Founded by Grace Oh, an Integrative Nutrition Health Coach and Certified Menopause Champion with an MBA from Harvard Business School, Sol was developed in collaboration with healthcare professionals and shaped by real experiences. Oh said the idea stemmed from her own struggle with misdiagnosis during menopause, which exposed how little support women receive during this transition.

“I started Sol because I was fed up with women quietly suffering, misunderstood, misdiagnosed, or simply ignored, during one of the most transformative phases of our lives,” Oh shared on the app’s website.

Sol offers users a confidential way to track symptoms and access personalised wellness plans grounded in scientific evidence. Its proprietary three-level scorecard rates the safety and effectiveness of different management options, from conventional treatments to lifestyle and complementary approaches.

The app also extends its reach to workplaces by helping organizations design policies that support employees experiencing menopause. By doing so, it seeks to reduce productivity losses and improve talent retention in companies across the region.

According to World Health Organization (WHO), one in ten women in the world is diagnosed with endometriosis, a chronic disease associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility.

The introduction of robotic-assisted surgery marks a significant advancement in the treatment of endometriosis, providing precise and minimally invasive surgical solutions across diverse medical specialities, including those with endometriosis.

Comparison between laparotomy and robotic-assisted endometriosis surgery

“Traditional surgical interventions have been the go-to method for many surgeries. Although effective to a certain level, they do carry notable drawbacks, including prolonged recovery times and the surgery itself is quite complex,” explains Dr Thow.

In traditional laparotomy (open surgery) for endometriosis, due to angle and vision limitation, surgeons usually have difficulty to complete excise endometriotic lesions. “In my experience, 90% of endometriotic lesions occur at the back of the uterus, which is challenging for surgeons to identify if performing conventional laparotomy. However, robotic-assisted surgery offers enhanced visual support (such as multiple-angle, higher quality vision) allowing surgeons to better identify lesions that may be hidden from direct sight and go unnoticed. Consequently, robotic surgeries emerge as viable options for minimally invasive procedures, particularly for addressing more complex and challenging cases of endometriosis. Overall, they offer more hope for improved outcomes and enhanced quality of life for women battling the condition,” Dr Thow added.

Furthermore, a shorter recovery period, reduced complications, and minimal scarring with less pain and blood loss make robotic-assisted surgery an appealing treatment option for endometriosis patients, especially in cases involving complex and hidden lesions. It also enables patients to get back to their normal lifestyle sooner. “We have many patients plagued by severe dysmenorrhea due to endometriosis. However, after robotic-assisted surgery, almost all experienced complete symptom relief,” shared Dr Thow.

One of the most compelling advantages of robotic-assisted surgery is its potential to preserve fertility.“ Endometriosis can severely impair reproductive organs such as the fallopian tube function, diminish ovarian reserve, and create a hostile environment for fertilisation and implantation, but robotic surgery can treat the disease while preserving the function of these organs, thus improving fertility outcome,” he added.

Determining candidacy for robotic-assisted surgery is a meticulous process. While any patient may be considered, Dr Thow emphasises its suitability for robotic surgery applies to cases of endometriosis that conventionally necessitate open surgery, such as deep infiltrating endometriosis, a severe form of endometriosis involves deep growth of endometrial-like tissue into pelvic structures, causing severe pain and other complications or large benign tumours, non-cancerous growths that can occur in various body parts, potentially causing symptoms due to their size and location.

The future of robotic-assisted surgery

Looking ahead, Dr Thow foresees a surge in robotic surgeries across Malaysia, particularly for challenging conditions like endometriosis. He also said despite the learning curve, newer surgeons are being trained to adopt the use of robotics in surgeries, further instilling the expertise needed to operate these innovative solutions.

Due to its precision and minimally invasive nature, robotic surgery may become the preferred choice for more complex treatments. Although there is rarely a misconception surrounding embracing robotic-assisted surgery, its cost could potentially be higher compared to traditional methods.

Dr Thow said: “While the accessibility of robotic-assisted surgery is limited at the present moment, I predict that robotics will play a larger role in surgery in addition to taking on a supportive role as it has potential to provide more precise insertions, shortening operating time and mitigating potential complications. In some cases too, our patients feel more reassured when robotics are involved in their procedure, especially for more complex ones. Ultimately, the decision to opt for robotic or traditional surgery will be made collaboratively between the patient and doctor, considering all available options and individual circumstances.”

