Enter into Your Prime:
20 – 34 years

Young AdulthoodThis is the prime period of a woman’s life, where she has outgrown the awkwardness of puberty and established her sense of self as a young adult. Some of the gynaecological needs or concerns affecting young women in their 20s and 30s are listed below:

1. Endometriosis

EndometriosisEndometriosis is a gynaecological condition in which the endometrium, or tissue lining the uterus, grows outside the uterus and in other locations such as the ovaries, fallopian tubes and ovarian ligaments. This tissue thickens and subsequently breaks down during every menstrual cycle. Severe pain during menstruation or chronic pain in the pelvic region is a common symptom of endometriosis. Women with endometriosis may also experience pain during sex, painful urination or bowel movements, and may struggle with infertility later on.

Do I Have Endometriosis?

Your doctor can check for clues of endometriosis during a pelvic exam or ultrasound. However, a laparoscopy or keyhole surgery will be able to determine with certainty if endometriosis is present. Treatment may be in the form of pain relief medication, hormonal therapy to control the build-up of endometrial tissue, or a laparoscopic surgery to remove the tissue.

2. Fibroids

FibroidsFibroids are non-cancerous growths consisting of muscle and fibrous tissue. Around 1 in 3 women will develop fibroids in their lifetime. They vary in size and may develop in or around the uterus, usually during a woman’s reproductive years, often shrinking after menopause.

Do I have Fibroids?

Most small fibroids are asymptomatic and no treatment is required. However, depending on their location and size, fibroids may cause certain symptoms which interfere with daily life, such as:

Excessive bleeding with passage of blood clots during menstruation

  • Pelvic pressure or discomfort
  • Increased frequency of urination
  • Pelvic and/or lower back pain
  • Difficulty or pain during bowel movement

Upon diagnosis, your gynaecologist may treat symptoms with medication to reduce the occurrence of menorrhagia or shrink the size of the fibroids. Fibroids may also be treated surgically, either through complete removal of the uterus (hysterectomy) or removal of the fibroids with the uterus in place (myomectomy). This procedure may be done via an abdominal surgery or a keyhole surgery (laparoscopy).

3. Ovarian Cysts

Ovarian CystsOvarian cysts are fluid-filled sacs which develop on a woman’s ovary. A large majority of ovarian cysts are harmless and will naturally disappear without presenting any symptoms (physiological or functional cysts). However, in some cases, an ovarian cyst may be a tumour, and if the cyst is large, may develop complications.

Do I Have Ovarian Cysts?

Your gynaecologist will be able to detect an ovarian cyst during a pelvic examination and ultrasound. Sometimes blood tests such as tumour markers may be performed. If your cysts are persistent, symptomatic or possibly malignant, your doctor may speak to you on the removal of cysts via an abdominal surgery or laparoscopy.

4. Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a condition which affects up to 27% of women during their childbearing years. It is characterised by the presence of multiple small ovarian cysts (due to egg follicles that failed to grow, mature or be released), higher levels of male hormones and irregular periods. Women with PCOS may also experience symptoms like hair growth or balding, weight gain and acne. PCOS is a common cause of infertility in women.

Do I Have PCOS?

Other than a suggestive history, hormonal blood tests and an ultrasound scan is necessary to aid in the diagnosis of PCOS. PCOS can be managed with oral contraceptive pills to regulate the menstrual cycle or with fertility drugs to improve fertility.

5. Family Planning

A. Contraception

Which Birth Control Method Should I Use?


  • Oral Contraceptive Pill
    The contraceptive pill is 99% effective if taken consistently according to instructions. The pill also regulates the menstrual cycle, lightens the flow and helps reduce menstrual cramps. It cannot be used when breastfeeding, or in women who smoke, have a history of breast or cervical cancer or deep vein thrombosis.
  • Hormonal Injections
    Hormonal injections are 99% effective and are administered every 3 months. They may cause side effects such as irregular menstrual cycle, weight gain and mood swings.
  • Intrauterine Device (IUD)
    Copper intrauterine devices are 97% effective and easily inserted in a clinic without the need for anaesthesia. They may result in heavier menstruation with cramping during the first few months, and will need to be replaced every 3 –5 years.
    A hormonal intrauterine device is more effective at 99.9% but may cause an irregular, light menstrual cycle.
  • Hormonal Implant
    This is a small, silicone tube containing a progesterone hormone that is placed in the arm just below the skin surface. It is 99.9% effective but may result in irregular menstrual cycles.

While reliable in preventing an unwanted pregnancy, these birth control methods do not protect against sexually transmitted infections, and should be used in conjunction with condoms during sex.

Selecting the most suitable birth control method should begin with a discussion together with your partner and doctor. The appropriate method will vary with individuals depending on your medical history, lifestyle, duration of contraception use, usage compliance and level of effectiveness.

B. Fertility

FertilityA woman’s highest chances of getting pregnant are in her 20s. Women below 30 have a 20% – 25% chance of conceiving every month. At this age, you also have lower chances of miscarriage, pregnancy complications and foetal abnormalities. However, women in their 20s are not immune from fertility problems. If you have been having regular, unprotected sex for a year without getting pregnant, you or your partner may be facing fertility issues.

6. Vaginal Infections and Discharge

Having vaginal discharge is a normal and regular occurrence in women of all ages. However, discharge that is abnormal in colour, consistency, odour or accompanied by other symptoms may indicate an infection or underlying condition.

Vaginal discharge is usually white or clear and watery. During ovulation, some women produce a discharge which is clear and stretchy like mucus. Towards the end of their periods, it is also normal for women to experience brown or bloody discharge.

Discharge is considered abnormal if it is:

  • Yellow or green in colour
  • Thick in consistency (similar to cottage cheese)
  • Accompanied by an unpleasant smell
  • Accompanied by itchiness
  • Accompanied by fever and/or pain

Abnormal vaginal discharge is normally caused by an infection. A white and thick discharge accompanied by vaginal itchiness or swelling is a sign of vaginal yeast infection or candidiasis, a common condition.

A yellow or green discharge with a foul smell is a sign of trichomoniasis, a sexually-transmitted infection. It may be accompanied by pain and vaginal itchiness.

Increased vaginal discharge which has a foul and fishy odour may be caused by bacterial vaginosis, a common bacterial infection which also occurs during pregnancy.

These common vaginal infections can be easily diagnosed by a doctor and treated with medication, creams and ointments. However, abnormal discharge can also be a symptom of sexually-transmitted infections such as gonorrhoea, chlamydia and HPV.

7. Vaccinations and Screening for Women

Under the Ministry of Health’s recently-established National Adult Immunisation Schedule (NAIS), it is recommended for expecting or young adult women to undergo the following vaccinations:

Vaccines Recommended Groups Schedule Why is vaccination important?
Human Papillomavirus (HPV) Women aged 18-26 years 3 doses
(0, 1-2, 6 months)
Some types of HPV infection may lead to cervical cancer. Maximize the benefits of HPV vaccinations by going for vaccination before the start of sexual activity, where HPV exposure occurs.
Tetanus, Diphtheria and Pertussis (TDAP) Pregnant women (between 16-32 weeks) 1 dose per pregnancy Pregnant mothers vaccinated against TDAP can pass on the protection to their babies for a short-term as newborns will not receive vaccinations immediately upon birth.
Influenza Women at all stages of pregnancy 1 dose annually Protects mothers and newborns against influenza


Read here for Gynaecological Screenings for women.


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