Although many women experience discomfort in their bodies, especially after childbirth, Dr Lisa Chan says a range of procedures and therapies are available.
Women’s Health Through Life Stages
We women go through a host of changes throughout our lifetime. From puberty to childbirth to menopause, the female body undergoes a range of physiological transformations across various stages of life. While we grow and blossom into our mature bodies and beyond, occasionally these hormonal and physiological changes can be distressing, especially after childbirth and menopause. The passage of a baby through the birth canal can result in vaginal laxity and stress incontinence (involuntary leakage of urine), while menopause can cause vaginal atrophy, a loss of vaginal lubrication and dyspareunia (pain during intercourse).
To reduce the chances of vaginal laxity and stress incontinence, pregnant women are often advised to strengthen their pelvic floor using Kegel exercises. Kegel exercises can be done lying down, sitting, or standing, and involve contracting the pelvic floor muscles — a sensation similar to holding in the urge to pee. When done in three sets of 10 to 15 times a day, Kegels will help improve the muscular support for the uterus and the bladder. It’s important not to do them while actually peeing, as this can result in incomplete emptying of the bladder and lead
to urinary tract infections.
After menopause, the main cause of vaginal atrophy and decreased lubrication is a drop in estrogen levels. Vaginal tissues also become thinner, more fragile and easily irritated, and there may sometimes be bleeding post intercourse. Options for treatment include lubricants, estrogen creams, vaginal suppositories and rings, oral medications and hormonal supplements. Your doctor may prescribe them based on symptoms and your previous medical history.
Some of the treatments, such as estrogen supplements, are contraindicated in patients who have had breast cancer, and non-hormonal treatments can be used instead. There are also minimally invasive options for vaginal rejuvenation, which include the use of radiofrequency, focused electromagnetic energy and laser treatments. These machines heat up the vaginal tissues and induce pelvic floor muscle contractions to improve tone and reduce laxity. They can be performed as a day procedure with or without topical anaesthesia.
Results typically last about six months to a year, before maintenance treatment is needed. They aren’t suitable for use in women who are pregnant, have an IUD, uterine or vaginal infection, pelvic inflammatory disease, a history of keloid formation, cancer or endometrial disorders.
Feeling confident in your body and enjoying connection and intimacy with your partner is something every woman should be able to take pleasure in. If you’re experiencing any of the above, be open with your doctor and know that there are various options available to you.
For more stories on women’s health, check out Dr Lisa Chan’s stories here
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Meet the ‘Girl Boss Misinfo Types’ Bringing Together Wellness Influencers and Canadian Trucker Convoy
With billions of dollars pumped into the sector resulting in a proliferation of services from luxurious sanctuaries to dedicated apps, we talk to Sonia Samtani, Hasanal Lythgoe-Zafrullah and Megan Lam about where the future of mental healthcare is headed.
After tennis player Naomi Osaka pulled out of the French Open last year to take care of her own mental health – for which she was penalised with a fine but received much support in the public for standing up for her own wellbeing – she penned a poignant piece in Time magazine that said, “It’s OK to not be OK.”
The following month, at the Tokyo Olympics, American gymnast Simone Biles shocked the world when she withdrew from her event, putting her mental health and physical safety first. The issue suddenly became a talking point at the Games, driving the conversation from merely raising awareness of the issue to creating positive action for change.
And not just for athletes. These days, millennials and Gen-Zs openly discuss their struggles and their therapists, and influencers tout the effectiveness of BetterHelp. Mental health has never been so talked about as it is now.
Hypnotherapy instructor Sonia Samtani, who runs All About You Wellness Centre, recalls a time when few people knew what the term mental health even meant and her centre, which she opened in 2013, was associated with going crazy. Fortunately, things have changed since then. “In some strata of society, it’s even considered cool to have a therapist,” Samtani says.
Today, mental healthcare is an industry, with billions of dollars poured into developing not just bricks-and-mortar centres and services, but also products that help people to manage their health and mental conditions from the anonymity of their mobile devices.
According to Report Ocean, revenues in 2021 from the mental-health market amounted to US$397.4 billion and are forecasted to reach US$539.97 billion by 2030. And while North America leads the sector and is likely to continue to dominate during the forecast period, the Asia-Pacific region is predicted to grow at the fastest rate.
In conservative Hong Kong, there are still barriers of entry against traditional mental healthcare. “Many people still subscribe to the notion that we need to pretend everything is good in our lives and that going to see a therapist means that there’s something wrong or defective with us,” says Samtani. “People haven’t fully comprehended that seeing a therapist for emotional pain is as normal as seeing a doctor for physical pain.”
The pandemic has definitely helped push people to look inwards and begin moving beyond the social stigma. It also helps that these days mental-health facilities look more like private clubhouses and spa resorts than a doctor’s surgery, enabling people to feel safer and more at ease when they walk into a therapy session.
Asaya, the Rosewood Hong Kong’s luxurious wellness sanctuary, goes beyond spa and facial treatments to offer a wide range of holistic therapies aimed at overall health, from skin and physical treatments to nutrition, sleep and emotional balance. Although not a clinic per se, it certainly puts a new spin on the meaning of taking care of our wellbeing. Held within Asaya’s tranquil surroundings, an Expressive Arts therapy session that deals with grief and trauma, or a quiet chat with a Naturopath doctor on adopting healthier habits over a cup of tea seem much more a luxurious experience than a clinical one.
And then, of course, there’s the newly opened mindish mental-health studio. The brainchild of Hasanal Lythgoe-Zafrullah, the studio promises to elevate the experience of mental-health services while speaking to the needs of progressive communities. “Mental health is health,” says Lythgoe-Zafrullah. “It’s time we start normalising access to it.”
