Ask Ferne

Have questions about sexually transmitted diseases (STDs), period pain, abnormal discharges, or other general sexual health?

Ask us anonymously, and one of our panel doctors will get back to you with the answers!

 

We will also publish the questions and answers below.

 

FAQ

ABOUT CERVICAL CANCER

What is HPV?


HPV stands for Human Papillomavirus, a common virus that can infect many parts of the body. There are more than 100 different strains of HPV, grouped into (i) high-risk types (may cause cancer) and (ii) low-risk types (non-cancer causing).

  • About 40 HPV strains can infect the genital area.
  • High-risk strains of HPV are associated with cervical, vaginal and vulvar cancer in women, and less commonly, anal or penile cancer in men. The most common high-risk strains are 16 and 18.
  • Low-risk strains of HPV may cause no symptoms or lead to genital warts. HPV types 6 and 11 are responsible for about 90% of genital warts.
  • Other HPV strains may infect the skin of the fingers, hands, and face.
Source: Healthhub.sg




What are the risk factors for cervical cancer?


Risk factors for the development of cervical cancer include the following:

  • HPV subtypes - Persistent infection with high-risk strains.
  • Immune status - People who are immunocompromised, such as those living with Human Immunodeficiency Virus (HIV), are more likely to have persistent HPV infections and a more rapid progression to pre-cancer and cancer.
  • Co-infection with other sexually transmitted agents, such as those that cause herpes, simplex, chlamydia, and gonorrhea.
  • Multiple sexual partners (in either partner).
  • The onset of sexual intercourse at an early age.
  • Tobacco smoking.
Source: Healthhub.sg




How is HPV transmitted?


HPV infection is very common in men and women. It can be transmitted through skin-to-skin contact, such as sexual activity, by sharing contaminated sex toys, and rarely during delivery from an infected mother to her baby. HPV cannot be spread by sitting on toilet seats or touching common surfaces. Source: Healthhub.sg




What are the signs and symptoms of a HPV infection?


  • Most HPV infections do not have any signs or symptoms.
  • Some HPV infection may cause genital warts.
  • High-risk HPV infection of the cervix does not cause any signs and symptoms. The abnormality on the cervix is detectable by cervical screening (Pap test) and by HPV DNA (genetic material) tests.
  • Symptoms of cervical cancer include abnormal vaginal bleeding such as bleeding after menstrual periods of after sex. There may also be changes in the amount, colour or smell of the vaginal discharge.
Source: Healthhub.sg




Can HPV be treated?


  • No treatment is required for asymptomatic HPV infections.
  • The body clears most HPV infections (90 percent of the cases) without the need for treatment.
  • Treatment is directed at HPV-associated conditions such as pre-cancerous lesions, cancer, or genital warts.
  • Although the HPV virus cannot be treated, regular cervical cancer screening tests can either detect changes in the cervical cells caused by HPV infection (Pap test) or to identify high-risk HPV cancer-causing strains.
Source: Healthhub.sg




How is HPV related to cervical cancer?


Certain types of HPV can infect the cervix (the lower part of the womb), vagina, and vulva. In most cases, the body's immune system can fight off the infection and clear the virus. However, sometimes the HPV infection can persist and cause abnormal changes to the cells. Some of these abnormal cells may develop into cervical cancer. This usually takes years to develop. Specifically, HPV subtypes 16 and 18 account for about 70 percent of cervical cancer cases. Source: Healthhub.sg




How can I best protect myself against cervical cancer?


  • Go for regular cervical cancer screening as it is the most effective way to detect abnormal changes in the cervical cells and cervical cancer.
  • All women aged 25 and above who have ever had sex should have either a Pap test once every three years (for women 25 to 29 years old) or an HPV (or HPV DNA) test once every five years (for women 30 years and above).
  • Speak to your doctor about the HPV vaccination to determine if you are suitable.
  • Even if you have received the HPV vaccination, it is important that you still go for regular cervical cancer screening as the HPV immunization only protects against 70 to 90 percent of high-risk HPV strains.
Source: Healthhub.sg




What is the difference between Pap Smear and HPV Screening?


