List of Gynecological Services
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AcuFem for women with a broad range of gynecologic problems, for example:
General Gynaecology
• abnormal bleeding
• pelvic pain
• dysplasia of the lower genital tract
• fibroids
• ovarian cysts
• urinary incontinence
• pelvic organ prolapse
• birth control management
• vulvar diseases 
General Health and Cancer Screening
We provide general health screening and gynaecological screening which include PAP smear, pelvic ultrasound,mammogram for breast cancer detection and bone mineral densitometry to assess bone health/ osteoporosis detection Screening for gynaecological cancers which include cervical, uterine and ovarian cancers Vaccinations for cervical cancer prevention using vaccines such as Cervarix and Gardasil.
Assessment,Investigation, Counselling and Treatment of Infertility
Monitoring of Ovulation (MOO) in Natural Menstrual Cycle for timing of intercourse Ovarian stimulation and Ovulation induction with fertility tablets (Clomiphene citrate) or Gonadotrophin injections.
Hysteroscopy
Hysteroscopy - Diagnostic for Abnormal Uterine Bleeding and Heavy Menstrual Bleeding (Menorrhagia)
Hysteroscopy - Operative for Removal of Endometrial polyps, Division of Uterine Septum, Division of Uterine Adhesions, Endometrial Ablation or Resection of Endometrium (TCRE), Resection of Submucous Myomas (TCRM).
Laparoscopic Surgery
Laparoscopic or keyhole surgery is operation performed through small abdominal cuts using slender instruments, as opposed to conventional surgery where a cut of up to 10cm is required. The benefits of laparoscopy, commonly known as keyhole surgery include smaller scars, less pain, faster recovery and shorter hospital stay (most patients are able to go home on the same day of operation or the day after), better dissection and precision during surgery,less internal scarring, less infection and fever post operatively.
Management of Menopause
We manage undesired menopause symptoms such as skin dryness, aging, hot flushes, mood swings and insomnia This includes medications and the use of natural based hormonal creams.
Family Planning and Contraception Advice
Oral Contraceptive Pills, Intrauterine Contraceptive Device (IUCD) insertion, Mirena IUCD insertion,
Subdermal Implants (Implanon), Contraceptive Patch (Evra), Laparoscopic Tubal Sterilization.
Menstrual Problems or Irregularities
This include assessment and treatment of common menstrual problems such as heavy or prolonged menses and irregular period.
Various symptoms and treatment
Single-port Laparoscopic Surgery
At AcuFem, we focus on minimizing the wound as much as possible and reducing the burden on the body when a surgery is performed. Dr John specializes in single-port laparoscopic surgery, which keeps wound size to the minimum. The burden on the body is reduced for such minimally-invasive surgeries, and the wound is almost unnoticeable.
Laparoscopic surgery, or keyhole surgery, is performed through a small incision on the abdomen. This is in contrast to conventional surgery, where a cut of up to 10cm is required. Many gynaecological disease such as ovarian cysts, endometriosis, fibroids, ectopic pregnancies, early cancers and womb prolapse can be treated by laparoscopic surgeries.
The benefits of laparoscopy include smaller and less noticeable scars, less pain, and faster recovery. In addition, most patients are able to go home on the same day of operation, or the day after. This minimizes disruption to the patients' everyday life.
Endometriosis
What is Endometriosis?
Endometriosis is a disorder in which tissue that typically lines the inside of your uterus; the endometrium, grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
Endometriosis can cause varying degrees of pain, especially during your period. Fertility problems may also develop.
Fortunately, effective treatments are available.
What are the treatment options?
Treatment for endometriosis is usually with medication or surgery. The approach you and your doctor opt for will depend on the severity of your signs and symptoms and your intention to get pregnant.
Generally, doctors recommend attempting conservative treatment approaches first before opting for surgery. Some options are:
- Pain medications
Your doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs), to ease painful menstrual cramps.
- Hormone therapy
Supplemental hormones are sometimes useful in reducing or eliminating the pain of endometriosis.
- Hormonal contraceptives
Birth control pills, patches help control the hormones responsiblefor the build-up of endometrial tissue each month.
- Progestin therapy
A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
- Danazol
This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis.
- Conservative surgery
If you have endometriosis and is attempting to get pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success.
- Assisted reproductive technologies
Assisted reproductive technologies, such as in vitro fertilisation, to help you become pregnant are sometimes preferable to conservative surgery.
- Hysterectomy
In severe cases of endometriosis, surgery to remove the uterus and cervix (total hysterectomy), as well as both ovaries, may be the best treatment.
Fibroid
What are fibroids？
Fibroids are common tumours in the female reproductive system. They are like hard, small muscle tissue or fibrous connective tissue made in the uterus.
Between 20 to 50 per cent of women of reproductive age may develop fibroids, although not all are diagnosed.
An estimated 30 to 77 per cent of women will develop fibroids during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a health care provider during a physical examination.
In more than 99 per cent of fibroid cases, the tumours are benign (non-cancerous).
These tumours are not associated with cancer and do not increase a woman's risk for uterine cancer.
They may range in size, from the size of a pea to the size of a softball or small grapefruit.
What causes fibroids?
While the cause of fibroids is not well established, it is likely to be developed from an aberrant muscle cell in the uterus, which multiplies rapidly due to the influence of estrogen.
Healthcare provider may suggest "watchful waiting” for women near menopause who have fibroids. With this approach, the health care provider monitors the woman's symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing.
In women whose fibroids are large or are causing significant symptoms, treatment may be necessary.
Treatment administered will be determined by your health care provider(s) based on:
- Your overall health and medical history
- The extent of the disease
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your desire for pregnancy
In general, treatment for fibroids may include:
- Hysterectomy.
Hysterectomies involve the surgical removal of the entir euterus (if there is no further desire for childbearing)
- Conservative surgical therapy.
Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.
- Medication to shrink the fibroids
- Anti-inflammatory painkillers.
These drugs may be prescribed for women who experience occasional pelvic pain or discomfort.
POSTCOITAL BLEEDING
Up to 63 per cent of postmenopausal women may experience vaginal dryness and vaginal bleeding or spotting during sex.
Additionally, up to nine per cent of menstruating women experiences postcoital bleeding.
Occasional light bleeding is usually not a cause for concern.
However, if you have specific risk factors or have gone through menopause, bleeding after intercourse warrants a visit to the doctor.
In younger women who haven’t reached menopause, the source of the bleeding is usually the cervix.
In women who have gone through menopause, the source of the bleeding is more varied. It can be from the:
- Cervix
- Uterus
- Labia
- Urethra
Regarding causes, cervical cancer is the most significant concern, especially for postmenopausal women. However, postcoital bleeding is likely to be caused by a common condition.
Infections
These include:
- pelvic inflammatory disease
- sexually transmitted disease (STD)
- cervicitis
- vaginitis
Polyps
Polyps are noncancerous growths. They’re sometimes found on the cervix or in the endometrial lining of the uterus. A polyp dangles like a round pendant on a chain. Polyp movement can irritate the surrounding tissue and cause bleeding from small blood vessels.
Vaginal tearing
Sex, especially vigorous sex, can cause small cuts or scrapes to the vagina. This is more likely to happen if you have vaginal dryness due to menopause, breast-feeding, or other factors.
Cancer
Irregular vaginal bleeding, including bleeding after sex, is a common symptom of cervical or vaginal cancer.
In fact, it was the symptom for which 11 percent of women diagnosed with cervical cancer first sought treatment. Postmenopausal bleeding can also be a symptom of uterine cancer.
