visit your gynaecologist at least once a year for a quick checkup to ensure that the IUCD is in the correct position. It is important to note that the above IUCDs are generally more suitable for ladies who have already had children.   What Other Options Are There Apart from IUCDs? 1. Implanon Implanon is another popular birth control device that is inserted under the skin at the arm area via an injection. It is generally recommended for ladies who have not had children yet. Implanon contains progesterone, which is released progressively over time. The lifespan of Implanon is 3 years.   Unlike IUCDs, ladies who choose Implanon will not need regular check-ups to check on the placement. You will only need to consult your gynaecologist at the end of 3 years to get it removed or replaced. A key thing to note is that with Implanon, your menstruation or period will stop during the time when Implanon is in your body.   2. Birth Control Pills (BCPs) Oral contraceptive pills have been around for a long time and there are a variety of brands to choose from. Your gynaecologist will usually let you try out one brand for a month, and if there are no side effects, that will be an appropriate brand for you. If you have some side effects, like a headache or nausea, your gynaecologist can then switch brands for you.   While the chances of failure are minimal for birth control pills, you will need to take it as instructed to achieve the contraceptive effect. BCPs can also help to regulate your menstrual cycle.   How effective are IUCDs and BCPs at preventing unexpected pregnancies? IUCDs and BCPs are generally very effective at preventing unexpected pregnancies. Mirena is considered the most effective, with a possible failure rate of 0.5%, which is even lower than undergoing a ligation procedure for contraceptive purposes. As for Nova-T, about 1% of women may still get pregnant, so if you miss your period, you need to see your gynae as soon as possible.   With regards to BCPs, about 1 in 100 women may still get pregnant, but always remember the importance of taking your pills as instructed. In the event that you forget to do so, visit your gynaecologist immediately.   For ladies considering your contraceptive options… It is necessary for you to talk about the various contraceptive devices available with your gynae as they will be able to best advise you on the most suitable option. This will depend on whether you have had children previously when you plan on having your next child, and what would best suit your lifestyle. Book an appointment with our O&G, Dr Kanika Chaudhuri, to find out more about your contraception options.    Schedule your appointment here >>    * Content is republished with permission from SMG Women's Health

School holidays are a much-anticipated time for children as they get a break from their daily routines. However, these extended breaks can sometimes lead to unhealthy habits if not managed properly. It's essential for parents and caregivers to ensure that their children remain active and maintain healthy habits during these holidays. In this article, we'll discuss four essential tips to help keep children healthy and engaged during the school holidays.   Encourage Outdoor Activities One of the most effective ways to keep children healthy during school holidays is to encourage outdoor activities. Spending time outdoors provides numerous physical and mental health benefits. It allows children to soak up vitamin D from the sun, which is essential for bone health and overall well-being. Additionally, outdoor activities promote physical fitness, improve mood, and reduce stress.   Consider planning family outings to parks, nature reserves, or local hiking trails. Engage in fun outdoor games like tag, frisbee, or soccer. Gardening is another fantastic way to teach children about nature while keeping them active. Limit screen time and encourage your children to explore the natural world around them.   2. Maintain a Balanced Diet During school holidays, it's easy for children to fall into unhealthy eating habits, such as excessive snacking on processed foods and sugary beverages. To keep your children healthy, it's crucial to maintain a balanced diet.   Ensure that they have regular, nutritious meals with a variety of fruits, vegetables, whole grains, lean proteins, and dairy products. Keep healthy snacks like cut-up veggies, fruits, and yoghurt readily available for when they're hungry between meals. Teach them about the importance of portion control and making mindful food choices.   Engage your children in meal preparation and cooking. This not only encourages them to appreciate wholesome foods but also teaches them valuable life skills.   3.  Maintain a Routine While school holidays are a break from the usual school schedule, maintaining a routine can help children stay on track and establish healthy habits. Create a daily schedule that includes set times for meals, physical activity, and bedtime. Having a routine provides structure and predictability, which can reduce stress and anxiety for both parents and children.   Make sure your children get enough sleep as well. A consistent sleep schedule is essential for their physical and cognitive development. Avoid letting them stay up late regularly, as it can lead to sleep deprivation, which affects mood, concentration, and overall health.   4.  Foster Creativity and Learning The school holidays are an excellent opportunity to foster creativity and continue learning outside the classroom. Encourage your children to explore their interests through hobbies, arts, and crafts. Provide them with books, educational games, and puzzles to keep their minds engaged.   Consider enrolling them in summer camps or classes that align with their interests, whether it's sports, music, science, or art. These structured activities not only provide opportunities for learning but also social interaction with peers.   Conclusion Keeping children healthy during school holidays is essential for their overall well-being. By encouraging outdoor activities, maintaining a balanced diet, sticking to a routine, and fostering creativity and learning, parents and caregivers can ensure that their children make the most of their break while staying physically and mentally fit. These tips will not only benefit their health during the holidays but also help establish lifelong healthy habits.