With all these in mind, Dr Thow also opines that with more adoption of innovative technologies within surgical procedures, healthcare professionals can be better equipped to undertake and manage more complicated cases, providing care for more patients long-term.

As one of the largest quaternary private hospitals in Malaysia, Sunway Medical Centre, Sunway City (SMC) is home to some of the most state-of-the-art robotic surgical systems in the market through its Robotics Surgery and MIS Centre of Excellence for various health concerns, including women’s health. SMC has also recently been named in the top 250 hospitals globally in Newsweek World’s Best Hospitals 2024 rankings earlier this year, setting the benchmark for hospitals around the world in areas of clinical excellence, research and innovation.

Silent crises

In many Asian cultures, motherhood is closely tied to ideals of self-sacrifice, strength, and family honor. Often, mothers are expected to hold the family together by staying silent about their own needs and struggles. They’re not supposed to complain.

These unfair expectations can silence women who are struggling, since speaking up about mental health is sometimes seen as a sign of weakness or failure. A 2020 study in BMC Pregnancy and Childbirth found that East Asian women—especially those living in Western countries—often underreport postpartum depression because of stigma and cultural taboos. This lack of disclosure can delay diagnosis and treatment, which can make the condition worse over time.

Common mental health challenges among mothers

The most common maternal mental health issues are postpartum depression (PPD), anxiety, and postpartum psychosis. PPD affects about 1 in 7 women and is characterized by persistent sadness, fatigue, changes in sleeping or eating patterns, and feelings of hopelessness or detachment from the baby. Anxiety disorders, including generalized anxiety and postpartum obsessive-compulsive disorder, are also prevalent. Unlike the “baby blues” that subside within two weeks, these conditions can persist and impair daily functioning. Studies show that Asian mothers are less likely to seek help for these symptoms, often attributing them to personal failure or stress rather than a medical condition.

Postpartum PTSD, an overlooked condition

One lesser-known but serious condition is postpartum post-traumatic stress disorder (PTSD), which can occur after a traumatic childbirth experience. Symptoms include flashbacks, nightmares, heightened anxiety, and emotional numbness. A study in the Journal of Affective Disorders found that up to 6% of women experience postpartum PTSD, with higher rates among women who underwent emergency C-sections, had a history of trauma, or lacked support during labor.

In Asian communities, the risk may be compounded by a tendency to downplay emotional suffering and avoid mental health services. For instance, a Korean study published in Archives of Women’s Mental Health noted that women who perceived childbirth as a loss of control were more likely to develop PTSD, yet were less likely to access psychological care.

Why Asian mothers are at high risk

Several factors put Asian mothers at increased risk, including

1. Cultural expectations: The ideal of the “perfect mother” who does not complain or struggle is deeply ingrained. In many Asian households, emotional problems are often managed privately or dismissed entirely.

2. Language and access barriers: Mothers coming from different cultures, such as in the case of migrants, may struggle to find mental health services in their native language or feel misunderstood by providers unfamiliar with their cultural background.

3. Stigma: Mental illness is often associated with shame in many Asian cultures, deterring women from seeking timely help.

4. Lack of support: With the erosion of traditional extended family networks, many mothers feel isolated, especially those living abroad or in nuclear families.

It takes a village to heal

Awareness and culturally sensitive interventions are important for improving maternal mental health outcomes for Asian women. Healthcare systems need to invest in screening tools and mental health services that are culturally appropriate. Community-based programs can also help. Peer-led support groups—especially those held in native languages and with a focus on gender sensitivity—have been shown to reduce stigma and make it easier for women to seek help.

Getting spouses and extended families involved in education programs can also ease the pressure on mothers and create a more supportive environment. A study in the International Journal of Mental Health Nursing pointed out that family involvement can make a real difference in postpartum care.

A mother’s mental and emotional well-being shouldn’t fall on her shoulders alone—it’s something for families and communities to care about too.

