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Wellness Centre
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Health Corner
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Now medisave covers Cervarix Cervical Cancer Vaccination for ladies age 9 to 26! Email wellness@ahppl.com.sg for more info today!
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ANTIOXIDANT
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ANTIOXIDANTS and OUR HEALTH
Antioxidants are natural substances that may protect our cells against the effects of free radicals. Free radicals are unstable molecules that arise during metabolism. Exposure to viruses, bacteria as well as cigarette smoke, pollution, radiation, sun and alcohol can lead to formation of free radicals.
Free radicals do accumulate with age. Normally our human body can cope with free radicals (oxidants). Oxidative stress occurs with imbalance between oxidants and antioxidants. If antioxidants are unavailable or there is excessive free radicals, damage to DNA of cells can occur. This may play a role in aging process and other diseases.
Diseases associated with oxidative stress:
- Heart disease
- Diabetes
- Cancer
- Dementia
- Autoimmune disease eg thyroid disorder
- Infection
- Cataract
Antioxidants are found in many types of food – fruits, vegetables, nuts, grains, fish and some meat.
Good sources of antioxidants –
1) Vitamin A – milk, liver, eggs, carrot
2) Vitamin C – fruits & vegetables eg orange, kiwi, papaya, strawberry, tomato, broccoli, cauliflower. Vitamin C has many functions. It is required for activation of hormones and recycling of Vitamin E. It also assists in iron absorption as well as eradication of Helicobacter pylori (stomach bacteria that can cause cancer). It may be useful to lower cholesterol and blood pressure. High dose Vitamin C reduces incidence of colds, decreases duration and severity of colds.
3) Vitamin E – nuts, seeds, green leafy vegetables
4) Beta-carotene – colourful fruits & vegetables
5) Lutein – green leafy vegetables, orange, papaya
6) Lycopene – red fruits & vegetables
7) Selenium – nuts, legumes, animal products
8) Zinc – beans, nuts, grains, meat, oysters, seafood. This is a nutrient required by antioxidant enzymes.
9) Glutathione – This has been termed 'Master Antioxidant'. It is a tripeptide made of 3 amino acids (cysteine, glutamic acid & glycine), body's most abundant natural antioxidant, produced in liver. It helps to maintain other antioxidants in their active form. Glutathione levels decline with age. Glutathione helps to protect the immune system and appears to have anti-aging effect.
Nutritional Therapy using antioxidants is available at Asia Healthpartners. Each therapy session is about 45 minutes to 1 hour. Consultation with our doctor with special interest in Anti-aging is required. Vitamin C therapy, as well as Wellness Cocktail (Vitamin B, C, Glutathione, Zinc, Copper, Manganese, and Chromium) therapy are available. Appointment is required.
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Sexually Transmitted Diseases
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Sexually transmitted diseases (STD) refer to infections that are transmitted through sexual intercourse. It can strike anyone, regardless of age, gender, race, sexual tendency, marital status and type of sex (oral, anal or vaginal sex) and the consequences may last a lifetime. Although condom is highly effective in reducing risk of contracting a sexually transmitted disease, it may not be 100% foolproof. Many STDs are silent – they cause no symptoms in the initial stage, especially in women. Even if a person is asymptomatic, the disease can still be transmitted to the sex partner.
Long term consequences for women include pelvic inflammatory disease, infertility, ectopic pregnancy and cervical cancer. It may also lead to irreversible damage to babies infected by their mothers during gestation or birth, including blindness and mental retardation. For men, the long term consequences include sterility and cancer of penis and anus.
HPV
Human Papilloma Virus (HPV) is the most common sexually transmitted disease. There are many subtypes of HPV that can infect the genital areas of both men and women. Even the mouth and throat can also be infected. Most people who are infected do not know that they have it as they do not have any symptoms. It is transmitted through genital and skin contact.
Complications –
1) Cervical Cancer – High risk oncogenic strains of HPV such as HPV 16 & 18 are responsible for at least 80% of cervical cancer cases.
2) Other types of cancer – Vulvar cancer, Vaginal cancer, Penile cancer, Anal cancer, mouth and throat cancer.
3) Genital warts – this presents as bumps in the genital area, within weeks or months after sexual contact. This is usually caused by HPV strains 6 & 11.
