Starting a new workout routine in your 40s and 50s may seem intimidating, but remember, it’s never too late to reap the benefits of exercise! In fact, regular workouts can help older adults slow down age-related conditions like muscle loss and improve bone, joint, and heart health. Sure, you may not be as fit and agile as when you once were in your 20s, but that doesn’t mean you can’t quickly get back in shape. Image Source: Envato Elements, Kenishirotie Before you begin, if you have any existing health conditions, it is best to consult your doctor for advice. Certain sports or exercises may be safer and more suitable for you, especially if you suffer from heart, bone and/or joint problems. As much as we’d like to throw caution to the wind, at this age, exercise does need to be ergonomic to reduce risk of injury. If you’re generally healthy, you can start with light cardio, strength and stretching exercises. Try low-impact activities like martial arts, yin yoga, and other sports that improve muscle strength as you grow older. Swimming is another excellent option — it’s easy on your joints, yet gets your heart rate going. If you’re at the gym, you can also brisk walk on the treadmill or spend some time on the elliptical machines to give you the cardio boost you need. Finally, remember to listen to your body and give yourself enough time to rest and recover, especially in the initial stages when you’re first starting out. Stay hydrated with plenty of water and always make sure to stretch and warm up adequately before exerting yourself. Reference: https://www.cnet.com/health/how-to-start-exercising-in-your-50s-and-beyond/
In this article, Dr Lim Min Yu, an IVF clinician and OB/GYN from the Astra Women’s & Fertility Centre shares more about egg freezing as a way of preserving fertility. Not only are fertility rates on the decline in Singapore, but couples are also choosing to get married and have children later in life. Age is an important factor affecting fertility and while you cannot stop the ageing process, there are ways to preserve fertility. What is Egg Freezing? Egg freezing, also known as oocyte cryopreservation, is a process in which a lady’s eggs (oocytes) are retrieved, frozen and stored as a way to preserve the fertility of a lady who wants to conceive later on in her life. Egg freezing enables ladies to avoid the issue of declining egg quality which is a common problem faced by women as they grow older. Reasons Why Ladies Freeze Their Eggs Ladies are born with all the eggs they will ever produce. Hence, as women grow older, the quality and quantity of eggs decline. Egg freezing is a way of preserving the healthy eggs of women when they are younger and not necessarily ready to conceive just yet. There are two main reasons why ladies often opt to freeze their eggs: 1. Medical A very common reason for ladies who want to freeze their eggs is to protect themselves from medical treatments that might affect their fertility and/or reproductive organs. A lady who is undergoing treatment for cancer might opt for egg freezing in case treatments such as chemotherapy and/or radiotherapy negatively affect fertility. Ladies who are at higher risk of getting cancer as a result of certain genetic conditions might also choose to freeze their eggs. This is because doctors may recommend removing the ovaries in order to reduce the risk of cancer developing. If ladies freeze their eggs before the ovaries are removed, they will still have the option of trying for pregnancy even after surgery. 2. Elective Some ladies are not ready to have a baby and start a family when they are in their peak reproductive years. As a result, some may prefer to have their eggs frozen so they can try for pregnancy even after their fertility has declined. This is also known as elective egg freezing. Egg Freezing in Singapore Egg freezing for medical reasons is allowed in Singapore and as of 2023, elective egg freezing will be allowed too. Each patient is different and therefore ladies should always consult their doctor to find out if egg freezing is a viable option. While there is no age limit for medical egg freezing, elective egg freezing is only available for ladies aged 21-35. To ensure ladies are able to make an informed choice, they will have to undergo counselling before their elective egg freezing procedure. The counselling session will highlight the invasive nature of the procedure, some of the limitations (no guarantee of a successful pregnancy, risks of a late pregnancy etc.) as well as the costs involved. What is the Egg Freezing Process Like? The initial stages of the egg freezing process are similar to the initial stages in an In-vitro Fertilisation (IVF) cycle. The lady is administered a series of hormone injections for about 2 weeks. She is observed with regular ultrasound scans and blood tests to determine if she is responding to the treatment well. When the eggs are mature, the lady will be administered a final injection. Then, the eggs are extracted from the lady while under sedation or a general anaesthetic. After the eggs have been extracted, they are examined by an embryologist and the mature eggs are then frozen. Most clinics use a flash-freezing method known as vitrification that will freeze the eggs at -196 degrees Celsius in under one minute. Vitrification is the preferred method of freezing as it has a much higher “post-thaw” survival rate for eggs of over 90% compared to the old method of freezing where the eggs only had a survival rate of about 60%. Are Eggs Harder to Freeze Than Sperms or Embryos Eggs are the largest cells in the human body, and largely made of water. When being frozen with the old slow freezing method, water forms ice crystals which can damage the egg. The vitrification process starts off with dehydrating the egg, to remove as much water as possible before ultra rapid freezing. Sperm are about 10,000 times smaller than eggs, with much less water in each cell. Therefore they are less susceptible to damage from ice crystal formation. Embryos are usually frozen when there are a few hundred cells. Therefore the chances of surviving the freezing process are better, as even if a few cells are damaged during the process, the other cells will survive, and resume cell division and multiplication once warmed up. What Happens After Egg Freezing? When the lady is ready to conceive, the eggs will be thawed and injected with sperm to achieve fertilisation. Upon successful fertilisation, the eggs are transferred to the uterus as embryos. Common FAQs Regarding Egg Freezing 1. When is the best age for me to freeze my eggs? Ladies should freeze their eggs before the age of 35. Fertility starts to decline after the age of 35 and this affects both the quality and quantity of the eggs. 2. How long can the eggs be kept frozen? In Singapore, there is no time limit on how long eggs frozen for medical reasons can be kept frozen. As freezing effectively hits the “pause” button, these eggs will be just as young and healthy as they were at the time of freezing. 