The Self-Employed Women’s Association (SEWA), a long-standing trade union representing informal women workers, is addressing this problem not with more paperwork, but with digital infrastructure. SEWA’s new Digital Health Passport initiative leverages blockchain technology to build a secure, scalable system for managing identity and welfare records, anchored in the Algorand blockchain and integrated with India’s Aadhaar and DigiLocker systems.

The goal is to establish a verifiable, tamper-proof layer of trust that enables access to health care, pensions, and other safety-net services for those traditionally left behind by analog bureaucracy.

At the heart of the effort is a blockchain-powered custodial wallet system that allows SEWA’s members to upload and manage essential documents. These wallets are not just storage devices; they are dynamic interfaces that allow for verified claims, such as eligibility for maternal health programs or proof of age for pension benefits, to be shared securely with relevant authorities.

SEWA’s on-the-ground workers, known as Aagewans, play a pivotal role. By conducting household visits across Gujarat, they guide women through the process of digitizing and verifying their information—ensuring technology meets people where they are, not the other way around.

This community-driven approach addresses a systemic flaw in welfare delivery: access is not just about eligibility but about proof. And in India’s fragmented documentation environment, proof is often elusive.

“Digital trust is the real innovation here,” said SEWA Director Mirai Chatterjee. “Technology becomes empowering when it’s co-created with users in mind—especially women who have historically been excluded from both formal systems and digital tools.”

Before implementing the blockchain solution, SEWA could support just a fraction of its 3.5 million members due to administrative constraints. Now, with a decentralized ledger offering immutability, transparency, and easy authentication, the organization is positioned to reach far more women at a fraction of the cost.

The project also changes how blockchain is perceived in India. Often associated with speculative finance or cryptocurrency, blockchain in this context is redefined as a public infrastructure layer, a trust protocol rather than a transaction mechanism.

“Blockchain isn’t just about tokens. It’s about trust at scale,” said Anil Kakani, Vice President at the Algorand Foundation. “SEWA’s work demonstrates how decentralized systems can remove friction from public service delivery and include those who’ve historically been left out.”

The Digital Health Passport is compliant with India’s data privacy laws and is being scaled through SEWA’s Shakti Kendras, local empowerment hubs that will serve as digital access points for the initiative. Future applications are already in the pipeline, including blockchain-backed insurance enrollment, claims processing, and direct benefit transfers.

By Associate Professor Dr Ganesh Ramachandran and Associate Professor Dr Khine Pwint Phyu – School of Medicine, Faculty of Health & Medical Sciences at Taylor’s University.

Cervical cancer is the fourth most common cancer among women worldwide, with approximately 660,000 new cases in 2022. Low- and middle-income countries, particularly in Sub-Saharan Africa, Central America, and Southeast Asia, bear the highest incidence rates due to socio-economic factors, affecting vaccination uptakes, screening, and treatment. ¹

In Malaysia, 1,740 new cases were reported in 2020 with a mortality rate of 57%. ² This cancer, primarily linked to Human Papillomavirus (HPV) infection (especially types 16 and 18), is influenced by risk factors such as early sexual activity, pregnancy before the age of 20, promiscuity, unprotected sex, multiple full-term pregnancies, smoking, long-term oral contraceptive use, Human Immunodeficiency Virus (HIV) infection, and sexually transmitted infections. These factors are often exacerbated in lower socio-economic communities, increasing their vulnerability.

Global efforts and WHO’s call to action

The World Health Organization (WHO) issued a bold call for the global elimination of cervical cancer by 2030, achievable through effective HPV vaccination, screening mechanisms for detecting pre-cancerous and early cancer stages, and access to treatment. Elimination implies less than 4 cases per 100,000 population. WHO’s targets include fully vaccinating 90% of girls by age 15, ensuring 70% of women undergo high-performance screening by ages 35 and once more at 45, and treating 90% of women with cervical cancer.³  High-performance testing, which includes HPV testing alongside pap smears or visual inspections of the cervix with acetic acid, should be done every five years. Self-testing kits can improve screening uptake by eliminating the need to visit a health care provider thus saving time and addressing the stigma associated with the disease.