Urinary health for females differs vastly from men, with events such as pregnancy and childbirth or a higher number of pregnancies being risk factors for urinary incontinence. Menopausal women are also at risk due to a drop in oestrogen (hormone) levels.   Additionally, because of structural differences in our anatomy, women are more prone to other urinary issues, such as urinary tract infections, than men. Thankfully, many of these conditions are highly treatable with behavioural therapies, nerve stimulation and surgery.   1. Urinary Incontinence Urinary incontinence refers to the involuntary leakage of urine from the bladder and is an increasing problem in an ageing population like Singapore.   Urinary incontinence can be caused by anything from hormonal deficiencies, weak pelvic floor muscles, urinary tract infections or problems with the nerves in the bladder. Types of urinary incontinence include: Stress Urinary Incontinence This is the most common type of incontinence and involves the leakage of urine when increased pressure is put on the bladder, such as when laughing, coughing, sneezing or during exercise. This is usually caused by the inability of the urinary sphincter to hold urine under pressure. Urge Incontinence Urge incontinence, also known as overactive bladder (OAB), is a type of incontinence where one feels a sudden or strong urge to urinate, often leading to uncontrolled early urination. This is caused by the bladder muscle contracting too early. Mixed Incontinence As the name suggests, if your symptoms sound like a mix of both stress urinary incontinence and urge incontinence, you may be diagnosed with mixed incontinence. Overflow Incontinence Overflow incontinence refers to the inability to empty the bladder fully, despite having the urge to urinate. This leads to “overflowing” and leaking.   Some women may also experience temporary urinary incontinence when they are pregnant or shortly after childbirth due to weakened pelvic floor muscles. These women are at a higher risk of incontinence in their later years as well.   Treatment for urinary incontinence largely depends on the type of incontinence you have and what is causing it. This requires a comprehensive diagnosis of your condition. There are a variety of treatment options, from lifestyle changes (i.e. pelvic floor exercises) to minimally invasive procedures such as neuromodulation for OAB to surgical intervention for severe incontinence.   2. Genitourinary Syndrome of Menopause (GSM) Also known as vaginal atrophy, genitourinary syndrome refers to symptoms caused by reduced oestrogen levels as a result of menopause in women. This leads to issues with the female genital area, pelvic floor tissues, bladder and urethra. Some symptoms include: Vaginal dryness or burning sensations Unusual vaginal discharge Urgent or frequent urination Spotting after sexual intercourse Vaginal dryness during sexual intercourse Shortening or tightening of the vaginal canal Recurrent urinary tract infections (UTIs) Genital itching Treatment provided is generally tailored to the postmenopausal symptoms one experiences. For example, topical oestrogen can be prescribed for vaginal dryness to help balance the vaginal ecosystem, reducing the risk of recurring UTIs.   There are also minimally invasive treatments, such as the FOTONA Laser for stress urinary incontinence (mild to moderate), which utilises thermal energy to remodel tissue in the vaginal wall. This helps thicken and tighten the vaginal tissues, providing greater support to the bladder and urethra. This, in turn, returns normal continence function.   3. Recurrent Urinary Tract Infection (UTI) A urinary tract infection (UTI) refers to infections involving any part of the urinary system, namely the kidneys, ureters, bladder and urethra. This leads to issues such as a burning sensation during urination, abnormal discharge, abdominal pain, difficulty urinating or frequent urination. Symptoms of a UTI include: A burning sensation during urination Blood in the urine Cloudy urine Abnormal discharge Incomplete voiding of the bladder Frequent, painful urination Incontinence Pelvic or abdominal pain In addition, acute pyelonephritis is known to result in high fever, pain in the back or flank, chills, as well as nausea or vomiting.   The first line of treatment involves the use of oral antibiotics. For recurrent UTIs or multi-drug resistant UTIs, intravenous antibiotic treatment may be administered, which will involve a short hospital stay.   It is important to note that a UTI may be a symptom of an obstruction in the bladders and kidneys, in which case a procedure to remove these obstructions may be needed.  Summary Although women are at risk of various urinary problems because of occurrences such as pregnancy and menopause, physiological differences and hormonal changes, many of these conditions are manageable with the right treatments.   If you suffer from urinary conditions such as frequent or difficulty urinating, blood in your urine or severe abdominal pain, please consult a urologist for proper diagnosis and a personalised treatment plan.    Schedule your appointment here >>      *Content is republished with permission from Aare Urocare.