Calling All Women: 6 Ways to Take Charge of Your Health in the ‘New Normal’
28th of May is the International Day of Action for Women’s Health—a great reminder for women to take charge of their health, even in the time of the new normal.
Between meetings and conference calls, a working mum darts in and out of the kitchen to fix meals for her children. Somewhere in all of it she’s teaching her child and making sure they are keeping up with schoolwork. That is what a typical day looks like for many mothers right now.
It doesn’t end there. In addition, mums often belong to the sandwiched age group – where they are caught between caring for their children as well as their ageing parents. This pandemic is likely to have deprived them of time for self-care, healthcare and the much-needed me-time. And therein lies the danger, because all too often, mums are caring for everyone oftentimes at the expense of their own health and wellbeing. As such, more than ever, they have considerably higher exposure to health risks.
It does not help that during this pandemic, many facilities are closing and the women's health services are now limited. In fear of exposure to the virus, many women, for various reasons, are missing important regular medical check-ups – and that includes family planning.
The United Nations (UN) reported recently that 47 million women from many countries may not be able to access modern contraceptives and 7 million unintended pregnancies are expected to occur if the lockdown carries on for 6 months, causing major disruptions to healthcare services.1
“The pandemic is deepening inequalities and millions more women and girls now risk losing the ability to plan their families and protect their bodies and their health,” said UNFPA Executive Director, Dr Natalia Kanem.
Are we then allowing circumstances to push us a step back in terms of progress in women’s health and equality?
28th of May is the International Day of Action for Women’s Health, which for over 30 years, have been commemorated in diverse ways by women’s rights advocates and allies in sexual and reproductive health, as well as rights movements worldwide2. This year also marks the 60th year since the invention of the contraceptive pill—an invention which has had a profound impact on gender equality and social progress. With the pill came the opening up of a world of opportunity by giving women the right to have a child by choice not chance and to ensure that they are engaged in a wide range of careers. Again, the pandemic should not change or destroy many years of hard work towards change and progress for women and their well-being.
How then do we keep this momentum and continue decades of hard work? We asked experts in Asia about 6 ways we can keep up the progress in women’s health and lives during the pandemic and after, ‘in the new normal’.
Here’s what they have to say.
1. Try out Telemedicine to support women's health
Dr Jessherin Sidhu, MBBS(Aus), Medical Director at Insync Medical, from Singapore explained that during a pandemic, movement restriction is key to controlling the spread of the disease. In this scenario that we are facing, if you are unsure whether you definitely need to be physically seen and examined by your doctor, you can first call through your doctor's clinic and ask for a teleconsultation. That way, you would know whether your issue could have been sorted with a teleconsultation alone or if you need to physically get yourself down to the clinic.
“I believe it’s even more efficient & cost-effective for women to access information and get expert advice since they do it from the comfort of their own homes. More importantly, whether it’s a chat or video conversation, women can open up more about sensitive topics, since they are still engaging with a real doctor through this online platform,” says Dr Mae Syki-Young, Obstetrician and Gynecologist, Fellow of the POGS (Philippine Obstetrical and Gynecological Society), Member of the PSGE (Philippine Society for Gynecological Endoscopy) and Member of the AGSPI (Aesthetic Gynecology Society of the Philippines), Philippines.
How does it work?
In countries such as Singapore, telemedicine is getting a medical consultation virtually through a secure platform that is often integrated into a clinic documentation software that doctors use in their clinics, explains Dr Jess.
Upon verifying your identity, the video call then begins. Just like a physical consult, the video consult is private. At the end of the consultation, your doctor would suggest what she thinks is going on with you, and if necessary she might prescribe some medications. If necessary, she will request that you physically see her in the clinic to be examined.
Medications are then arranged to be delivered to you at your home. Dr Jess shared how telemedicine can be used for scenarios such as topping up contraceptive pills, emergency contraception, obtaining treatments for vaginal or urinary tract infections, period pains and menstrual abnormalities, amongst other things.
“While telemedicine is relatively new to most Filipino women, this channel has significant advantages over face-to-face consultation. There is no unnecessary risk of exposing themselves by going out to visit me in my clinic. It’s more convenient and saves them both time and effort from travelling. Women should get used to this communication platform as telemedicine would most likely become more popular even after we have overcome this pandemic,” said Dr Mae.