Malaysian scenario

Cancer of the cervix stands out as the second most common cancer among Malaysian women aged 15 to 44, primarily caused by HPV. The disease is largely preventable through vaccination, screening, and treatment.  Up to 1% of women may carry the virus, with 40% potentially becoming chronic carriers. ⁴These women are at high risk of developing cervical cancer.

Malaysia has implemented an HPV vaccination or primary prevention programme since 2010, targeting 13-year-old girls in schools. The WHO reported that 80% of girls received the final dose by age 15 in Malaysia. Although the COVID-19 pandemic slowed the programme, the untiring efforts of the Ministry of Health and non-governmental organizations (NGOs) such as the National Cancer Society of Malaysia in providing catch-up vaccination should ensure that Malaysia is likely to continue to do well in vaccinating the population at risk.

The Ministry of Health recommends yearly pap smears for sexually active women aged 21 to 65 for two years, followed by every three years if initial smears are normal as a secondary prevention method. High-performance HPV testing is recommended every five years and for women above the age of 65 who have never been screened. Despite the existence of a government-run cervical screening programme since 1969 and the availability of free screening since 1995, uptake remains poor at 35% to 48% which is far below the WHO requirements. A 2020 WHO report indicated only 4 in 10 women had been screened in the previous five years with educational status, awareness of the availability and the effectiveness of screening, knowledge of the disease, and family support being likely factors in determining access to screening. Other factors hindering screening were time constraints, embarrassment, and lack of knowledge.

Improving screening uptake

To improve screening acceptance, education about cervical cancer must begin early, and the stigma and embarrassment associated with pap smears must be addressed. This requires educating not only girls and women but also men, who play an important facilitative role.

Many women face significant barriers such as fear of discomfort from the invasive procedure and cultural sensitivities about male doctors. There are also technical challenges with the procedure that may necessitate retakes thus inconveniencing patients. Hence, accommodating patient preferences, such as the availability of female practitioners, improving procedural techniques, allaying anxiety, and promoting the use of less invasive HPV DNA testing and making available self-testing kits, can enhance the screening experience.

The final piece of the puzzle for eliminating cervical cancer is the availability and accessibility of diagnostic and treatment facilities. While diagnostic and treatment facilities exist in both the government and private sectors, costs are high in the private sector and waiting times are long in the public sector which compounds the problem. Smart partnerships between the government, private sector, and NGOs are being put into place to optimise resources, which will positively impact combating cervical cancer in the coming years.

High vaccination rates are a success story in Malaysia’s initiative to eliminate cervical cancer. Improving screening acceptance and building capacity in the form of gynaecological oncology surgeons, radiation, and medical oncologists are crucial to effectively combat cervical cancer and achieve the goal of elimination by 2030. With concerted efforts, collaboration, and education, we can indeed win the battle against cervical cancer.

Sources:

1. https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
2. https://www.thestar.com.my/news/nation/2024/01/14/statistics-on-cervical-cancer-in-malaysia-alarming
3. https://www.who.int/initiatives/cervical-cancer-elimination-initiative
4. https://hpvcentre.net/statistics/reports/MYS_FS.pdf?t=1557678064474

Endometriosis is a chronic disease where tissue resembling the uterine lining grows outside the uterus. Though it is a condition affecting millions of women all over the world, it often remains veiled in mystery and misconceptions.

Many struggle silently with undiagnosed symptoms—including severe pain during periods, sexual intercourse, bowel movements, and urination, alongside chronic pelvic pain, abdominal bloating, nausea, and fatigue. Consequently, these symptoms can often even lead to mental health issues like depression and anxiety.

It may also be more difficult for them to become pregnant. 30% to 50% of infertile women are diagnosed with endometriosis, with their infertility likely rooted in a distorted anatomy of the pelvis, adhesions, scarred fallopian tubes, inflammation of the pelvic structures, altered immune system functioning, changes in the hormonal environment of the eggs, impaired implantation of a pregnancy, and altered egg quality.

Highlighting the challenges faced by women with endometriosis, Dr. Liza Ling Ping, Consultant Obstetrician & Gynaecologist, Fertility Specialist of TMC Fertility, highlighted the need to shed light on the profound impact of this condition on infertility.

