Endometriosis: Symptoms, Impact, and How to Cope

Painful and/or heavy periods, pain during or after sex, chronic pelvic pain in your lower tummy or back, or pain when urinating during your period? If you’ve experienced some of these symptoms, you might have endometriosis.



Credit: TODAY

What Is Endometriosis?

Endometriosis is a condition where the tissue that lines the inside of the womb (uterus), called the endometrium, grows in other parts of the body, typically within the pelvis.

In a normal cycle, the uterine lining thickens in preparation for pregnancy and sheds during menstruation if pregnancy does not occur. With endometriosis, similar tissue outside the womb responds to the same hormonal signals, building up and breaking down each month, but the blood has no way to leave the body.

Over time, this internal bleeding can cause:

  • Cysts in the ovaries

  • Lesions or nodules on pelvic organs (uterus, ovaries, fallopian tubes, bladder, intestines)

  • Adhesions that cause organs to stick together

Endometriosis affects an estimated 20–30% of women in their reproductive years (from puberty to menopause). While the exact cause remains unknown and there is currently no cure, effective treatments exist to manage symptoms and improve quality of life.

The Hidden Struggle of Endometriosis

Despite its prevalence, awareness of endometriosis is low, even among healthcare professionals. Many women face delayed diagnoses or misdiagnoses with some women waiting years for answers.

The pain and fatigue can disrupt daily life, lower productivity, and lead to withdrawal from social activities. This often creates feelings of isolation when loved ones don’t understand the condition. Nearly half of those affected also report depression and anxiety.

For some, endometriosis also impacts fertility, adding grief to an already challenging experience.

How to Cope with Endometriosis

Living with a chronic condition like endometriosis isn’t easy, but there are strategies to help manage both the physical and emotional toll.

1. Practice Radical Acceptance

Start by acknowledging your feelings, anger, sadness, anxiety, or frustration, without judgment. Notice the thoughts running through your mind and whether they are supportive or self-critical.

Radical acceptance means facing reality as it is, without getting stuck in “Why me?” or “What did I do wrong?” Accepting doesn’t mean approval or giving up. It simply frees up energy for what matters most to you.

2. Challenge Unhelpful Thoughts

A medical diagnosis can trigger negative thinking patterns such as:

  • Catastrophising: “I’ll never live a normal life.”

  • All-or-nothing thinking: “I’m useless because of this condition.”

  • Self-blame: “This is my fault.”

To challenge these, ask:

  • What’s the evidence for and against this thought?

  • What’s the worst and best case scenario?

  • What advice would I give a friend in this situation?

3. Ask for Support

Endometriosis is real, and asking for help doesn’t make you a burden. It can feel difficult, but you can ease this by preparing what you want to say. For example:

  • “Could you accompany me to my medical appointment?”

  • “If you see me curled up on the couch, could you make me a hot drink?”

Educate your loved ones about your condition and express gratitude when they help. A simple “Thank you” goes a long way.

Supporting Someone with Endometriosis

If your loved one has endometriosis, here are two key ways to help:

1. Offer Emotional Support

  • Show compassion and flexibility. Plans may change if pain flares up.

  • Avoid minimising their pain with phrases like, “It’s just cramps” or “Others have it worse.”

  • Validate their feelings: “It makes sense you’re frustrated. I’d feel the same.”

Rather than rushing to solve the problem, listen and acknowledge their experience.

2. Provide Practical Help

  • Learn about the condition so you can better understand what they’re going through.

  • Offer specific help: grocery shopping, meal prep, or accompanying them to appointments.

  • Take care of yourself, too. Supporting someone with a chronic condition can be emotionally draining.

Final Thoughts

Endometriosis is more than a “painful period.” It’s a chronic, life-impacting condition that requires compassion, from both ourselves and others. With awareness, support, and the right coping strategies, it’s possible to live meaningfully despite the challenges.

Pregnancy Hormones and Link with Mental Health

Pregnancy is a transformative experience filled with joy and exhilaration. However, it can be physically and emotionally taxing on the mother’s body. During pregnancy, hormonal fluctuations occur and can manifest positively or negatively on a mother’s mental health. These hormonal changes may lead to or exacerbate mental health conditions and can occur before, during or after the pregnancy. Understanding these hormonal changes is crucial to understanding their impact on a mother’s mental health. 