Investigation – HPV DNA test together with PAP smear for females
Treatment – There is no treatment for the virus itself. Treatment is available for warts and cancer. For warts, podofilox, imiquimod, cryotherapy using liquid nitrogen, surgical removal can be considered.
Prevention – HPV vaccines – Cervarix and Gardasil are highly recommended from age of 9 years old.
Chlamydia
This is caused by the bacteria Chlamydia trachomatis which can damage the female reproductive organs. It can be transmitted through oral, vaginal and anal sex and from mother to baby during childbirth.
Majority of patients have no symptoms. Symptoms may occur within 1 to 3 weeks.
Women – abnormal vaginal discharge, burning sensation during urination, pain during intercourse, lower abdominal pain, bleeding between menstrual periods, fever.
Men – penile discharge, pain during urination, itch of penis.
Complications – chronic pelvic pain, pelvic inflammatory disease, fallopian tube infection, ectopic pregnancy, infertility, epididymitis, Reiter’s syndrome
Investigation – urine, cells from penis / cervix for Chlamydia DNA PCR test
Treatment – Antibiotics eg doxycycline, azithromycin
Gonorrhea
Gonorrhea is caused by Neisseria gonorrhoeae bacterium. It can infect the mucous membranes of the female reproductive tract, the urethra and the mouth, throat, eyes and anus. It can be transmitted through sexual contact (no ejaculation required) with mouth, vagina, penis, and anus and from mother to child during childbirth.
Many do not have symptoms. Symptoms may occur within 1 to 14 days.
Women – painful urination, foul smelling vaginal discharge, abnormal vaginal bleeding, lower abdominal pain.
Men – painful urination, white/yellow/green urethral discharge, scrotal pain
Complications – pelvic inflammatory disease, ectopic pregnancy, epididymitis, infertility, disseminated gonococcal infection.
Investigation – urine, urethral, endocervical, vaginal specimen for Gonorrhea DNA PCR test
Treatment – Antibiotics – combination therapy using intramuscular ceftriaxone and oral azithromycin or doxycycline
Genital Herpes
This is caused by Herpes Simplex Virus – Type 1 or Type 2. HSV Type 1 usually causes cold sores, but sometimes may cause genital herpes. HSV Type 2 is the usual cause of genital herpes. The virus is spread by direct physical contact.
Incubation period ranges from 2 days to 2 weeks. Some people do not have symptoms. Others get blisters on or around the genitals, anus or mouth. The blisters break and leave painful sores that may take up to 1 month to heal. Once infected, the virus hides in neurons in the body indefinitely and gets reactivated in times of triggers such as stress and hormonal changes.
Complications – bacterial and fungal superinfections such as balanitis, eye infections, corneal ulcers, blindness, skin infections, brain infections (encephalitis and meningitis), disseminated herpes, neonatal herpes (baby).
Investigation – blood test for HSV Type 1 and 2 antibodies, HSV culture and PCR test for viral DNA or RNA.
Treatment – There is no cure for herpes. Antiviral medications can prevent or shorten outbreaks.
Syphilis
This is caused by the bacterium Treponema Pallidum. It is transmitted through direct contact with syphilitic sore, chancre. Chancres can occur at the external genitalia, vagina, anus and mouth. Pregnant women can transmit the disease to the unborn child.
Symptoms may appear as early as 10 days or as late as 3 months after exposure. In the primary stage, there may be a single chancre (sore) or multiple sores. The sore is usually firm, round and painless. It usually lasts 3 to 6 weeks and heals regardless of treatment. If the person is not treated, it progresses to secondary stage, whereby there are rough, red, non itchy skin rashes on hands and feet and sores in mouth, vagina, and anus. There are non specific symptoms of fever, sore throat, headache, swollen lymph nodes, fatigue and weight loss. Without treatment, it will progress to latent stage with no signs or symptoms. Late stage of syphilis can occur after 10 to 20 years, with damage to multiple organs – brain, nerves, eyes, heart, blood vessels, liver, bones and joints.
Genital sores caused by syphilis make it easier to transmit and acquire HIV sexually.
Investigation – Blood test for VDRL and TPHA
Treatment – Intramuscular injection of penicillin
Chancroid
This is caused by a bacteria – Haemophilus ducreyi. It is transmitted through sexual contact.