According to Dr. Liza of TMC Fertility, Malaysia’s leading fertility centre with branches in Puchong, Kota Damansara, Johor Bahru, Penang, and Ipoh, the center can offer support and personalised care to patients, ensuring they have the best access to seek expert guidance and professional advice. “We aim to help empower women to seek timely diagnosis and access comprehensive care so that no woman faces the hardships of endometriosis alone,” she added.

Surita Mogan, Founder and President of Endometriosis Association of Malaysia (MYEndosis) also echoes the lack of awareness in Malaysia, stating, “There are many females who are affected by endometriosis in Malaysia. Unfortunately, there is limited documentation on these females. Malaysians generally are not aware of what endometriosis is and why some women have this condition because it is often considered as a taboo subject. People are quite uncomfortable speaking about menstrual health openly.”

Four stages of Endometriosis

There is currently no cure for endometriosis, but getting an official diagnosis for the disease can help classify the stages of endometriosis based on the severity of the condition and the level of pain. After diagnosis, there are several treatment options available that aim to ease the symptoms so the condition does not interfere with daily life.

Stage I: Minimal Endometriosis – During this phase of the condition, small and scattered patches of endometrial tissue exist outside the uterus, typically located on the pelvic lining or ovaries. Symptoms may not be evident in some cases. However, mild pelvic pain or discomfort during menstruation might be present.

Stage II: Mild Endometriosis – At this stage, there is an increased number of tissue patches,and they might be slightly deeper. These patches may also appear on the fallopian tubes and the ligaments supporting the uterus. Besides mild pelvic pain, there could be painful menstruation, discomfort during intercourse, and difficulty getting pregnant in some cases.

Stage III: Moderate Endometriosis – For stage 3, there will be an increased amount of tissue patches. There may also be scar tissue and adhesions. In addition to the symptoms in the previous stages, chronic pelvic pain and digestive issues might be experienced.

Stage IV: Severe Endometriosis – In the fourth stage, there would be many deep-seated tissue patches, often accompanied by large cysts and extensive scarring. Pain might be more severe and particularly heightened during menstruation and sexual intercourse. Additionally, there would likely be painful bowel movements and frequent urination.

Managing symptoms and treatments available

If endometriosis is suspected and conceiving is an issue, making an appointment with a reproductive endocrinologist or gynaecologist that specialises in endometriosis and reproductive surgery will provide patients with the right treatment options that will preserve and improve fertility.

A fertility specialist will consider a person’s age, overall health, symptoms and other factors—including their conceiving goals—when determining which treatment is best. Treatment choices include medicine, surgery or both.

Fertility specialists may also recommend laparoscopic surgery to remove abnormal tissue growths or refer patients to reproductive endocrinologists for specialised fertility treatments. In rare cases, open surgery is needed. In all cases, a specialist will consider all treatment options to determine a patient’s timeline to conceive and explain the best options for them to manage their symptoms.

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Approximately 1 in 500 individuals inherit a mutated BRCA (BReast CAncer) gene. This inheritance significantly increases the risk of cancer, with probabilities ranging from 45% to 87% in European women. Previously, medical professionals in Asia were unable to provide accurate risk estimates for Asian women due to the majority of data being based on European women and the lack of reliable estimates from Asian women. The new study is expected to fill this gap and provide critical information for Asians.

Related: Advocating for Timely Detection and Cancer Screening in Women’s Healthcare

CRMY Chief Scientific Officer, Professor Datin Paduka Dr Teo Soo Hwang and the lead of the study said, “This study builds on our work in the past two decades to develop better ways of detecting breast cancer early and saving lives. Until recently, only 5% of the genomic and genetic studies globally were conducted in Asians and we are delighted that by continuing to focus on Asians, we can ensure that advances in precision medicine can also benefit the Asian population.”

Women with inherited changes in the breast cancer predisposition genes face challenging decisions, contemplating whether to opt for prophylactic surgery to remove healthy breasts or ovaries, thereby reducing the risk of breast or ovarian cancer.

Alternatively, they may consider more frequent or different types of screening to ensure early detection and increase the chances of successful treatment in case cancer does develop.

In making these decisions, it is critical that they have accurate information about their risk of cancer – for example, if a woman has an 87% chance of developing breast cancer, her choices may be different from that if she has a 45% chance of developing the disease.