Pregnancy Hormones  

Drastic hormonal changes can have a toll on the mother’s emotional well-being. This includes changes in hormones such as progesterone, estrogen and oxytocin. 

1. Progesterone  

Progesterone is thought to help in regulating our mood and anxiety. During pregnancy, progesterone levels progressively rise but decreases sharply after delivery. This sudden decline results in a drop in mood, increasing the risk of postpartum depression. 

2. Estrogen  

Like progesterone, estrogen levels increase steadily and then sharply decline after birth. It affects body functions including brain function and works together with serotonin to impact an individual’s mood. Its sudden decline could also increase the risk of postpartum depression. 

3. Oxytocin  

However, not all hormonal changes have negative impacts. Oxytocin, also known as the “love hormone” increases in its production during pregnancy. This promotes stress and anxiety relief.  

The intensity of hormonal changes varies by individuals. Factors such as a history of mental health issues, lack of social support, trauma and biological predispositions can increase the risks of experiencing poor mental health during pregnancy.  

 Effects of hormonal changes during pregnancy are more common than you think, with up to 40% of mothers in Singapore reporting feelings anxiety or depression. Therefore, it is important to be aware of the signs and symptoms of these maternal mental health conditions to tackle the symptoms before they escalate. 

Symptoms of Declining Mental Health 

Maternal mental health refers to the social, emotional and mental well-being of a mother during pregnancy or postpartum. These hormonal changes, if left untreated, can result in maternal mental health disorders such as perinatal anxiety, perinatal depression, post-traumatic stress disorder or bipolar affective disorder. Therefore, it is crucial to understand some of the symptoms and warning signs of pregnancy related mental health disorders.

Symptoms of perinatal anxiety and depression include:  

  • General or persistent worrying  

  • Feelings of irritability, frustration, or restlessness 

  • Changes in appetite  

  • Difficulty sleeping, waking early in the morning, or oversleeping 

  • Withdrawing from friends or family  

  • Diminished interest or enjoyment in activities  

  • Feelings of worthlessness, guilt or helplessness 

Building Mental Resilience During Pregnancy 

Apart from understanding how hormonal changes in pregnancy can affect our mental health, there are also active steps we can take to build our mental resilience. Mental wellness strategies include: 

  • Engaging in regular exercise  

Moving your body promotes the release of endorphins also known as “happy” hormones that naturally boost your mood and relieve feelings of stress.  

  • Maintain a support network  

Surrounding yourself with people you love and trust, such as your partner, family, friends or pregnancy support groups can provide emotional comfort and practical help. You do not have to struggle alone. 

  • Get into a routine  

When your mind feels out of control, maintaining a sense of structure in your life can be reassuring. Setting regular sleep, meal and relaxation times can create a sense of control and reduce feelings of anxiety in your life. 

  • Eat a balanced diet 

Did you know that what you eat can also affect your mood? Ensuring you consume a well-balanced diet rich in all the essential vitamins and nutrients is crucial in promoting healthy brain function and mood regulation. 

  • Practice mindfulness and relaxation techniques 

Engaging in mindfulness and relaxation techniques (e.g. 4-7-8 breathing) can help manage anxiety and promote feelings of calm, even in moments of stress.  

However, if emotional distress during pregnancy affects daily functioning or persists for an extended period, it is crucial to seek guidance from a mental health professional.  

Hormonal changes play a significant role in shaping a mother’s mental health and the overall pregnancy experience. Thus, understanding the connection between hormones and mental health is essential for fostering self-awareness and reducing stigma. By engaging in self-care strategies and seeking professional care when required, you are equipped to thrive in your pregnancy journey. 

Breast & Ovarian Cancer

The shock of the diagnosis. The uncertainty of treatment, results or mortality. The feeling of everything being out of our control.  

But first… 

What is Breast Cancer? 

A kind of cancer that begins as a growth of cells in the breast tissue. Abnormal breast cells grow out of control and form tumours.  

Breast cancer usually occurs in older women above 50 but can also affect men and younger women. In Singapore, breast cancer is the most commonly occurring cancer among women, accounting for 29.7% of all cancers diagnosed in females. 

What is Ovarian Cancer? 