2. Practice Self-care and Keep Track of Your Symptoms
An important aspect of self-care is being able to self-identify when something is wrong with your body. Dr Jess shared that in medicine, things are all about a pattern. Women experience several bodily changes that occur before or after periods and even after sexual intercourse. Some women find they have increased vaginal discharge or infection after their period, or a few days after sexual intercourse. Menstrual cycles, its quality and quantity of bleeding, can be influenced by several factors like moods, emotions, bodily stress from exercise and air travel and recent illnesses and medications too.
“Tracking these symptoms can help you see whether or not there is a pattern to your symptoms, making it easier to identify what triggers it. Once a pattern is discovered, this gives valuable information to your doctors, who can then analyze this pattern and formulate more accurate possibilities that can explain your condition.”
Dr Jess gave an example of endometriosis, a gynaecological condition presenting symptoms like chronic pain and excessive menstrual bleeding. Women with this condition experience painful periods that can occur before, during or slightly after their period flow. These pains can also be associated with other pains like pain with passing stools.
“Often when you are at the doctor’s, you are overwhelmed with things you would like to report to them, and it is very likely that you might miss out relaying a few things. By tracking your symptoms using an app or making simple calendar notes, this gives a better picture over a reasonable window of time, to emphasize to your doctor that your symptoms are really recurrent, have an established pattern, and they come with other significant symptoms that might suggest a problem. In a way, tracking your symptoms empowers you to ‘push your case’.”
The good news is that there are many mobile phone apps now available for period tracking, shared Dr. Jess. She urged women to take a look and try some of them out to find one they like. For women in Singapore who suffer from endometriosis, there is an Endo Diary App, available on IOS and Android, that allows women to track their pains, moods, bleeding and if they are taking any medication for this, it allows them to track their consumption. It also contains useful and reliable information on endometriosis.
3. Be Aware of Women’s Health and Family Planning Options
Dr Shilpa Nambiar, Consultant Obstetrician and Gynaecologist and Maternal Medicine Specialist at the Prince Court Medical Centre, from Malaysia, shared that contraceptive and treatment options are aplenty and the choice depends on various characteristics like a woman’s age, weight and pre-existing medical issues or medications that she is taking. It also depends on whether long-term or short-term contraception is desired. There are many different types of contraceptives. Some of these such as the pill, hormonal implants and intrauterine devices are more reliable than barrier contraceptives like condoms and diaphragms.
The contraceptive pill is either a combination of estrogen and progestogen or the progesterone-only pill. The combined pill works by preventing ovulation primarily and if taken reliably is almost 99% effective in preventing pregnancy, says Dr Shilpa.
According to Dr Shilpa, the benefit of the pill is that it regulates a woman’s menstrual cycle and makes it lighter and less painful. The pill can help prevent ovarian and uterine cancer and can be used as a treatment for painful menstruation and troublesome premenstrual syndrome. However, pill formulations have varied side effects.
Implants and Intrauterine Devices
Dr Shilpa describes the benefits of these to be “fit-and-forget” options as they do not require discipline and are more useful if long-term contraception is needed. However, these devices require insertion by a medical practitioner.
She stressed that knowledge about contraception is essential to a woman’s right to make healthy decisions about her body. It allows women to “choose the right time to get pregnant.” Regardless of whether the decision may be social, financial or as a method of ensuring good health, only when a woman is aware of her options would she be able to choose the best one.
4. Taking advantage of digital resources for education
Dr Boy Abidin, MD., Consultant Obstetrician and Gynecologist at the Reproductive Endocrinology and Fertility Clinic (Mbrio Clinic), Mitra Keluarga Kelapa Gading Hospital, Jakarta, Indonesia, talked about how technology has enabled everyone to access information online, and health information is no exception. However, while it is now easier for people to access information and make choices, it is “necessary to be aware and understand the accuracy of online information since many of them may be inaccurate.”
Indonesia is the world's largest island country with a population spread in different socio-cultural conditions. Conducting health promotion in areas all over Indonesia is not an easy task. According to Dr Boy, we cannot rely on the government alone to do so. If we do, it will be difficult to achieve a healthy Indonesia in the near future. Therefore, the communication network will play an important role to fulfil this need.