To detect cervical cancer, the Pap test has been the gold standard for more than 60 years. Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in cancer, has emerged in recent years, and screening for HPV, aka HPV DNA test, has started to rival the Pap. It has been well-established that the HPV DNA test was more successful in assessing cervical cancer risk than the Pap smear. Differences primarily are:

  • Pap test involves scraping and brushing cells from your cervix, which are then examined in a lab for abnormalities. A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase cervical cancer risk.
  • HPV DNA test involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer.
Pap test looks at abnormal cells without checking for the viral DNA material. However, the HPV DNA test looks for viral infection with different types of HPV. Source: Mayo Clinic, Time





OUR PRODUCTS & SERVICES

What is Ferne Health?


Ferne Health is a Singapore based company that delivers at-home consulting and screening services for sexual health. We started in January 2020 and hope to become the first sexual health companion for everyone in Asia. We never stop listening to our customers’ voices and learning from the experts –– so here we are –– delivering the most convenient services to your place with full privacy! No more long waits in the clinic and awkward conversations about your sex history. It’s your health, it’s your rules. Learn more about us here .




What products and services does Ferne Health offer?


We offer home-based screening kits for common sexually transmitted infections, including:

We also offer home-based screening service with: If you're not sure which kit to purchase, or suspect that you may have an STI; you could get in touch with our doctor through our tele-consultation services:
  • STI Tele-consultation –– Seeing some symptoms but not sure if it’s STD related? Book an online consultation right now to find out! Our doctor will connect with you within 24 hours.
  • Women’s Health Tele-consultation –– Are you worried about your cycles, unusual discharge, or suffering from pains during urination? Speak to our specialist or GP doctors today and learn more about what you should do!




How long will it take for me to receive my screening results?


The screening time varies per screening kit:

  • Cervical Cancer Kit –– 2-3 business days
  • Made For Women Kit –– 3-6 business days
  • G&C Kit For Female –– 3-6 business days
  • G&C Kit For Male –– 3-6 business days
  • Peace of Mind Package –– 6 business days




What are home-based STI screening kits?


Home-based screening kits use self-collected, mail-in samples to perform lab tests that will screen for sexually transmitted infections (STIs). Home-based screening kits offer discreet screening process for STIs in the privacy of your own home, free of social stigmas and unnecessary discrimination.




How does tele-consultation work?


You can easily get in touch with our doctor from the comfort of your home through teleconsultation:

  • Schedule a teleconsultation session through our website
  • Receive a confirmation email with instructions and a link for the scheduled teleconsultation session
  • On your first visit, our doctor may ask for some additional details, so have your NRIC/FIN card ready
  • During the session, our doctor will be ready to answer any questions you have, and suggest a relevant home-based screening kit, or formulate a treatment plan for you
Your fees will be waived if you decide to purchase our home-based screening kit after the teleconsultation.




How would I know if my results are accurate?


All samples and screening results with be reviewed by our partner clinic. A free doctor consultation is included with every kit purchase, so if you have any questions about your results, you could get in touch with our doctor through the tele-consultation service. Our products and services are provided in partnership with iDOC Clinic.




How would I get my screening results?


Results will be delivered to you with full privacy. Once your results are ready, our partner clinic will reach out to deliver them to you. Your results will be between you and the doctors.




Why do I need to schedule an online consultation before receiving my home-based screening kit?


The mandatory online consultation is for our doctor to check in with you on your health history and answer any questions you may have regarding the self-sampling process.




How to mail-in my self-collected sample?


You can schedule sample pick up through our schedule link or WhatsApp. The self-collected sample should be returned within 24 hours after collection to ensure better quality results.





ABOUT STI/STD

What is STI?


A sexually transmitted infection (STI) is a bacterial, viral, or parasitic infection transmitted through sexual contact.




Why should I care about STIs?