It occurs when abnormal cells in ovaries or fallopian tubes grow and multiply out of control. It may originate from the ovary or more commonly from nearby structures such as fallopian tubes or the inner lining of the abdomen.  

Ovarian cancer usually occurs in older women above 60 who are in the menopausal stage but can also affect younger women. In Singapore, ovarian cancer was 4.4% of all cancers diagnosed in women from 2016-2020. It is the 5th most common cancer in Singaporean women. 

Mental Health Challenges 

Here are the moments that women may struggle the most in the cancer journey:  

6. Awaiting follow-up results  

  • Waiting for the outcomes of follow-up tests 

7. Survivorship phase (Life after diagnosis or treatment) 

  • Persistent guilt (about family, children, responsibilities) 

  • Fear of recurrence 

  • Diminished self-esteem 

  • Problems with social acceptance and body image 

  • Difficulty in re-entry into previous life 

  • Perceived and actual loss of employment and insurance discrimination 

  • Concerns about infertility 

8. Symptom recurrence 

9. Facing end of life 

As treatment goes on, distress heightens (with all the physical and social impacts too). It is then no surprise that these can culminate into anxiety, depression, PTSD, or other conditions. 

1. Before diagnosis  

  • Noticing a concerning symptom  

  • Anxiously awaiting test results 

2. Initial diagnosis  

  • Receiving the news of the diagnosis for the first time 

3. Anticipating treatment 

  • Waiting to learn about the recommended treatment plan  

4. Leaving the hospital  

5. Completion or adjustment of treatment  

  • Fear of finishing a treatment course   

  • Adapting to a change in the plan 


How to Cope, Psychologically 

Receiving a diagnosis is never easy. The shock and distress can be overwhelming, and we might not know how to cope with such complicated emotions and thoughts.  

Yet, how we feel, think and cope with the diagnosis and treatment can greatly affect our physical health, treatment progress, adherence and recovery. So let’s take time to prioritise ourselves – physically and mentally.

Here are some ways to cope better: 

1. Find your support pillars 

Lean on those trusted friends and family, they tend to be the reasons we keep going even in tough times. 

Many have also gone through the same journey, and we do not need to fight cancer alone. Consider the links below to find communities of like-minded individuals who may share the same struggles as you:  

How are you feeling? What emotions can you pinpoint exists? Was it fear, anxiety, shock, anger, regret, or hopelessness?  

What about your thoughts about this journey – from diagnosis to treatment? What do your thoughts tell you about… 

  • Cherished things and people 

  • Personal hopes and dreams 

3. Stay engaged, moment-to-moment 

We know we bring up mindfulness often, but bear with us. When time seems limited and more precious than ever, we often want to capture and “stay” in the moments we cherish the most.  

This speaks to a part of us that wants more presence, and connection to what is going on around us. To do so, we need pause, observe and engage.  

Here’s our guide to being more mindful (general tips are at the bottom of the article). 

4. Show kindness to yourself 

Your pain and suffering is valid. Your feelings are valid. The journey is not easy, and there is little that others can do to make it easier on us.  

 Yet, how do we respond to our pain and emotions? What our pain and emotions often need is soothing. Like a mother soothing a child in pain, aim to soothe the pain and emotions within you. Here are some ways to soothe and be kind to yourself: 

  • Cry it out 

  • Calming music or smells  

  • Visualise a place that is calming to you  

    • Sunsets, starry night sky, pet café, comforts of a bed or bath 

    • Focus on your 5 senses  

  • Repeat personal mantras  

    • “I can do this” 

    • “I got this” 

    • “Take it easy” 

    • “This will pass” 


People differ in how they cope with difficult emotions and painful situations. There is no “best” method here, so find ways that you are comfortable with and personalise your recovery journey in your own way.  

“It is during our darkest moments that we must focus to see the light.” – Aristotle 

Understanding Disordered Eating and Mental Health

Misconceptions of Disordered Eating
Credit: TEDx Talks

Wait! Disordered eating or eating disorder? Aren’t they the same?

Not exactly! While they share some similarities, they are different.

An “eating disorder” is a clinical diagnosis, with specific criteria for conditions like anorexia or bulimia.

On the other hand, “disordered eating” refers to unhealthy eating behaviours or patterns that don’t meet the full criteria for an eating disorder.