Symptoms appear within 1 day to 2 weeks. It starts with a small bump at the genitals. The bump transforms into a soft, painful, well defined ulcer with grey base that bleeds easily. Inguinal lymph nodes may be swollen.
Complications – urethral fistulas and scars
Investigation – diagnosis is clinical
Treatment – Antibiotics eg azithromycin, erythromycin, ciprofloxacin, ceftriazone
Bacterial Vaginosis
This is a common type of infection of the vagina caused by bacteria. It occurs when the normal balance of bacteria in the vagina is disrupted and replaced by overgrowth of bad bacteria. The cause is not fully understood, but it may be related to douching, smoking and having multiple sexual partners.
Symptoms include abnormal white/gray/yellow foul smelling vaginal discharge, itch around genitalia, and burning sensation during urination
Complications – increase in risk of other STDS, increase risk of miscarriage and preterm delivery during pregnancy.
Investigation – vaginal discharge for bacteria and DNA, PAP smear
Treatment – antibiotics – oral or vaginal eg metronidazole, probiotics for prevention
Trichomoniasis
This is caused by a parasite- Trichomonas vaginalis. It is transmitted through sexual contact. Only about 30% of people infected develop symptoms. Infection is more common in women. Symptoms occur within 5 days to 1 month.
Symptoms in men include itch, irritation inside penis, burning sensation after urination or ejaculation, penile discharge. For ladies, there is itch, burning sensation, redness of the genitals and vaginal discharge.
Complications – premature delivery (for pregnant women with the infection).
Investigation – urine, vaginal swab for Trichomonas PCR DNA test
Treatment – antibiotics – metronidazole for patient and partner
HIV
The Human Immunodeficiency Virus is a virus that kills the body’s CD4 cells. CD4 cells help the body fight infection and disease. AIDS (Acquired ImmunoDeficiency Syndrome) is a disease whereby HIV destroys the immune system. HIV is transmitted by blood and body fluids. It is not transmitted though sharing of food and drinks. Babies born to mothers with HIV can get infected during pregnancy, birth and breastfeeding.
HIV remains asymptomatic for years. Stages of HIV – acute retroviral syndrome (fever, fatigue), HIV without symptoms, HIV with symptoms (e.g. weight loss, pneumonia, cancer), AIDS
Complications – AIDS (late stage of HIV infections) – this usually develops within 10 to 12 years after infection. The CD4 count is very low and person succumbs to multiple infections caused by viruses, bacteria, fungi and parasites and cancers such as Kaposi sarcoma, lymphoma and cervical cancer.
Investigation – HIV antibody test (window period up to 6 months), Confirmation blood test using Western Blot
Treatment – Anti HIV drugs
Viral Hepatitis
The most common forms of viral hepatitis are A, B and C. These are viruses that affect liver.
Hepatitis A is spread through ingestion of contaminated food or drinks. Symptoms of fever, vomiting, abdominal pain, yellowing of skin, dark urine and pale stools occur within 2 to 6 weeks of exposure. It may lead to liver failure.
Hepatitis B & C are transmitted by childbirth, blood and body fluids. They are not spread through food and water. They may cause acute hepatitis (symptoms similar to hepatitis A) with 6 weeks to 3 months. Chronic infection can occur whereby the virus resides within the body – Hepatitis B / C carrier state.
Complications – Liver damage, Liver hardening, Liver cancer, Liver failure.
Investigation – Blood test for Hepatitis A, B, C
Treatment – No treatment is available for acute Hepatitis A, B, C. Chronic Hepatitis B, C carriers require lifetime surveillance with blood test, ultrasound liver & fibroscan. Medications may be considered if clinically warranted.
Prevention – Hepatitis A vaccine is advised from age 1 onwards. Hepatitis B vaccine is advised at birth / any age. Combined Hepatitis A & B vaccine is available. There is no vaccine for Hepatitis C.
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FAQ on HPV Vaccination (Cervical Cancer)
(2 brands: Gardasil and Cervarix)
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Gardasil
• Recommended for ladies above 9 years of age and men.
• Protects against HPV types 6, 11, 16 & 18
• Protects against Cervical cancer, pre-cancer of cervix, Vulvar cancer, Vaginal cancer, Anal cancer, Oral cancer, and Genital warts.