While many STIs can be cured or treated with medication, the consequences of untreated STIs can include: infertility, pregnancy complications, cervical cancer, pelvic inflammatory disease, congenital disabilities, and a 3- to 5-fold increased risk of HIV transmission. The only 100% effective way to prevent the transmission of STIs is abstinence. For sexually active persons, correct and consistent use of condoms is highly effective in preventing many STIs.




What are the common STI in Singapore?


Based on Singspore's Department of Sexually Transmitted Infections Control, in 2018 the most common STIs in Singapore are as follows:

  1. Chlamydia
  2. Gonorrhea
  3. Syphilis
  4. Genital Warts
  5. Herpes Simplex Virus (HSV)




What are the STI symptoms?


Rashes, sores, and ulcers are common symptoms of STIs, but what else should you be watching for? Common STI symptoms for women may include:

  • An unusual vaginal discharge, which may be thin or watery and green or yellow in color
  • Pain or a burning sensation when passing urine
  • Bleeding between periods, heavier periods, and bleeding after sex
Common STI symptoms for men may include:
  • Pain or a burning sensation when urinating
  • Inflammation (swelling) of the foreskin
  • An unusual discharge from the tip of the penis, which may be white, yellow, or green
  • Infection in the rectum can cause discomfort, pain, or discharge.
For more info on STI symptoms, visit our blog post here.




How would I know if I have STI?


Some STIs have symptoms, and you could refer to our STI symptoms checklist to identify some unusual itchiness or pain. However, many STIs may only show subtle or not show any symptoms at all. Some symptoms may also appear after a long incubation period. STIs, including Chlamydia, Gonorrhoea, Trichomoniasis, Hepatitis B&C, or even HIV, may not show any symptoms for a very long time. So the only way to know if you have contracted STIs is to get tested regularly.




What do I do if I have STI?


There are 3 different types of STIs: bacterial, viral, and parasitic.

  • Bacterial STIs can generally be cured with antibiotics. However, if left untreated, they can lead to further complications. Common bacterial STIs are Chlamydia, Gonorrhea, and Syphilis.
  • Viral STIs cannot be cured, although many can be treated with medication. Some viral STIs, such as Human Papilloma Virus (HPV), can disappear on their own. Common viral STIs include HIV, genital herpes, HPV, Hepatitis B, and Hepatitis C. There is a vaccine available to prevent both HPV and Hepatitis B.
  • Parasitic STIs can be cured with medications and creams. Common examples include scabies and pubic lice.
If you suspect that you may have an STI, please immediately get in touch with our doctor through our teleconsultation service or visit your preferred clinic.




Why should I screen for STI?


STIs usually don’t show symptoms right away, but they can lead to serious health conditions if left undetected and untreated. There are many chances you could contract STIs, from unprotected sex to even just skin-to-skin contact. The only way to know if one has contracted STIs is to get tested, so it’s critical to get screened regularly to protect your own health.




How do I get Gonorrhea and Chlamydia?


Both Gonorrhea and Chlamydia are bacterial infections. The bacteria are usually spread through sex or contact with infected genital fluids (semen or vaginal fluid). You can get Gonorrhea and Chlamydia through:

  • Unprotected vaginal, anal, or oral sex
  • Sharing sex toys that are not washed or covered with a new condom each time they're used
  • Your genitals coming into contact with your partner's genitals – this means you can get chlamydia from someone even if there's no penetration, orgasm, or ejaculation
  • Infected semen or vaginal fluid getting into your eye
  • A pregnant woman can also pass it to her baby.
Both Gonorrhea and Chlamydia cannot be passed on through casual contacts, such as kissing and hugging or sharing baths, towels, swimming pools, toilet seats, or cutlery. The bacteria cannot survive outside the human body for long.




What are the consequences if STIs are left untreated?