Someone with disordered eating may not have an eating disorder, but people with eating disorders often exhibit disordered eating behaviours. Disordered eating is quite common and can often go unnoticed, as it may show up in small actions you might do daily without realising.

How do I know if I have disordered eating and not an eating disorder?

While there is no single, perfect guideline on what constitutes “normal eating” as each of our bodies is different, healthy eating is about nourishing our body in a balanced and flexible way. Not overly restrictive, preoccupied, or obsessed (binging, excessive calorie counting).

The golden rule: eat when hungry and stop when satiated (not when you’re about to unbutton your pants).

Whether it’s 3 regular meals a day, or smaller portions but more frequently, our food intake should have all the necessary nutrients our body needs.

In contrast, disordered eating can fly under the radar because its signs are usually more subtle. In contrast, eating disorders are generally more severe and easier to spot. For more information, read more about eating disorders here.

But when it comes to disordered eating, here are a few behaviours to take note of:

Ψ     Eating when stressed or for comfort
Ψ     Eating when not hungry or not for nourishment
Ψ     Following restrictive diets
Ψ     Fasting for extended periods (more than 24 hours)
Ψ     Regularly skipping meals
Ψ     Episodes of binge eating
Ψ     Using diet pills to control weight
Ψ     Misusing diuretics, laxatives, or enemas
Ψ     Feeling guilty after eating or for eating certain foods

If any of these sound familiar, it may be time to reflect on our relationship with food.

Here’s a short summary of the differences between disordered eating and eating disorders:

Disordered Eating

Eating Disorders

Eating for emotional reasons

Frequently thinking about food

Eating to cope with distress

Extreme calorie concern

Rigid rituals or routines around food and exercise

Fixation on weight and body shape

Occasional calorie restriction or bingeing

Disruption in daily life

Selective eating

Significant weight changes

Disordered Eating and Mental Health: The Connection

While disordered eating might seem less severe than an eating disorder, it can still impact both physical and mental health over time.

Disordered eating often stems from emotional reasons, particularly to cope with distress. This distress may come from feeling heightened stress in our lives, or anxiety about our weight, health or appearance.

For example, finding ourselves rummaging through the office pantry right after lunch because we’re feeling stressed or skipping dinner because we’re already full from snacks, telling ourselves, "I need to lose weight.”

Soon after, feelings of regret and guilt may arise, whether from eating or restricting food. This can lead to anxiety, low self-esteem, or feeling unsatisfied, prompting behaviours like skipping meals or overeating. This cycle of stress, eating, guilt and restriction can create a pattern that’s hard to break.

If you notice the signs, it might be time to check in on your emotional needs.

disordered eating image

Okay, I think... I might have it. So, what should I do now to stop it?

The key is to start from within. Addressing disordered eating isn't just about changing eating habits – it's also about understanding the emotional and mental factors that drive these behaviours. Here are some steps you can take:

Ψ    Gather knowledge and check in with yourself often

Start by learning the signs of disordered eating and eating disorders, just like you’re doing now! Recognising these patterns early can help you catch them before they become more ingrained.

Mindfulness plays a big role here. Stay grounded and present and be aware of your emotions and physical cues. Eat when you’re hungry and try to differentiate between physical hunger and emotional hunger.  

Ψ    Try alternative coping mechanisms

If you’re using food to deal with emotions like stress or sadness, or even binge eating when you’re feeling happy, try adopting healthier ways to manage your emotions and eating, such as:

  • Exercise: Physical activity can help relieve stress and improve mood.

  • Creative hobbies: Engage in activities like painting, writing, or crafting to channel your emotions in a productive way.

  • Heathy snacks: Opt for nutritious options like fruits.  

Ψ    Avoid fad diets

Fad diets often promise quick results but can harm your body and disrupt healthy eating habits.

Focused on balanced, long-term changes (choosing healthier options, or preparing your own meals) instead of drastic restrictions that can lead to disordered eating behaviours.

Ψ    Self-positive encouragement

Celebrate small victories! Even the tiniest steps toward healthier behaviours, deserve recognition. Use positive self-talk to motivate yourself. You could say things like:

  • “Good job to me! I didn’t overeat, even though I loved the food!”

  • “I made it! I didn’t skip any meals this week!”

