Old wives’ tales and hearsay on health matters can seem strange when seen from the medical point of view.
Take menstruation, one of the most common women’s health topics, for example. It is a response of the uterine lining to hormonal changes. But some people still believe it to be the body’s monthly cleansing process, a myth that has no scientific basis, said Dr Julinda Lee, an age management specialist from Singapore Medical Group’s (SMG) Wellness and Gynaecology Centre by Dr Julinda Lee.
In certain situations, trusting the wrong information can be dangerous. “Some patients have allowed themselves to bleed heavily each month, perhaps resulting in severe anaemia and tiredness. If long-standing and severe, anaemia can result in heart failure,” said Dr Lee.
We ask experts to debunk some myths here.
Wearing underwired bras, dyeing your hair and using antiperspirants can cause cancer: MOSTLY MYTH
According to Dr Wong Seng Weng, medical director at SMG’s The Cancer Centre, the belief that wired bras may lead to an increased breast cancer risk started when African countries — where the use of bras is less common than in the West — were observed to have lower breast cancer rates compared to the West. However, further studies have not shown such a link.
As for antiperspirants, the misconception started with paraben. This preservative is commonly used in cosmetic and pharmaceutical products, and has a chemical structure similar to female hormones, said Dr Wong.
“Since the increased exposure to female hormones is known to increase breast cancer risk, there is a concern that applying paraben-containing substances around the breasts and armpits would trigger such an effect. But this is unlikely since the hormonal stimulatory effect of parabens is very low compared with natural female hormones,” he said.
There is, however, some truth in cancer-causing hair dyes. The World Health Organization (WHO) stated that some hair dye substances could possibly cause cancer, in particular, bladder cancers. But the risk only applies to certain occupations such as hairdressers where the exposure is high. The WHO does not consider the personal use of hair dyes as potentially carcinogenic.
Dr Wong’s breast cancer prevention tips:
1. Start a family before age 35
Pregnancy and breastfeeding have been shown to reduce the cancer risk as it interrupts the menstrual cycles early in life, thus reducing fluctuating levels of female hormones associated with menstrual cycles.
2. Maintain a healthy weight
Fat tissue in women’s bodies can convert substances in the blood into female hormones, which when in excess, increase cancer risk.
3. Have regular work and sleep hours
The World Health Organization classifies working night shifts as “probably carcinogenic”, due to the impact of light exposure at night on the hormonal balance of the body.
Osteoporosis is an old woman’s disease: SOMEWHAT TRUE
In Singapore, the number of osteoporotic hip fractures has increased five-fold in women aged 50 and above over the last 30 years, according to the Osteoporosis Society (Singapore). While thinning bones typically occur with age, it is never too early to start building a solid bone bank from childhood.
The body’s bone mass grows and peaks around the age of 30. Thereafter, the body starts to lose more bone than form new ones. This process speeds up with age, and even more so in postmenopausal women when the female hormone oestrogen declines, said Dr Leon Foo, an orthopaedic surgeon at Mount Elizabeth Hospital.
According to Dr Foo, the higher a person’s peak bone mass, the better start she has as age catches on and bone density inevitably starts to decline.
Dr Foo’s brittle-bone prevention tips:
1. Have adequate calcium and Vitamin D
The recommended daily intake for calcium is 800mg for adults aged 19 to 50, and 1,000mg for teens, breastfeeding and pregnant women, as well as adults above the age of 50. As for Vitamin D, the Health Promotion Board advises getting some sunlight on the arms and legs twice a week for about five to 30 minutes each time.
2. Screen bones regularly
Opt for a bone density scan around menopause. If the result is within the normal range, repeat the scan every two to three years. An annual bone density scan is recommended if it is within the osteopenia (moderate degree of bone mass loss) or osteoporosis range.
3. Control existing medical conditions
Health issues like thyroid and malabsorption disorders — as well as the prolonged use of steroids — can impact bone health.
Heart disease is a man’s thing: MYTH
Along with stroke, heart disease is the top killer of women in Singapore, accounting for one in three deaths. While heart disease and stroke are more common in men than women in the younger age group, a woman’s risk catches up after menopause and becomes as high as that of men, said Dr Goh Ping Ping, medical director of Board of Directors at Singapore Heart Foundation.
