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.

What are the risk factors for cervical cancer?

Risk factors for 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 gonorrhoea.
• Multiple sexual partners (in either partner).
• Onset of sexual intercourse at an early age.
• Tobacco smoking.

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 very rarely, during delivery from an infected mother to her baby.
• HPV cannot be spread by sitting on toilet seats or touching common surfaces.

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.

Can HPV be treated?

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

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.

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 a 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 immunisation only protects against 70 to 90 percent of high-risk HPV strains.

What is the difference between Pap Smear and HPV Screening?

For the detection of 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 contributing to 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 the risk of cervical cancer.

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:

• Cervical Cancer HPV Kit –– Screen for high-risk HPV strains that could lead to cervical cancer.
• Made For Women Kit –– Designed to help women better understand their reproductive health.
• Gonorrhea & Chlamydia Kit For Female –– Screen for the two most common STIs: Gonorrhea and Chlamydia.
• Gonorrhea & Chlamydia Kit For Male –– Screen for the two most common STIs: Gonorrhea and Chlamydia.

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 tele-consultation:

• Schedule a tele-consultation session through our website
• Receive a confirmation email with instructions and link for the scheduled tele-consultation 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

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 (Hong Kah).

How would I get my screening results?

If your results are high-risk, you'll be contact by our partner clinic to schedule appropriate follow-ups. If your results are low-risk, you'll receive the results through your registered email. You could also get in touch with our partner clinic for a complimentary results consultation.

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 to help 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 on Monday to Friday from 8:00 - 3:00pm through our website or WhatsApp. Self-collected smaple should be returned within 24 hours after collection to ensure better quality results.

What is STI?

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, birth defects 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

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.

Why should I screen for STI?

STIs usually don’t show symptoms right away, but if left undetected and untreated, they can lead to serious health conditions. 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 very critical to get screened regularly in order to protect your own health.

What is yeast infection?

Vaginal yeast infections, also called vaginal candidiasis, are very common in women. It is estimated that 75% of women will have at least one yeast infection in her 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 easy 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 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 complication of UTI can lead to more serious consequences.

What is BV?

Bacterial vaginosis (BV) is an infection of the vagina that happens when there are too much of 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.

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:

1. External reproductive organs
2. Internal reproductive organs
3. (Optional) Rectum