• Not recommended during pregnancy.
Dosage schedule
First dose: decided by patient and doctor
Second dose: 2 months after the first dose
Third dose: 6 months after the first dose
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Cervarix
• Recommended for ladies above 10 years of age.
• Protects against HPV types 16 & 18
• Protects against Cervical cancer, pre cancer of cervix, Vulvar cancer, Vaginal cancer, Anal Cancer and Oral cancer.
• Not recommended during pregnancy.
Dosage schedule
First dose: decided by patient and doctor
Second dose: 1 month after the first dose
Third dose: 6 months after the first dose
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Common questions on HPV vaccination (cervical cancer)
What is the HPV vaccination for?
HPV vaccination is a preventive measure to protect one from HPV, a virus that can affect many parts of the body. HPV is a family of many subtypes of virus, with some that lead to certain types of cancer, including Cervical Cancer, one of the top cancers that affect women worldwide. For example, HPV types 16 & 18 cause about 80% of cervical cancers, while HPV types 6 and 11 cause about 90% of genital warts.
Our clinic carries both vaccines that have been approved for use in Singapore- Cervarix & Gardasil.
Is HPV vaccination medisave-claimable?
As with MOH’s regulations, for HPV vaccination, ladies (Singaporeans and Singapore PRs) between the ages of 9-26 years old are eligible to claim under Medisave (from own account or family members’ account), for up to $400 per year.
Why is HPV vaccination important?
Without vaccination, it is estimated that the majority of sexually active people will catch HPV during their lifetime. Non-sexually active people can also get infected with HPV through contact- e.g. towels, underwear, skin etc. Many people who have HPV may not show any signs or symptoms. This means that they can transmit (pass on) the virus to others without knowing it.
How long will the HPV vaccine last?
From research and modeling predictions, the HPV vaccine should last about 10 to 20 years. However, it varies with individual. No booster is required at the moment.
How is the HPV vaccine given?
The HPV vaccine is given as an injection usually in the arm muscle by our certified nurse. The full course comprises of 3 doses to be administered in 6 months.
The dosage schedule depends on the vaccine brand. (pls refer above). The schedule is flexible.
How do I know if I’m suitable for the HPV vaccine?
All ladies above 9 years of age and men 9-26 years of age are suitable.
The vaccine works best when given before exposure to HPV and when the person has not become sexually active.
Studies have shown benefits of the vaccine in age groups up to 45 years of age.
You can consult our doctor to find out the appropriate vaccine for you and your child.
You are not suitable for the HPV vaccine if:
You are allergic to any of the ingredients in the vaccine (including any of the ingredients listed under inactive ingredients) or if you have an allergic reaction after receiving a dose of the vaccine. The vaccine is not recommended during pregnancy.
If I’m already sexually active, will I still benefit from the HPV vaccine?
What if I already have HPV? Will the HPV vaccine still work on me?
Can I do the vaccination if my PAP smear test is abnormal?
YES! You can still benefit from the vaccine, because even if you have been exposed to HPV, you may not have been exposed to the types of the virus covered by the vaccine. Moreover the body may not be able to mount sufficient antibodies to prevent future infections.
By doing the HPV vaccine, your body will be able to produce sufficient antibodies to prevent future HPV infections. Clinical studies have shown that women, who have been previously exposed to HPV type 16 or 18 but had cleared the infection, were subsequently protected after vaccination.
HPV vaccine does not cure HPV infection.
Are there any possible side effects of the HPV vaccine?
The vaccine is generally well tolerated with minimal side effects. The reported side effects include pain, redness, and swelling at the injection site and generalized reactions.
For any unusual or severe symptoms after receiving the vaccine, patient should contact the doctor immediately.
Is the HPV vaccine suitable for young children?
The HPV vaccine can be used in children as young as 9 years old.
Is there anything I should do or take note of before the HPV vaccination?
You should tell the doctor if you or your child:
• has had an allergic reaction to the vaccine
• has a bleeding disorder and cannot receive injections in the arm
• has any illness with a fever higher than 100°F (37.8°C) is pregnant or is planning to get pregnant
• takes or plans to take any medicines, including over- the-counter medicines
• has a weakened immune system, for example due to a genetic defect or Human Immunodeficiency Virus (HIV) infection, or if you take medicines that affect your immune system.