While many STDs can be cured or treated with medication, the consequences of untreated STDs can include: infertility, pregnancy complications, cervical cancer, pelvic inflammatory disease, congenital disabilities, and a 3- to 5-fold increased risk of HIV transmission. The only 100% effective way to prevent the transmission of STDs is abstinence. For sexually active persons, correct and consistent use of male latex condoms effectively prevents many STDs. This is why it's important to get tested and treated as soon as possible if you think you might have STIs.





ABOUT WOMEN'S HEALTH

What is yeast infection?


Vaginal yeast infections, also called vaginal candidiasis, are prevalent in women. It is estimated that 75% of women will have at least one yeast infection in their lifetime. A vaginal yeast infection is a fungal infection that causes irritation, discharge, and intense itchiness of the vagina and the vulva — the tissues at the vaginal opening. Although it is very common to treat yeast infections, the symptoms of yeast infections are similar to other, more serious conditions, including sexually transmitted infections and bacterial vaginosis (bacterial overgrowth in the vagina). Therefore an accurate diagnosis is important before you use any over-the-counter treatment products.




What is urinary tract infections or UTI?


A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder, and urethra. It is one of the most common infections in humans. Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. Women’s urethra (the opening to your urinary tract) is shorter than men’s and is located near the rectum. A simple UTI can be treated with a short course of antibiotic meds, but a UTI complication can lead to more serious consequences. The most common UTIs occur mainly in women and affect the bladder and urethra:

  • Infection of the bladder (cystitis) is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Sexual intercourse may lead to cystitis, but you don't have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder.
  • Infection of the urethra (urethritis) can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia, and mycoplasma, can cause urethritis.
Urinary tract infections are common in women, and many women experience more than one infection during their lifetimes.




What is bacterial vaginosis or BV?


Bacterial vaginosis (BV) is an infection of the vagina that happens when there are too many certain bacteria in the vagina. This changes the normal balance of bacteria in the vagina. A type of bacteria called lactobacillus keeps your vagina slightly acidic, so bad bacteria don't grow well. If your lactobacillus levels drop, more bad bacteria move in, and you get BV. Women in their reproductive years are most likely to get bacterial vaginosis, but it can affect women of any age. The cause isn't completely understood, but certain activities, such as unprotected sex or frequent douching, increase your risk. About half of the time, women with BV have no symptoms. But if a symptom develops, it can be:

  • Burning feeling when you pee
  • Fishy smell that gets stronger after sex
  • Itching
  • Thin white, gray, or green discharge
BV is not the same as a yeast infection. Bacterial vaginosis has been tied to a higher risk of other health problems, so it is crucial to take a diagnosis and get early treatment.




What other common GYN exams I should to know about?


During a gynecologist visit, a doctor might ask questions related to private topics, such as sex, birth control, pregnancy, and problems related to menopause. Common exams may include thyroid gland check, breast examination, and a pelvic examination. The pelvic examination includes the following:

  • External reproductive organs
  • Internal reproductive organs
  • (Optional) Rectum
A pelvic examination is not usually done before age 21 unless there is a symptom, such as irregular periods, pelvic pain, or vaginal discharge.





ASK FERNE

If I have a yeast infection, can I still have sex?


It is best to clear off any infection before engaging in sexual intercourse, in particular vaginal sex, receiving oral sex, or putting anything into the vagina (e.g sex toys, fingers).

  • With an ongoing infection, the external genitalia may be extra sensitive or even itchy, sore and painful. Friction during sexual intercourse during such circumstances may cause a lot of discomforts, or even cause more skin irritation and aggravate symptoms further.
  • New microorganisms may be introduced, (yes you can have more than 1 organism causing infection at any given time), making the infection more severe or harder to treat.
  • In addition, some medications used to treat vaginal infections may contain properties that can weaken condoms and make them more likely to break during intercourse, thereby putting you at risk of pregnancy.
  • There is also a possibility that yeast infection can be passed on to your partner if it has not been fully treated.




If I perform oral sex on someone who’s wearing a condom, will I get STDs?