3. Where are the eggs kept? Frozen eggs are kept in storage tanks filled with liquid nitrogen called Dewars. These tanks are stored in assisted reproduction centres. Some centres have sophisticated temperature monitoring systems that will send messages to the staff mobile phones if a rise in temperature is detected, enabling them to assess the situation and move the eggs to another tank if there is a problem. 4. Is egg freezing safe? Research to date has not shown an increased risk of babies having birth defects as a result of egg freezing. 5. If I freeze my eggs, will it increase my chances of falling pregnant? If you freeze your eggs when you are younger, you can use these healthier eggs when you are trying for a baby once you are much older. It is important to keep in mind that using the eggs that you have frozen to try for a baby does not mean you will definitely have a baby. There are many other factors that can affect your chances of falling pregnant. 6. Is egg freezing legal in Singapore? From 2023, the Singapore government has announced that ladies can now freeze their eggs for non-medical reasons.. You can find out more here. 7. How much will it cost if I need to freeze my eggs for medical reasons here in Singapore? The estimated cost of one cycle of egg freezing is $10,000. Consult SMG Women’s Health for professional advice if you have any enquiries. *Content is republished with permission from SMG Women's Health.
Pregnancy and delivery changes a woman forever – beyond physical changes, it also changes one mentally and emotionally. At a time when the new arrival takes priority over everything else, many women find themselves sacrificing their own practical and self-care needs in favour of the baby’s nutrition and safety. It is important to remember that postpartum care for yourself is critical so that you can be your best self as you bond with and care for your infant. Understanding the postpartum periodThe postpartum period encompasses the first 6 weeks after giving birth. This period, often dubbed as the fourth trimester, is a time when your body begins to heal and adjust to not being pregnant. It is described as a period of significant transition characterised by changes in self-identity, the redefinition of relationships, opportunities for personal growth and alterations to sexual behaviour as women adjust to the ‘new normal’. In short, there is definitely a lot going on! There are many factors that come into play in your postpartum recovery journey. These include whether you’ve just had your first child or your third, vaginal or C-section delivery, if you had gestational diabetes or if your baby was born preterm. Nevertheless, there are some general changes in your body and mind that you can expect. Changes to your bodyExpect some soreness in your vagina if you had a vaginal delivery. This would be accompanied by some bleeding over the first week. Bleeding is likely to gradually change to light-coloured discharge that may continue for about 6 weeks. You would also feel contraction-like sensations as your uterus is contracting back to its pre-pregnancy size.If you had delivered via C-section, you will experience pain at the site of incision. Movement is likely to be difficult. For example, you may have trouble getting in and out of bed. However, you are advised to move around to avoid blood clots from developing. Mood changesIt is common to feel sad during the first few days after delivery. You may also feel irritable, moody, anxious, may have difficulty concentrating or even experience sleep problems. As your hormone levels are changing during this period, with oestrogen and progesterone levels dropping off and prolactin and oxytocin levels rising and falling as your baby nurses, it is normal to experience a case of baby blues. These feelings typically peak on the third or fourth day and subside within 2 weeks. Do seek help if you find yourself experiencing severe mood swings, loss of appetite and overwhelming fatigue as these may be symptoms of postpartum depression. How can you care for yourself?Your body has done a lot of work throughout your pregnancy and continues to as you care for your newborn. It’s important that you also care for yourself and get the support that you need to cope during the intense postpartum period. Ask for and accept help from your partner, family and friends. There are many remedies you can try to ease discomfort and pain, including pain medications. Talk to your doctor to know what is safe to take, especially if you are breastfeeding. It’s okay to feel uncomfortable about your postpartum body but remember to be gentle on yourself and set realistic weight loss expectations. Plan small trips to get out of the house from time to time for a change in environment It’s normal to feel like you have no idea what you are doing in the early days. As you spend more time with your baby, you’ll be able to figure out what your baby needs and wants. The postpartum period is overwhelming. You may experience a range of conflicting and contrasting emotions, including intense feelings of joy and love as well as guilt and lack of control. Be gentle on yourself. Accept that your life has changed and while the transitioning phase may be hard, it will get better. References Healthline. Your Guide to Postpartum Recovery. Available at: https://www.healthline.com/health/postpartum-recovery-timeline Accessed 10 November 2021. Finlayson K, et al. PLoSOne 2020;15(4):e0231415. MSD Manual Consumer Version. Overview of the Postdelivery (Postpartum) Period. Available at: https://www.msdmanuals.com/home/women-s-health-issues/postdelivery-period/overview-of-the-postdelivery-postpartum-period Accessed 10 November 2021.
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.
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