Can I go for other vaccines and medications after I have received the HPV vaccine?
Yes, you can do so with common vaccines such as Hepatitis A, B, DPT, polio, Flu vaccines.
What should I do if my child or I miss a dose?
The doctor will decide when to give the missed dose.
It is important that you follow the instructions of the doctor regarding return visits for the follow up doses. Usually, our nurse will give a reminder call to the patient one day before the designated date.
What other important information about the HPV vaccination should I know?
There are more than 100 HPV types: the HPV vaccine will not protect against every type.
Regular PAP smear test is still advisable for all ladies who have had sexual intercourse.
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FEMALE CANCERS - Womb, Ovary, Cervical and Breast Cancer
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Womb Cancer
Womb cancer usually affects ladies in age group 60 – 70 years.
Risk factors include early onset of menses, late onset of menopause, never being pregnant, obesity, tamoxifen, long duration of estrogen therapy, medical conditions such as diabetes, polycystic ovary syndrome, endometrial polyps and colon cancer as well as high fat diet.
Symptoms include abnormal menses, bleeding after menopause, abnormal vaginal discharge and persistent abdominal pain.
Screening tests include PAP smear (abnormal cells eg endometrial cells), Ultrasound Pelvis (non invasive scan of womb and ovaries with no radiation). Ultrasound pelvis can visualize the womb for the womb lining, growths of the womb eg uterine fibroids and ovary lesions such as ovary cysts and ovary cancer. Other tests include endometrial sampling (office procedure) and hysteroscopy, dilation and curettage.
Prevention – lifestyle modification with low fat diet, oral contraceptive pills.
Ovary Cancer
Ovary cancer can affect ladies of any age group.
Risk factors include personal medical history of breast, womb, colon and stomach cancer, never being pregnant, high fat diet and family history of ovary, womb, breast and colon cancer.
Symptoms include abnormal menses, abdominal pain, bloatedness, loss of weight and appetite, change in bowel and urination habits and backache.
Screening tests include pelvic exam, blood test for CA125 and Ultrasound pelvis.
Prevention – lifestyle modification with low fat diet, oral contraceptive pills.
Cervical Cancer
Cervical cancer can affect ladies of any age group ranging from as young as 18 years old til as old as 80 years old.
The main cause of cervical cancer is the Human Papilloma Virus (HPV). There are more than 100 subtypes of HPV – some non cancer causing, some cancer causing, some can cause genital warts. HPV strains 16, 18, 31 and 48 account for more than 80% of all the cervical cancer cases. This is the most common sexually transmitted disease - up to 50% of all ladies have this virus at some point in time of their lives.
This virus is transmitted by sexual intercourse, skin contact, fomites eg towels, undergarments and mother to newborn. Condoms reduce the risk of transmission but it is not 100% effective. There is no treatment available for the virus. The virus may be cleared by the body’s immune system, but the body does not develop sufficient antibodies to prevent future infections.
Risk factors include multiple sexual partners, sexual intercourse from young age, having sex with partner whose sexual history is unknown, personal history of other sexually transmitted diseases, those with weakened immune system such as diabetes and HIV, smokers, those on long term steroids and oral contraceptive pills and family history of cervical cancer.
Symptoms include abnormal menses, intermenstrual bleeding, abnormal vaginal discharge, pain during sexual intercourse, lower abdominal pain, loss of weight and appetite.
Screening tests include PAP smear, Thin Prep and HPV test. PAP smear is a painless, non invasive test whereby cells are collected from the cervix via a soft brush. It should be done at least once in 3 years. The accuracy is not 100%, hence if done yearly, the accuracy is enhanced.
Thin Prep is the most comprehensive FDA approved PAP smear test available. The cells are placed in a solution instead of being spread on a slide. The solution with the cells will be sent to the lab. The thin prep imager system increases disease detection.
HPV test is a FDA approved molecular test which screens the cervix for 14 high risk HPV types. The high risk HPV types will cause transformation of normal cells in cervix into abnormal cells. The abnormal cells will become pre-cancer cells (CIN) which will subsequently change into cervical cancer if not treated. It is highly recommended for ladies above 30 years of age and those with abnormal PAP smears. HPV test is only available for ladies.