There is little to no risk of contracting HIV from oral sex,. However STDs such as chlamydia, gonorrhea, syphilis, herpes, and HPV can be transmitted via oral intercourse. Using condoms during oral sex can significantly reduce the risk of contracting these STDs. It is very important to ensure condoms are used correctly and should always be placed completely covering the penis. They should also be discarded after each use and even when changing between oral sex and penetrative sex. One thing to note is HPV is spread through intercourse or close contact skin-to-skin touching during sexual activity. Thus, despite condoms, it can still be passed between partners as the virus may be present on skin areas that areare not covered by condoms.




How often should I get checked for STDs?


The recommended STD screening frequency would differ among individuals based on lifestyle and sexual practices. It would be dependent on the following factors.

  • number of partners
  • types of relationship, e.g., open relationship or polyamory, whether your partner has other partners
  • types of intercourse engaged in
  • any casual partners or contact with commercial sex workers
  • whether any barrier protection is used regularly
  • any “accidents,” e.g., condom breakage/ slip-off
As a good practice, here are some general guidelines:
  • test before commencing sexual activity with every new partner
  • test after any possible risk exposure such as unprotected sex or condom breaks with casual /unfamiliar partners or new partners
  • testing yearly minimally is also a good idea, especially for all sexually active women from 16 onwards, in the 20s (women in this age group are more likely to contact different partners). Older women with risk factors such as new or multiple partners should also undergo STD testing.
  • Nonetheless, it is always best to discuss this with your doctor and seek their advice on this!




What types of STDs should I be looking out for?


The following diseases can be transmitted through sexual intercourse due to the exchange of body fluid, blood, or close skin contact.

  • HIV
  • Hepatitis
  • Syphilis
  • Herpes
  • Chlamydia and Gonorrhea
  • Trichomonas
  • Mycoplasma, Ureaplasma
  • Genital warts (due to HPV)
It is important to look out for the presence of symptoms and seek medical attention straight away. This includes:
  • vaginal or penile discharge
  • itchiness/ rashes/ bumps / blisters or ulcers at the genital region
  • urinary symptoms such as discomfort, pain, burning
  • discomfort or pain during sexual intercourse
  • bleeding during or after sex
  • swollen bumps, especially at the groins (lymph node swelling)
  • fever
Not everyone will experience symptoms (or sometimes symptoms only show up sometime later). However, STDs are still transmissible from asymptomatic individuals to their partners. Therefore, it is crucial to assess your risk of STDs with your doctor and have regular testing if needed. Lastly, always adopt safe sex practices!




I’m lesbian and have never had sex with a boy. Will I still get STDs?


As mentioned earlier, STDs such as HPV and resultant genital warts can be transmitted through close skin to skin contact. Other STDs such as chlamydia, gonorrhea, herpes, and syphilis can also be spread since body fluid involvement when couples engage in manual stimulation, oral sex, genital-to-genital touching, and sharing of sex toys. When either party is having their menses, the presence of blood also makes the risk of STD transmission during such periods higher. Lesbian couples can reduce the risk of acquiring infections through the following methods:

  • Using dental dams - a thin, flexible piece of latex placed over the genital region for oral sex, it acts as a physical barrier, similar to what a condom does
  • Using disposable latex gloves for any form of fingering or manual stimulation - remember to use a new set of gloves before touching your own genitals or when switching to the penetration of another body region (e.g., between the anus and vagina)
  • using condoms for sex toys - similarly, always uses a new condom for each partner and penetrates a different body opening. Also, make sure to wash sex toys with soap and water thoroughly after
  • Avoid oral sex if either party has cuts or sores in the mouth or lips




Should I tell my current and previous sexual partners if I tested positive?


It's important to tell your current and previous sexual partners as their health could also be at risk. It's natural to feel worried, embarrassed, and even scared. But to protect yourself and your partner, it's a conversation you need to have. If you tested positive, we could help you anonymously message your sexual partners in the past few months to notify them that they may have been exposed to an STD. This is at your request, we will not send anything on your behalf unless you give consent.





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