As actual risk varies based on other genes, lifestyle, and reproductive choices, such as the number of children a woman has, making these decisions is only possible if we have accurate data on cancer risk in Asians. This then is the area of clinical need: to conduct Asian specific studies to provide accurate information to thousands of Asian BRCA carriers so that they can make informed decisions to save their lives.

Researchers from Malaysia and Singapore collaborated on this study, which received funding from Yayasan Sime Darby, Yayasan Petronas, Estee Lauder Group of Companies, and Vistage Group of Companies, to provide a comprehensive analysis of breast and ovarian cancer risk in Asian women. We found a significant shift: for women born from 1920-1940s, Asian BRCA carriers had about half the risk compared to European carriers.

Related: Shanghai Researchers Announce Groundbreaking Treatment for HER2-Positive Breast Cancer Brain Metastases

However, in the GenX generation born from 1960-1970s, the risk aligned with European BRCA carriers. The key takeaway is that lifestyle changes have not only increased cancer risk for the general population but also for BRCA carriers. Doctors should consider the patients’ birth era and lifestyle factors when advising on cancer risk.

“Accurate quantification of disease risk in BRCA carriers demands substantial sample sizes. Our study is a testament to the power of research unity, bringing together brilliant minds from Singapore, University of Cambridge and our home base in Malaysia. Through these expansive collaborative efforts, we’ve achieved a groundbreaking milestone, advancing our understanding of breast and ovarian cancer risks in Asian BRCA carriers and paving the way for more informed decisions in healthcare,” said Associate Professor University of Nottingham Malaysia (UNM) and first author of the study, Dr Ho Weang Kee.

Moving forward, the CRMY-Nottingham team have won the global Basser Grant to identify the lifestyle and genetic factors that are associated with cancer risk in Asian BRCA carriers. This grant aims to create advanced tools tailored for Asian BRCA carriers, offering precise guidance on their risk of breast and other cancers. The upcoming tools developed by Malaysian researchers will integrate additional gene variants and lifestyle factors, enhancing precision in prevention and treatment strategies for Asian women.

“This is a milestone in our efforts in saving Asian lives through precision guidance. Having more accurate risk information for Asian women is crucial when providing genetic counselling to patients and their family members. This development will help us to work with the patients and empower them to make informed, life-saving medical decisions,” said CRMY Consultant Genetic Counsellor, Yoon Sook-Yee.

This study was made possible by the Wellcome Trust Collaborative Science Award to Professors Teo and Doug Easton, led principally by A/Prof Ho. Additionally, the research team has recognized the following hospitals for their participation: Subang Jaya Medical Centre, University Malaya Medical Centre, Beacon Hospital, Gleneagles Penang, Hospital Universiti Sains Malaysia, KPJ Ampang Puteri Specialist Hospital, KPJ Johor Specialist Hospital, KPJ Sabah Specialist Hospital, Loh Guan Lye Specialist Centre, Mount Miriam Cancer Hospital, Pantai Hospital Kuala Lumpur, Penang Adventist Hospital, Universiti Kebangsaan Malaysia Medical Centre, Sunway Medical Centre, National Cancer Centre Singapore, Singapore General Hospital, Changi General Hospital, Tan Tock Seng Hospital, KK Women’s and Children’s Hospital, and National University Hospital Singapore. Their collaboration in recruitment and interviews, according to the researchers, significantly contributed to the success of this study.

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By: Dr Thangesweran Ayakannu, Consultant Gynaecology Oncology and Robotic Surgeon, Sunway Medical Centre, Sunway City

SMC’s Dr Thangesweran Ayakannu delves into the importance of cancer screening among women, especially for cervical cancer and provides advice for Malaysian women to empower them in their journey towards optimal gynaecological health.

Early detection and regular screening for cervical cancer are imperative for women’s health. Cervical cancer is a silent threat that affects women worldwide, but early detection holds the key to successful treatment and improved outcomes. In Malaysia, it is the 4th most frequent cancer among women and 2nd most frequent cancer affecting women 44 and below. This worrying finding shows that it is crucial to shed light on the significance of proactive health measures, breaking taboos, and embracing regular screenings.