Colposcopy is recommended if PAP smear test shows precancerous changes.
Prevention – keep to 1 sexual partner, delay age of sexual intercourse, and avoid unprotected sexual intercourse. Consider HPV vaccination for yourself and your family members for prevention of pre-cancer and cervical cancer. The vaccination is highly recommended for all men and ladies above 9 years of age. It is safe and 99% effective with no significant side effects. It is incorporated in childhood immunisation programmes world-wide. The vaccine is also recommended for ladies who are already married. Older women can also benefit from the vaccine. Protection should last at least 10 to 20 years.
Singaporeans and Singapore PRs under 27 years of age can make use of their own or family members’ Medisave for full payment of the HPV vaccine at Medisave accredited clinics.
Asia Healthpartners is a Medisave accredited clinic.
Breast Cancer
Breast cancer is the top cancer for ladies. It is more common in ladies after 40 years of age.
Risk factors include early age of menses, late age of menopause, never being pregnant, family history of breast, womb, ovary and colon cancer, defective genes (BRCA1 and BRCA2), radiation exposure to chest during childhood days, obesity, high fat diet, excessive alcohol consumption, long term conventional hormone replacement therapy with estrogen.
Symptoms include breast lump, breast pain, nipple discharge and skin changes over the breast.
Screening tests include mammogram and ultrasound breasts. Mammogram is a low dose x-ray of the breasts that can pick up very small breast cancers, breast calcifications (benign and malignant). It is recommended yearly for ladies between 40 – 50 years of age and once in 2 years for ladies above 50 years of age. Asia Healthpartners Mammogram is fitted with Mammopad Breast Cushion which makes the mammogram experience softer and more comfortable. Ultrasound breasts is a painless, non invasive, no radiation type of scan for breast lumps. It can determine if the breast lump is solid or liquid and if it looks suspicious in nature. It is recommended for any age group, especially those with lumpy breasts. MRI Breasts is recommended if mammogram and ultrasound breasts are abnormal, to give more information about the nature of the growth. Other tests will include Breast Biopsy done by needle aspiration, ultrasound guided, mammotome or open.
Prevention – lifestyle modifications including low fat diet, regular exercises reduction in alcohol intake and maintenance of healthy weight.
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Premature Ejaculation and Ulthera
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Dr Chong Yeang Chern - Featured in Mind Your Body magazine 27 January 2011
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Dr Chong Yeang Chern - Featured in
Men's Health magazine 14 January 2011
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Dr Chong Yeang Chern - Featured in
Men's Health magazine 10 January 2011
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Dr Chong Yeang Chern - Featured in
Men's Health magazine October 2010
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Dr Chong Yeang Chern - Featured in
Men's Health magazine September 2010
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Dr Chong Yeang Chern - Featured in
Men's Health magazine August 2010
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Male menopause – Myth or Fact?
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Men and women are not alike. Most of us are aware of this fact.
When a woman goes through menopause, she experiences a variety of physical and emotional
changes. The truth is that, men also go through a change very much like women in
the middle years. Hence the term – 'mid life crisis' is derived.
Of course, every one of us is different. Not everyone will experience turbulence
in the middle years. Sometimes it may be difficult to differentiate the symptoms
of such changes from symptoms due to other diseases.
Male menopause, also known as andropause, generally occurs from around 40
years of age. This happens as a result of decline in hormones such as male sex hormone
– testosterone. Compared to women, the decline is more gradual, hence the changes
may be more subtle. As a result, a lot of men attribute the changes to normal ageing.
Testosterone is the most important male sex hormone. It is essential for maintaining
health as well as quality of life. It is produced mainly in the testes. Testosterone
declines with age due to death of testes cells and decreased stimulation by the
brain.
As a result of reduced levels of testosterone, a multitude of symptoms
can occur in the male body.
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Feel tired
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Tend to fall asleep after meals
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Anxious, irritable, depressed
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4.
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Poor sense of well being, decreased enjoyment of life
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Increased sweating
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Problem with sleep
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7.
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Decrease in muscular strength, endurance, sports ability
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Decrease in work performance
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9.
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Bodyache
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Increase in weight, especially around the waist
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11.
