Gynaecologist and Obstetrician at Gleneagles Medical Centre, Singapore

Overview. Fibroids are non-cancerous growths that develop within or around the wall of the uterus. They vary widely in size, number and position, and their effect differs greatly between individuals.

Symptoms may include. Heavy or prolonged menstrual bleeding; pelvic pressure or a feeling of fullness; pain during periods; frequent urination; discomfort during intercourse. Many fibroids cause no symptoms at all and are found incidentally on a scan.

Assessment available. Clinical examination, pelvic ultrasound, blood tests to check for anaemia, and hysteroscopy where the fibroid position warrants it. Management ranges from monitoring through to medical treatment or minimally invasive surgery, depending on size, position and impact on daily life.

Overview. Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus, most often on the pelvic organs and peritoneum. It is a common cause of persistent pelvic pain and can affect fertility.

Symptoms may include. Painful periods that interfere with normal activity; pelvic pain between periods; pain during or after intercourse; pain on opening the bowels or passing urine, particularly during menstruation; difficulty conceiving.

Assessment available. Detailed symptom and menstrual history, clinical examination, pelvic ultrasound, and laparoscopy where diagnosis or treatment requires direct visualisation. Management is tailored to symptom severity and to your reproductive plans.

Overview. Ovarian cysts are fluid-filled sacs that form on or within an ovary. Many are functional, related to the normal ovulatory cycle, and resolve without intervention. Certain types, sizes or associated features warrant further assessment.

Symptoms may include. Pelvic pain or a dull ache on one side; bloating or abdominal fullness; pain during intercourse; sudden severe pain if a cyst ruptures or twists. Many cysts produce no symptoms and are detected on a routine scan.

Assessment available. Pelvic ultrasound to characterise the cyst, tumour marker blood tests where indicated, and interval scanning to monitor change. Surgical removal is considered where the size, appearance or symptoms make it appropriate.

Overview. PMOS (formerly PCOS) is a hormonal condition characterised by irregular or absent ovulation, raised androgen levels and, in many cases, multiple small follicles visible on the ovaries. It is among the more common causes of irregular periods and subfertility.

Symptoms may include. Irregular, infrequent or absent periods; difficulty conceiving; acne; excess hair growth; scalp hair thinning; weight changes that are difficult to shift.

Assessment available. Hormonal blood tests, pelvic ultrasound to assess follicle count and ovarian appearance, metabolic screening where indicated, and a structured review of symptoms. Management addresses the symptoms that matter most to you, whether that is cycle regulation, fertility or metabolic health.

Overview. Pelvic pain is a symptom rather than a diagnosis, and it has a wide differential. Causes range from gynaecological conditions such as endometriosis, fibroids or ovarian cysts through to bowel, bladder, musculoskeletal and pelvic floor causes.

Symptoms may include. Pain that is cyclical or constant; pain localised to one side or diffuse across the pelvis; pain associated with periods, intercourse, bowel movements or bladder filling.

Assessment available. Detailed pain history mapping timing, character and triggers; clinical examination; pelvic ultrasound; and further investigation directed by the findings. Identifying the cause precedes any discussion of treatment.

Overview. Bleeding that is heavier, longer, more frequent or more irregular than usual can arise from structural causes such as fibroids or polyps, from hormonal imbalance, from contraception, or in some cases from changes in the lining of the uterus.

Symptoms may include. Soaking through protection hourly; passing large clots; bleeding lasting longer than seven days; bleeding between periods or after intercourse; bleeding after menopause; fatigue or breathlessness from associated anaemia.

Assessment available. Pelvic ultrasound, blood tests including full blood count and hormonal profile, endometrial assessment, and hysteroscopy where appropriate. Bleeding after menopause always warrants prompt assessment.

Overview. Menopause is the point at which menstruation has ceased for twelve consecutive months. The perimenopausal transition preceding it can last several years and produces the majority of symptoms.

Symptoms may include. Hot flushes and night sweats; disturbed sleep; mood changes and irritability; vaginal dryness and discomfort during intercourse; urinary symptoms; changes in cycle length and flow; joint aches; difficulty concentrating.

Assessment available. Clinical assessment of symptoms and their effect on daily life, review of personal and family medical history, and blood tests where the picture is unclear. Whether management options — including hormonal and non-hormonal approaches — are suitable and safe depends on your individual health profile, and this is discussed in full.

Overview. Prolapse occurs when the pelvic floor support to the uterus, bladder, bowel or vaginal walls weakens, allowing one or more of these structures to descend. It becomes more common after childbirth and after menopause.

Symptoms may include. A sensation of pressure, heaviness or bulging in the vagina; a visible or palpable bulge; difficulty emptying the bladder or bowel completely; discomfort during intercourse; symptoms that worsen through the day or with lifting.

Assessment available. Pelvic examination to determine which compartment is affected and to grade severity, assessment of bladder and bowel function, and discussion of options ranging from pelvic floor physiotherapy and pessary support through to reconstructive surgery. This is a specific area of clinical focus for Dr Harvard Lin.

Overview. Urinary incontinence takes several forms. Stress incontinence involves leakage on coughing, sneezing, laughing or exercising. Urge incontinence involves a sudden need to pass urine that is difficult to defer. Both can occur together.

Symptoms may include. Leaking with physical effort; sudden urgency; frequent daytime urination; waking at night to pass urine; leakage before reaching the toilet; restricting activities or fluid intake to manage symptoms.

Assessment available. History and symptom characterisation, bladder diary review, pelvic examination, assessment of pelvic floor function, and urodynamic or further testing where indicated. Options range from pelvic floor training and behavioural measures to medical and surgical management. This is a specific area of clinical focus for Dr Harvard Lin.