Touted as the first of its kind in the world, the mindish studio in Central offers a safe members-only community with a private lounge, six private session rooms, a meditation room and an events space. Designed to make members feel both grounded and empowered, the centre offers a wide range of therapies, plus complimentary group meditations and sound-bath sessions that aid growth and healing.
What’s special about mindish is that it understands the mentality of any newcomer going into therapy. “Starting therapy can be scary and landing the right therapist is often hit and miss,” says Lythgoe-Zafrullah. “Our research is very clear: people are often mismatched with what they need. This not only means that there’s currently widespread consumer dissatisfaction in the market, but so many people don’t get the support they need.”
To raise accountability, each mindish member is assigned a dedicated personal growth manager from the outset, who plans and manages their experience and makes recommendations around suitable therapy, meditation classes and events, and subsequently provides follow up and support as they work to implement healthy behaviour. “We’re the first mental-health facility in the world to implement this model, which removes the burden from the consumer having to know what they need,” says Lythgoe-Zafrullah.
Again, the experience at mindish is a luxurious one – the space is designed to make you feel pampered and good about yourself. It’s a private sanctuary for self-improvement, where members can feel good about working on their mental health because they’re entitled to good mental health, and not feel as if they’re there because there’s something wrong with them.
There’s one drawback, even as increasing numbers of people – and especially those aged between 35 to 55 – seek out therapy: places like mindish and All About You Wellness come at a price.
However, technological advancements have made mental healthcare more accessible than ever before by providing an alternative for those who may not be able to afford traditional mental healthcare, or who may still feel uneasy about seeking help in person. The pandemic for one, has made the latter point much more difficult.
The proliferation of technology in the mental-health sector has brought us apps such as BetterHelp and Mentor360, which connect users to mental-health services, offering counselling and therapy online, as well as phone and text communications with licensed therapists.
But one app stands out from the rest. Clara utilises artificial intelligence and is labelled a behavioural wellness companion that looks after the mind and lifestyle for each unique user. The app was developed by Megan Lam and Caleb Chiu, who founded Neurum Health in 2018 to bridge the gap between public health services, private clinical care and real human beings in their everyday life, using data to get rid of guesswork when it comes to health.
Lam’s own personal health journey began after losing two close family members to suicide. Getting sick wasn’t the worst bit, Lam felt. “It was the stigma and how much guesswork there was in even knowing what red flags looked like, and where and what help is available and needed … The care journey is so opaque, we’re just feeling our way through with no headlights,” she says.
She turned to technology for answers, calling it “a tool that can address such guesswork and barriers by re-designing and augmenting the journey to the right support, in a way that makes people comfortable and confident.”
Lam also purposefully chose to base her company in Hong Kong, to better understand and cater to the mindset and lifestyle here, especially among older people for whom the subject can still be taboo. There’s still the notion that these issues are best kept private, she says. “While we’re doing our bit in raising awareness and discussing the topic, especially in a culturally relevant way, we also want to ensure there’s a solution people felt comfortable using, and rooted in science,” she says.
Clara gives each user unique access to hundreds of interactive exercises and educational content to maintain their behavioural health, all of which are backed by studies to help them handle a variety of situations that best fit their story. It’s the first and only mental-health app to use AI to deliver a personalised care journey that’s designed to grow and adapt to each user. The app is rolled out initially by enterprises to maintain the wellbeing of their organisations, and currently serves more than 125,000 employees at AXA, PALO IT, Swire and New World Development.
Lam believes it offers accessible mental healthcare for the future: “87.8 percent of the time, people find our recommendations relevant and useful,” she says. And while the model is still only available on a corporate basis, a consumer offering is being planned. “Since the pandemic started, we saw a 70 percent increase in inbound enquiries on Clara, so we’re currently working hard on a version of Clara that’s for everybody.”
Will AI and online services one day replace the need to talk to a real therapist? I posed this question to all three interviewees. The short answer is no.
Lam would be the first to agree that the strengths of AI and human support serve different purposes. “Nothing can replace talking to a real therapist,” she says. “We recommend having resources for both, depending on the individual’s need. Clara is a great companion in paving the stepping stones towards learning about mental health, and also for those looking to maintain their wellness and learn exercises to keep daily stresses at bay.” It can also prompt the need to seek human support, providing personalised recommendations for appropriate help and enabling calls to be made directly from the app.
Samtani has some reservations, saying she regards AI as being functional only when the user is in the right state of mind. “I’d say that AI will be able to do many things that therapy may do, but it cannot replace therapy. To use AI, the client will need to open the app and input data in order to receive the appropriate therapy. When people are in breakdown, it’s hard for them to do this, because they’re not in a resourceful state. A therapist can meet a client where they’re at, move them along to be in a resourceful place and then check if the client has processed their trauma enough to learn from it and use their wisdom to make a different choice in the future. Technology can be a huge support, yet I don’t see it replacing or being better than therapy.”
Lythgoe-Zafrullah sees technology as part of the solution, “but not the entire solution”, he says. “Our obsession with the idea that in the present day, technology is the salvation of our times has overridden our sense of critical thinking. Mental health is fundamentally a human concern and requires a human solution.”
Lythgoe-Zafrullah warns against using apps that are poorly informed, citing one of his staff’s previous experiences at a large employee-wellness app where she used to manage more than 1,000 members. “She openly admits she wasn’t able to provide the quality of care she wished she could have provided because she was spread too thin,” he says.
Ultimately, technology is a tool that can supplement the fundamental human experience. It may not replace the need for real therapists, but that was never the goal. As apps and online services such as these reach millions daily – people who might never have turned to mental health due to stigma, price point or other reasons – the best thing tech has brought to the mental health sector is accessibility.
[Header image from Getty Images]
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