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Decrease in sexual desire/ libido
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Decrease in morning erections
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Erection is less strong
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If a man in such a situation ignores the problem, he may be at
greater risk of heart disease as well as osteoporosis.
How does one confirm the condition?
If you do have some of the symptoms listed above, a blood test
for testosterone, sex hormone binding globulin (protein that binds to testosterone),
other hormones such as DHEA(S) and growth hormone is advised.
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Tips to cope with the change -
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Healthy diet
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Regular exercise
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Adequate sleep
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Stress reduction techniques
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Sufficient fluids
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Less alcohol and caffeine
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Good social support
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Treatment
Testosterone replacement therapy must always be administered
by trained physicians. Regular follow-up including blood test for testosterone,
prostate cancer marker and blood counts is required.
Testosterone is available in different forms – oral tablet, topical cream
and injection. Oral tablet does not provide steady blood levels – hence not generally
recommended. The cream form makes use of bio-identical testosterone and the preparation
is custom made in doses suitable to patient’s needs and condition. The cream is
applied daily in the morning to the inner arms / thighs. As for the injection form,
it provides convenience to the patient as it requires only 4 injections per year.
The testosterone level with the injection method is more consistent.
DHEA therapy is administered orally. This is an adrenal gland hormone. Low
levels may lead to fatigue and low sex drive.
Growth hormone therapy is administered by own self via injection – fine needle
or needleless method on daily basis. This is a brain hormone. Decline may contribute
to memory and sleep problems, increase in weight, decrease in muscle bulk, poorer
hair and skin.
In my clinic practice, I encounter many men in mid 40s with the problem of andropause.
A lot of them were not aware of such a condition previously due to lack of publicity.
For those who are on the treatment programme, they are happy with the outcome as
the treatment has ‘renewed’ their life. As one patient has said – I feel like a
different person altogether! I have become stronger in sports and I have lost weight
too.
In conclusion, early diagnosis and treatment is the way to go to improve your health
and vitality!
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Dr Chong Yeang Chern - Featured in Men's Health
magazine June 2010
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Dr Chong Yeang Chern - Featured in Men's Health
magazine May 2010
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Looking into the Brain – Connecting Body & Mental
Health
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The mind speaks a thousand words. Our state of mind can relate
to the status of our health. In the current economic situation, we are bombarded
with bad news from multiple sources. Financial issues, work stress, family problems
will lead to a cumulative impact on our mind. The stress and frustration that one
faces, if poorly managed, can lead to a cascade of health issues. The classic scenario
is that of a tired, nervous person with pain at different parts of the body and
suffers from indigestion, poor appetite and sleepless nights.
It is therefore essential to manage stress well to maintain good physical and mental
fitness in order to fight the challenges of life. Stress can have a negative impact
on health as it may weaken the immune system, making us more susceptible to diseases.
Stress management involves recognizing and acknowledging that one is under stress,
looking for the sources of stress and learning healthy ways to overcome stress.
Time management, prioritization and positive thinking are important techniques.
Living a healthy lifestyle and having a strong social support network are equally
as crucial.
It is never too late to make the first step to overcome stress and reverse the damage.
Here are some great tips:
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For The Mind -
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Practice slow deep breathing in between work – this will allow
your mind to relax and recharge
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Listen to soft smoothing music
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Talk to a friend/colleague – vent out your frustrations
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Pen down your thoughts and things that bother you
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Indulge in something enjoyable, take up a new hobby
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Laughter is the best medicine. Look for humor in life.
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For The Body -
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1.
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Start a regular exercise regime - 3 times a week, 30 minutes
for each session. Walk whenever there
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are opportunities
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Increase your intake of vegetables and fruits
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Consider supplements such as anti-oxidants
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Pamper yourself with a massage to release muscle tension and
relax the mind
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Kick-starting the routine may seem hard at first but as it develops
into a habit, it would be a breeze. Remember to assess the overall progress. Seek
professional input and guidance. Health screening is also useful as a guide to assess
for any medical problems and complications as a result of stress.
Economical comprehensive health screening packages which include anti-stress massages
are now available at Asia HealthPartners.
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Sports – The double edged sword
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People who exercise may lower their risk of diseases but only
those who are aware of the possible risks of strenuous sports and be prudent about
it will reap the full benefits of physical activities.