Digital resources can support women in taking preventative care for their health, instead of only taking action when a cure is needed. According to Dr Boy, in Indonesia, this is no easy task as the vast majority of people are still focused on cure rather than prevention.
Dr. Boy emphasizes it is important to ensure that online information is accurate and reliable, on an accessible digital platform that is publicly available, and easy to understand. This way, sharing information on women's reproductive health and family planning programs can be more effective and can help women better maintain their reproductive health.
Some Digital Resources Readily Available
In the Philippines, the Commission on Population and Development (POPCOM) offers online information on their website (www.popcom.gov.ph) and Facebook page (facebook.com/commissiononpopulationanddevelopment/). They also have helplines for those with limited internet access, says Dr Grace Caras-Torres, a laparoscopic surgeon & Fellow of the Philippine Society of Reproductive Medicine.
Indonesian women can access Bicara Kontrasepsi to learn more about reproductive health and contraception options. This can be a good starting point for those reluctant to schedule a visit to the doctor or to even speak on these matters.
There are even chatbots developed as go-to online resources on contraception and reproductive health. Known as Ask Maya in Malaysia and Ask Mara in the Philippines, these chatbots help to bridge the knowledge gap and offer women easy access to credible and reliable information and resources on reproductive health from the convenience of their mobile phone.
“Collectively, these resources provide initial guidance and answers to common questions about women’s health and family planning. While some insights will certainly come in handy, when it comes to choosing from different family planning options and considering medication, women should talk to their doctors as digital resources cannot replace expert advice,” said Dr Caras-Torres.
5. Find a Supportive Community to Share Experiences
As awareness about some women’s health conditions is low in Malaysia, not many are able to empathize with women suffering from conditions such as endometriosis. The problem is often misinterpreted as period pain that would go away after pregnancy.
Seeing this void in information leading many women to suffer alone in silence, Ms Surita Mogan, President of Persatuan Endometriosis Malaysia (MyEndosis), started this patient group in 2014 to rally women and end the silence on the topic of menstrual health, often considered a taboo topic in Malaysia. The purpose of MyEndosis is to create awareness and educate people on endometriosis
“We wanted this to not only be a woman’s issue. Females with endometriosis are wives, mothers, sisters, employees and employers. It is a community issue that must be addressed,” she expressed.
Such communities are important as they create a platform for women to share their experiences, spread awareness, and have a sense of belonging in a group where others can empathize with their emotional and physical pain,” Ms Surita elaborated.
Women should harness digital platforms to find and join such communities. For example, Ms Surita shared that MyEndosis maintains a closed Facebook group MyEndosis and a Facebook page Endomarch Malaysia.
6. Change your mindset to take timely action
Last but definitely not the least, to benefit from the tips and resources mentioned above, it is important that women make a decision to take action to safeguard their health. Caring for your health means taking action preemptively and not always reactively.
Asked about why women sometimes choose to delay treatment or seek medical advice on women’s health issues, Dr Surasak Taneepanichskul, President of Planned Parenthood Association of Thailand, mentioned that some women are afraid of visiting doctors for pelvic examinations.
For others, the biggest problem is ignorance, says Ms. Surita. “Women tend to think that pain is something they have to go through. This may be due to their childhood conditioning. They are taught from young to bear the pain silently, especially period pain, or else they will be mocked. This perception has to change.”
Change it must, because the possible consequences of delaying medical consultation or treatment are further disease progression and often result in difficulty in treatments, shared Dr. Surasak. Seeking treatment early can mean the difference between you taking control of your condition, instead of the condition controlling your life.
Where sexual and reproductive health is concerned, not taking action to find out more about which contraceptive option is right for you may lead to an unplanned pregnancy. With the pandemic already putting a strain on women, families and workers’ livelihoods, the added strain of an unplanned pregnancy might adversely affect your and your family’s overall health.
The battle for women and their wellbeing has been long and hard.
But just a simple reminder like the infight oxygen mask rule can help us remind ourselves of the value of our own health. You have to put your own oxygen mask on first before attempting to help anyone else. Women must take care of themselves in order to be able to take care of others. We must continue to fight to make sure women all over the world get the same chance to fulfil their dreams in the next 60 years and beyond – for themselves, for their health, for their families and for every woman.
This initiative is brought to you by TheAsianParent in partnership with Bayer.