Women also tend to have more subtle and atypical symptoms of heart disease, said Dr Goh, who is also the official spokesperson for Go Red For Women Singapore, the local chapter of an international campaign to empower women to take better care of their hearts and their families. They include breathlessness, indigestion, arm numbness, neck or jaw discomfort, irregular heartbeat or simply unexplained tiredness.
“These symptoms may mimic other disease such as gastric problem, which is why heart attacks in women tend to be deadlier than men. Detection is usually later due to subtle symptoms,” said Dr Goh.
Seek medical attention if these symptoms persist or if there is an unexplained drop in stamina, she said.
Dr Goh’s tips for a healthier heart:
1. Tweak your diet
Lower your intake of sugar, salt and saturated fats. Avoid trans fat, which is usually found in processed foods and baked goods.
2. Get screened yearly if you’re above 40
Check your body mass index, blood pressure, cholesterol and sugar levels. Ask for a stress test such as a treadmill test if you have one or more risk factors, and especially if there is a family history of early heart disease.
3. Exercise right
Do moderate-intensity exercise that causes you to perspire and breathe deeply without discomfort. For maximum benefits, go for a mix of aerobic (jogging, cycling, swimming) and muscle strengthening (lifting weights) exercises. Exercise for 30 minutes five times a week.
You can snap out of depression: MYTH
Anyone struggling with the condition will not be able to “snap out” of it on her own, said Dr Lim Boon Leng, a psychiatrist at Gleneagles Hospital.
“When a person has clinical depression, her judgement may become impaired and her views, unduly negative. To recover, she needs treatment that may include medications and/or therapy,” he said.
Compared to men, women are twice as likely to be diagnosed with depression, probably due to a combination of biological, psychological and environmental factors. Women at risk of depression include those going through major life changes like childbirth, loss of a loved one, and during the period before and after menopause. Depression is also likely to recur.
“A depressed person is unable to handle the stress in her life and this can lead to more problems and stress, and increase the severity of depression, resulting in a vicious cycle. The consequences of depression are dire when untreated and can result in loss of job, failure of marriage and even suicide,” said Dr Lim.
Seek help if these signs persist for more than two weeks:
– Persistently low mood
– Loss of interest in work, social life or hobbies
– Sleep and/or weight issues
– Poor concentration and attention
– Easily tired and/or irritated
– Excessive guilty feelings and loss of confidence
– Suicidal thoughts or behaviour
Getting fat, feeling moody and no sex drive are inevitable during menopause: SOMEWHAT TRUE
This may not apply to all women. According to Dr Lee from SMG’s Wellness and Gynaecology Centre by Dr Julinda Lee, dwindling oestrogen levels during menopause can lead to symptoms like mood swings, fatigue and weight gain, especially around the waist.
It can also take a toll on a woman’s sex life, in the form of lower libido and painful sex due to vaginal dryness. “Some patients may transition into menopause without so much as a bump,” said Dr Lee.
“Others will have years of symptoms before they stop menstruating and continue to have symptoms after. There is no one-size-fits-all approach to managing menopause,” she said.
In addition, the hormonal changes increase a woman’s risk for inflammatory conditions such as inflammatory joint conditions, bone loss, osteoporosis and heart disease, said Dr Lee.
Dr Lee’s menopause-transiting tips:
1. Reduce inflammation
Do so by improving the four pillars of health: Diet, exercise, sleep, and stress management.
2. Get the right information
Seek professional help instead of getting information and advice from friends as there is no one-size-fits-all approach to managing menopause.
3. Use topical vaginal oestrogen
It is a safe option for women experiencing vaginal dryness and painful intercourse.
To HRT or not?
PROS: Some women may need to consider hormone replacement therapy (HRT) to help them manage menopause symptoms, said Dr Julinda Lee from the Wellness and Gynaecology Centre by Dr Julinda Lee. But due to the risks of breast cancer, blood-clotting tendencies and heart attacks, she advises patients to discuss with their physicians to determine if the risks outweigh the benefits. A low-dose HRT for a short time is associated with the lowest side effects, she said.
CONS: Women on HRT after menopause are at a higher risk of breast cancer, said Dr Wong Seng Weng, medical director at SMG’s The Cancer Centre.