In Singapore, there is an increasing trend of mortality- marathon related sudden
death cases over the past few years, with the latest headlines of a 17 year old
death in a triathlon and a 25 year old death in a 21km run. Even so, the number
of participants for the competitions did not seem to decrease but continue to soar
with popularity.
Do the participants fully understand the risk they have put themselves through?
A recent study in Orlando cited that the risk of sudden death in participants of
triathlons is at least twice that of marathons. Statistics showed that there are
15 deaths per million participants of triathlons compared to 4-8 deaths per million
participants of marathons. It was concluded that the main risk is due to heart failure
during the swimming part. Autopsies revealed that 60% of the death was due to underlying
problems.
"When we exercise, the heart is made to pump harder to ensure sufficient oxygen
and nutrients reach the heart muscles. Contacting an external lower temperature
such as cold water will constrict vessels resulting in the heart having to pump
even harder to push the blood through," explained Dr. Chong Yeang Chern, Wellness
Physician at Asia HealthPartners. “In whichever case, over-stressing the heart may
aggravate pre-existing problems and increase mortality risk. Hence a pre-race checkup
is important to screen for pre-existing medical conditions and should not be overlooked."
This is supported by the Triathlon Association of Singapore which encourages participants
to have a thorough medical check up before any race.
When carefully manipulated, physical exercises can lower the risk of heart diseases,
hypertension, diabetes, high cholesterol, and osteoporosis; reduce stress and keep
the body looking fit!
Here are some advices from Dr Chong to lower athlete’s health risk:
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Have regular health screening. Ensure that your medical screening
includes Treadmill Stress Test to
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check that the heart is fit for the physical stress of exercise
and does not have underlying problems such as heart artery diseases.
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Self-check assessment: Measure your own heart rate during peak
exercise and look out for any chest
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discomfort or difficulty breathing. Maximum heart rate should
not exceed (220 – age)/ minute. Recommended heart rate to achieve is 60-80% of the
maximum heart rate.
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Be well-trained and conditioned for any types of physical competition.
Check with your trainer or
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professional pertaining to the risk of activities if unsure,
especially for any physical challenges.
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Eat right. Seek a professional or a dietician’s advice at least
months before any competition.
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Remember – Staying fit is a challenge. So be sure to take good care of your health!
Prevention pays in the long run!
Live Well. Live Happy.
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Uncontrollable Weight Gain
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- A repercussion of hormone deficiency
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If you have been experiencing weight gain despite cutting down
on daily food intake portion, choosing food wisely and exercising regularly, you
may have medical conditions that contribute to the weight gain such as hormone deficiencies
and food intolerance.
Hormone deficiencies will have an impact on the quality of life. Symptoms such as
sleepless nights, body ache, dry skin, thin hair, fatigue, poor concentration, poor
physical stamina, low sex drive as well as weight gain may creep in. Unfortunately
many people attribute it to part and parcel of the ageing process and live with
it without realizing that medical options are available for treatment as well as
prevention. In the long run, the hormone deficiencies can lead to serious health
consequences such as heart diseases and osteoporosis.
Determine your Health Status
Before concluding that the above symptoms are due to hormone deficiencies, one should
have a thorough check done.
Health Screening can detect silent pre-existing medical conditions and prevent deterioration
of the existing problems, thereby reducing healthcare costs incurred due to serious
conditions. An affordable yet comprehensive screening can be done with a simple
blood test checking on hormones such as male hormone (testosterone), female hormones
(estrogen and progesterone), brain hormone (growth hormone), thyroid hormones and
adrenal hormone (DHEAs). It is always advisable to consult the doctor prior to the
screening so that appropriate tests can be done as each and every one of us is different
in our genetic makeup and lifestyle habits.
Know the options & keep an open mind
Based on in-depth consultation as well as medical analysis, a holistic multi-pronged
approach by a medical practitioner will be used. This will involve advice with regards
to nutrition, exercise, supplements as well as use of bio-identical (natural) hormone
therapy. The therapy can be administered via oral, topical or needleless (pain-free)
injection. These treatments will be customized based on individual needs and requirements.
With a good treatment programme and monitoring, the hormonal imbalance can be reversed
and the harmony of good health and beauty can be achieved.
Finally scientific revolution has proved its worth in both treatment and prevention.
Live Well. Live Happy.
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