Types of gynaecological cancers are rising

There are three primary gynaecological cancers: uterine cancer, cervical cancer, and ovarian cancer. Cervical cancer is one of the most common forms of gynaecological cancer, even in Malaysia, where 12.9% of female cancers are caused by cervical cancer.
However, uterine cancer is on the rise, correlated with increasing obesity rates. According to the National Cancer Registry of 2011-2016 report, uteri cancer among women has increased from 3.8% in 2007 -2010 to 4.6% in 2011 -2016. As a healthcare professional, we have been seeing a rise in uterine cancer. This could be mainly due to the hormonal imbalance as a result of obesity. This imbalance is one of the contributing factors of cancers affecting organs like the uterus, breast, and ovaries.

Role of the HPV vaccine

According to the World Health Organisation (WHO), human papillomavirus (HPV) is a common sexually transmitted infection affecting the skin, genital area and throat. Persistent HPV infection of the cervix (the lower part of the uterus or womb, which opens into the vagina – also called the birth canal) if left untreated, causes 95% of cervical cancers.

HPV, a widespread infection affecting nearly everyone, both men and women is a leading cause of cervical cancer. One of the most prevalent preventative measures is the HPV vaccination, which can substantially lower the risk by targeting the most dangerous strains of the virus. However, HPV vaccines should not be considered a substitute for pap smears as a proven method of gynecological cancer screening.

Fertility treatments and cancer risk

As one of the main risks of cancer is hormonal imbalance or fluctuations, and the main function of fertility drugs is to overstimulate the ovary, there may be concerns surrounding the increased risks of cancer to women undergoing or who have undergone fertility treatments. Fertility drugs, especially those that overstimulate the ovaries, pose a risk, especially when it is done frequently. It is important for women who have undergone fertility treatments to monitor their ovarian tissue closely through ultrasounds, and blood tests, especially after strong and frequent IVF or fertility treatment cycles.

Infertility has been found to be an important risk factor for ovarian cancer. However, the association between infertility drugs and ovarian cancer needs to be addressed with consideration of other factors such as age, body mass index, parity, genetic factors (i.e. family history for ovarian cancer), and aetiology of the infertility, along with longer follow-up times.

Importance of Cancer Screening

Early cancer screening for Malaysian women is critical since early detection is paramount in the fight against cervical cancer. Regular screenings empower women to take control of their health, allowing us to identify potential issues in their infancy.

In Malaysia, where cultural nuances sometimes hinder open discussions about women’s health, breaking these taboos and embracing early screening is a pivotal step. It improves treatment outcomes and transforms the narrative around women’s well-being.

By fostering awareness and encouraging proactive health-seeking behaviours, we can collectively move towards a future where cervical cancer is not just treatable but preventable. Prevention involves detecting cell changes early through HPV vaccines, regular pelvic exams, HPV DNA tests every 4 years and pap smears every three years. Late-stage diagnoses, preventable with these measures, are something we aim to avoid.

Early detection is not just an option but a shared responsibility. An expert guidance underscores the transformative power of early detection, open communication, and regular screenings. By breaking taboos and fostering a culture of awareness, we pave the way for a future where cervical cancer is not just treatable but preventable.

Knowing Your Risks and the Importance of Managing your Gynaecological Health and Wellbeing

• Know Your Body, Break the Taboos: Understanding one’s body is the first step towards empowerment. Monitoring your menstrual pattern, being alert of irregularities, and seeking early help can help. Do not ignore these symptoms.

• Clear Communication and Regular Pelvic Examinations: When doing your health checkup, it is important to communicate your medical history during doctor visits. Regular pelvic exams can also help with your overall gynecological health and provide vital information to the healthcare professional

• Risk Assessment and Screening: Risk assessment guides healthcare professionals in determining the right screening tests. The best treatment outcome is when we can catch it early. Dr Thangesweran Ayakannu advises that Robotic surgery, for example, has advanced technologies that can help. Catch it early; the earlier you catch it, the better the outcome.”

• Recognising and Addressing Symptoms and Risk factors: For women who know their bodies best, it’s important not to ignore your symptoms even though you may think it’s normal. For example, bleeding after menopause or postmenopausal bleeding is not normal but it may be an early warning sign for endometrial cancer. Dr Thangesweran Ayakannu adds, “Other conditions like PCOS and endometriosis predispose you to gynecological cancers. Keep an eye on these long-term problems, monitor your periods, and undergo regular checkups, including ultrasound scans.”

