(35 – 50 years)

1. Endometriosis, Fibroids and Ovarian Cysts
2. Declining Fertility & Treatments

Many women only start thinking about starting a family in their 30s as more opt to pursue their careers and other priorities. Though age may be an most important factor affecting a woman’s fertility, there are several fertility treatment options that have made conceiving and pregnancy possible well into your 40s.


Discuss with your partner about how far both of you would like to go with fertility treatments if you are facing fertility issues. Couples should seek help in diagnosing their infertility issues before working with their doctor on a suitable solution. Read on to find out more about fertility management options.

In-Vitro Fertilisation (IVF)

In-Vitro Fertilisation (IVF) is considered one of the most effective types of Assisted Reproductive Technology (ART) for couples who have not had much success with other treatments.


A woman’s ovaries are first stimulated with daily hormone injections to stimulate the egg maturation during IVF. Mature eggs are collected from the ovaries under anaesthesia and a semen sample is obtained from the male partner. The sperm and egg are fertilised in a laboratory and incubated for a further 3 – 5 days. Using a catheter inserted through the cervix, fertilised eggs are then placed in the uterus.


The success rate of IVF depends on several factors including the mother’s age, cause of infertility and pregnancy history.


Do consult your doctor to understand the potential risks and your treatment suitability as IVF is a time-consuming, expensive and invasive process.

Intrauterine Insemination (IUI)

An alternative method to the IVF is the intrauterine insemination (IUI), a treatment in which sperm is placed into the uterus to facilitate fertilisation.


The male partner’s semen sample is obtained and processed to extract the sperm. The sperm will then be inserted into the woman’s uterus during the ovulation period via injection, maximising the number of sperm cells placed in the uterus thereby, increasing chances of natural conception. It may be paired with fertility medication to stimulate ovulation before starting a cycle. A pregnancy test can be administered in 2 weeks to determine if it was successful.


IUI may be a suitable treatment for couples who experiencing erectile dysfunction, poor sperm mobility or other unexplained infertility issues.

3. Regular Health Screenings

In addition to regular overall health screenings, women need to take preventive steps and regularly screen for cancer to ensure their protection.

Pap Smear

Cervical cancer ranks among the top 10 women’s cancers in Singapore. It can be detected through a pap smear – a simple and effective procedure where your gynaecologist will gently scrape some cells from the cervical wall to examine for any abnormalities. Sexually active women should have a pap smear once every 3 years. A pap smear can be performed together with the HPV vaccination every 5 years.


Breast cancer is the top cancer among women in Singapore with around 1850 new cases diagnosed every year. A mammogram can detect malignant lumps, offering an effective screening solution for the early detection of breast cancer and greatly increasing cancer survival rates. Women above 40 are advised to get a mammogram done annually.

4. Vaginal Laxity and Dryness

After childbirth, some women may experience some vaginal changes such as dryness and laxity. This may caused by the strain on the muscles during a vaginal delivery. Vaginal laxity and dryness may result in vulvar irritation and itchiness, vaginal soreness, pain during and after sex, urinary incontinence, and recurrent urinary infections.

What is Vaginal Rejuvenation?

A non-invasive laser treatment with no downtime, vaginal rejuvenation harnesses laser and radio frequency waves that stimulates formation of collagen and restores connective tissue in the vagina, treating the symptoms arising from vaginal dysfunction. The result is increased elasticity, improved vaginal lubrication, increased sensation and reduced occurrences of urinary incontinence.

5. Gynaecological Cancers (Cervical, Endometrial, Ovarian)

The most common types of gynaecological cancers are those which start in the cervix (neck of the womb), endometrium (lining of the uterus) and ovaries.


Symptoms & Diagnosis


Cervical Cancer

Abnormal vaginal bleeding outside of your period, pain during sex, or abnormal vaginal discharge may be a symptom of cervical cancer. It is important to pay your gynaecologist a visit for a thorough check. Screen and detect abnormalities in the cervix (see above) with a pap smear. HPV vaccinations before sexual contact can also prevent against certain strains of HPV infections that could lead to cervical cancer.


Endometrial Cancer / Womb Cancer

Abnormal vaginal bleeding may be a sign of endometrial cancer, especially for post-menopausal women. Other risk factors for endometrial cancer include obesity, not having children, menstrual history and family history.


Endometrial cancer can be diagnosed via a biopsy of the uterus lining or via a regular transvaginal ultrasound.


Ovarian Cancer

The 5th most common women’s cancer in Singapore, ovarian cancer does not often present clear symptoms in the early stages. It is often undetected until symptoms such as abdominal pain, bloating, or abnormal vaginal bleeding surface in the later stages. While there is no specific screening test for ovarian cancer, risk factors associated with ovarian cancer include age, infertility, family history of breast and ovarian cancer, endometriosis and genetics. Women who are at an increased risk may wish to undergo a CA125 blood test and transvaginal ultrasound during their health screening.

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