Too Embarrassed To Ask

Has a health issue been bothering you but you’re simply too embarrassed to ask anyone about it? Here’s where you find out what could be causing your woes

From bad breath to a horrible itch, we’ve all suffered from embarrassing body and health problems at some point. It doesn’t help that we’re often too self-conscious to ask anyone about it.

To help you tackle some of these embarrassing issues, Urban Health speaks to Clinical Psychologist, Jessie Foo; Dental Surgeon, Dr. Cindy Wu; Consultant Dermatologist, Dr. Bong Jan Ling; Consultant Gastroenterologist and Hepatologist, Dr Sheikh Anwar Abdullah; and Consultant Obstetrician, Gynaecologist and Fertility Specialist, Dr. Kannappan Palaniappan from Sunway Medical Centre.

1. I’m female, and I think I’m going bald! Clumps of hair are falling out and I’m very stressed about it. My exams are coming up as well and I don’t know how to deal with this. What should I do?

Losing follicles*, 18

Jessie Foo: To rule out any medical or hereditary causes, please consult a dermatologist. It’s possible that stress may be one of the factors causing your hair loss. If your hair loss is stress-related don’t worry, as it will not be permanent. To deal with stress effectively, it is important to develop healthy lifestyle habits. Ensure you have enough sleep, exercise regularly, make healthy eating choices and avoid snacking on junk food. Draw up a schedule for studying and stick to it. Remember to also include short breaks during your study hours.


2. I’m self-conscious about my bad breath and have tried many kinds of mouthwashes. I floss and brush daily but nothing seems to work. Is this something I should be worried about?

Stinky breath*, 32

Dr Cindy Wu: The most common causes of halitosis or bad breath comes from eating certain foods (like onion and garlic), coffee, alcohol and smoking. Poor-fitting dentures, which cause food to get trapped between teeth, regular dieting, as well as dry mouth (xerostomia) are also other causes for bad breath. Bacteria that causes periodontal disease can enter the bloodstream and travel to other parts of our body to cause secondary infections such as bacterial endocarditis (inflammation of the inner layer of the heart) and glomerulonephritis (inflammation of either the glomeruli-filtering unit of the kidney- or small blood vessels in the kidneys). Patients who are particularly at risk of developing these secondary infections are those with cardiovascular diseases, respiratory infections and diabetes.


3. I have red-brown vaginal discharge in between periods which lasts for a few days. Is this normal?

Confused*, 22

Dr Kannappan Palaniappan: This is sometimes referred to as an intermenstrual bleed. If it is of recent onset, it could be due to a local lesion or growth either at the cervix or in the uterine cavity. Usually an internal examination to examine the cervix and a pelvic ultrasound will be helpful in identifying the cause of the problem. If there are no abnormal findings, then it could be due to a hormonal imbalance in the menstrual cycle. Occasionally, it happens when the patient has started using the pill.


4. My scalp and eyelids have been itchy, oily and flaky. Worse, the flakes are now on my eyebrows and beard as well. What is wrong and how do I fix it?

-Flaky and Annoyed*, 29

Dr Bong Jan Ling: The most common cause of scaly flakes and itchiness on the scalp, eyebrows and sometime along the side of nose, is a condition called seborrhoeic dermatitis. The good news is that symptoms can improve with mild topical steroids but the bad news is that it is difficult to cure. This problem is believed to be caused by a hypersensitivity or allergic reaction to a commensal yeast on the skin called Malassezia furfur. Because yeast is present in the environment, it is not possible to permanently eradicate it from the skin. It is best to see a dermatologist who can take a look at your problem and decide upon a course of treatment that is suitable for you.


5. I have diarrhoea every other day. It isn’t food poisoning because I haven’t eaten at a new restaurant or changed my diet. What is happening?

Troubled tummy*, 26

Dr Sheikh Anwar Abdullah: Chronic diarrhoea is defined as loose stools that last for at least four weeks. This usually means three or more loose stools per day. There are many possible causes of chronic diarrhoea, such as irritable bowel syndrome (IBS), inflammatory bowel disease (Crohn’s disease and ulcerative colitis), malabsorption syndrome where food can’t be digested and absorbed and chronic infections. Treatment is aimed at correcting the cause of diarrhoea whenever possible, firming up loose stools, and dealing with any complications caused by the diarrhoea. Consult your doctor if diarrhoea persists or you have severe abdominal or rectal pain, blood in your stools, black tarry stools, fever, signs of dehydration and weight loss or you have a strong family history of colon cancer.


6. My friend has just broken up with her long-time boyfriend and spends lots of time feeling depressed. What are the signs that she needs help and whom should she see?

Worried*, 24

Jessie Foo: If the person has been consistently experiencing or showing three or more of the following characteristics for at least two weeks and these characteristics are affecting other aspects of her life such as her studies or work, it is recommended that the person seeks assistance from a mental health professional such as psychiatrist or clinical psychologist. Red flags include feeling sad or constant crying, changes in appetite or sleep patterns, loss of interest in activities she used to enjoy, acting recklessly such as speeding or substance abuse or talking about thoughts or desires to not continue living. As this is not an extensive list of the signs of depression, it is recommended that your friend seek professional assistance. Please do get your friend to speak to a mental health professional to help alleviate the intensity of her depressed feelings and guide her into moving forward with her life.


7. I’m on the pill and I had a one-night stand. Now, I have unbearable itching in my crotch. How do I stop it?

Itchy and bewildered*, 24

Dr Kannappan Palaniappan: There are a few possibilities such as a vaginal infection including those that are sexually transmitted either viral, bacterial or parasitic. There could be associated ulcers or vaginal discharge. Candidiasis (a type of yeast) infection would be another possibility. The other causes include allergic reaction such as an allergy to any lubricant used. Please remember that the pill does not protect one from infections. Condoms are the safest option. It is best to seek early medical advice especially for sexually transmitted infections as some may have long-term implications.


*Names were changed to protect privacy.

Editor’s Note: This article features advice from medical professionals. However, please see a doctor if your symptoms persist.

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