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Women have noticeably higher rates of chronic illness despite living longer than men. These high rates of illness can be managed by prioritising a diet of brightly-coloured fruits and vegetables such as kale, spinach, yams, watermelon, bell peppers, tomatoes, oranges, and carrots – the pigmented carotenoids act as antioxidants to prevent visual and cognitive loss, according to researchers at the University of Georgia (UGA).

Research shows women tend to store vitamins and minerals in their bodies differently from men: UGA professor of psychology Billy Hammond pointed out that women reserve many dietary vitamins and minerals in their body fat, to be used for pregnancy. This unfortunately means that the nutrients are less readily available for the brain and retina in women, putting them at risk of degenerative problems.

A UGA study details several degenerative conditions, from autoimmune diseases to dementia that, even controlling for lifespan differences, women experience at much higher rates than men. Women account for nearly 80% of all autoimmune diseases, said Hammond, and so, need extra preventive care.

Dietary intake of two specific carotenoids, lutein and zeaxanthin, have been shown to directly improve ocular and central nervous system health. Lutein and zeaxanthin are found in specific tissues of the eye and brain.

“Men and women eat about the same amount of these carotenoids, but the requirements for women are much higher – there are, generally, not any recommendations for men or women for dietary components that are not directly linked to deficiency disease (like vitamin C and scurvy),” said Hammond.

“Components of diet influence the brain, from things like personality to even our concept of self. I don’t think people quite realise what a profound effect diet has on basically who they are, their mood, even their propensity to anger. And now of course this is extended to the microbiome and the bacteria that make up your gut – all of these components work together to create the building blocks that compose our brain and the neurotransmitters that mediate its use.”

Carotenoids are also available via supplements, and the National Institutes of Health has focused resources on specific carotenoids through the National Eye Institute program. And though supplements of lutein and zeaxanthin are a way of increasing intake, Hammond said getting them through food is a much better strategy.

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US women had poor cardiovascular health before becoming pregnant, said researchers of a new study carried out at Northwestern University in Illinois. According to the study, over half the women were reported to have at least one risk factor for poor heart health, including overweight/obesity, hypertension, and/or diabetes, before becoming pregnant.

“As women, we tend to think about the baby’s health once we become pregnant, but what so many women don’t realise is the very first thing they can do to protect their babies (and themselves) is to get their heart in shape before they even conceive,” said Dr. Sadiya Khan, assistant professor of medicine in cardiology and epidemiology at Feinberg School of Medicine, Northwestern University.

Dr. Natalie Cameron, an internal medicine specialist and instructor at Feinberg, echoed Dr. Khan’s statement. “Women with favorable heart health before pregnancy are less likely to experience complications of pregnancy and are more likely to deliver a healthy baby. Even more importantly, optimising heart health before and during pregnancy can prevent the development of heart disease years later.”

[Poor heart health puts expectant mothers and their babies at risk, with heart disease causing upwards of one in four pregnancy-related deaths, statistics show.]

More than one in two young women between the ages of 20 and 44 who gave birth in the country in 2019 had poor heart health before becoming pregnant. When comparing data by geographical region, the percentage of women with good heart health was found to be lower in Southern (38.1%) and Midwest (38.8%) states, compared with states in the West (42.2%) and Northeast (43.6%). There were also variations among states, ranging from less than one-third of women in Mississippi (31.2%) having good heart health prior to pregnancy compared to nearly half (47.2%) in Utah.

“The geographic patterns observed here are, unfortunately, very similar to what we see for heart disease and stroke in both women and men,” Dr. Khan admitted. “They indicate factors, such as social determinants of health, play a critical role in heart health as well as maternal health.”

Women are therefore encouraged to see a clinician prior to becoming pregnant, so they can be advised on how to maintain a healthy lifestyle before and during pregnancy. These include staying physically active, eating a healthy diet filled with vegetables, whole grains, and plant-based proteins, and avoiding tobacco to reduce the risks for being overweight or developing high blood pressure or diabetes.

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