Sometimes, enjoying a good meal can be a form of celebration – just remember to enjoy it in the right portion and be aware of when you feel satiated. 

Okay, but what is the right portion?
There’s a Chinese saying, “qi (7) fen bao, gang gang hao,” which means “eat until you’re 70% full.” This could be the balanced portion your body needs.

Ψ    Set realistic goals

Don’t expect to change everything overnight. Set achievable, small goals that focus on improving your relationship with food and your body. This could be as simple as:

  • Eating 3 regular meals per day

  • Reducing emotional eating from 5 times a week to 3 times

Lastly, if you’re struggling to manage disordered eating on your own, reaching out for professional support is a great next step. Therapists, dietitians, or counsellors specialised in eating behaviours can guide you toward healthier coping strategies and a balanced relationship with food.

Body Image & Self-Esteem

How do you view your body? What do you see when you look into the mirror? How do you feel?

Do you fear what others might be thinking about your body?


In these cases, our perception and feelings about our bodies are referred to as body image.

On the other hand, self-esteem is about our sense of self-worth and how we view ourselves as people.

Body Image and Self-Esteem

Similar in how both revolve around our feelings about ourselves, they can affect our behaviour and interactions with others.

Highly interconnected, body image issues can make us feel poorly about ourselves (low self-esteem), and low self-esteem can also lead to self-criticism, self-doubt and viewing our bodies more negatively (hyper-focusing on imperfections).

A negative body image may lead to hyper-fixation of food, appearances, or exercise. Paired with lower self-esteem, this may contribute to low self-confidence, social withdrawal or anxiety, difficulty expressing ourselves and needs, low moods and even people-pleasing for validation.

What are some signs of a negative body image?

Consider: Someone makes an offhand remark about your physical appearance. How do you feel about your own body after hearing the remark?

If you find yourself experiencing any of the below, you might have a negative body image:

Ψ Ruminating and nitpicking your body’s weight, shape, or appearance
Ψ Feeling ashamed, anxious, and self-conscious about your body
Ψ Frequently comparing your body with others’ and never feeling satisfied with your own body
Ψ Finding ways to change your body’s appearance, such as extreme dieting and fasting, vomiting, taking laxatives, cosmetic
procedures

Healthy Body Image

The ‘perfect’ body has always been defined by societal norms (like when voluptuous bodies were the ideal in the 18th and 19th centuries). Even the people around us can sometimes affect the way we view our own bodies.

How then, do we inculcate a positive or healthy body image?

Changing our body image does not mean changing our bodies. What matters is changing how we think about our bodies. Healthy bodies come in all shapes and sizes – it’s rarely about the numbers. A healthy body is determined by how the body is functioning (think: immune system, illnesses, hormone levels, muscle-fat composition).

A positive body image means embracing all aspects of our bodies – warts and all. It means focusing and appreciating our body’s health and functionality.

Most importantly, it’s about feeling comfortable and proud about our bodies, regardless of body size and shape.

How do I improve the way I see my body?

Ψ Telling ourselves frequently:

o I have physical imperfections, and that’s okay
o   I am recognised and loved for who I am, not how I look
o   Physical health is not about shape or size

Ψ Being grateful, instead of judgmental, of our bodies

o Remind ourselves of the parts we like about our bodies – make a list!
o Giving yourself daily, verbal encouragements and reminders
o   Appreciating all that our bodies do:
§ Our limbs help us carry out daily activities
§ Our feet carry our weight as we move around
§ Our different systems work together to keep us functioning – digesting food, breathing, circulating blood and oxygen
§ Try a body scan to re-connect with the different parts of our bodies

Ψ Detoxing from or diversifying your social media

o Detoxing from social media for several weeks or months for a “reset” on how you define a healthy body
o Finding social media accounts that celebrate bodies of all kinds – be it in terms of shape, size and complexion

If it gets too hard trying to change how we think about our bodies, reach out to us.

Breast & Ovarian Cancer

The Shock of a Breast or Ovarian Cancer Diagnosis: Understanding the Emotional Impact

The shock of receiving a diagnosis. The uncertainty of treatment, results or mortality. The feeling of everything being out of our control.

But first…

What is breast cancer? 

Breast cancer is a kind of cancer that begins as a growth of cells in the breast tissue.

Breast cancer in Singapore: Breast cancer is the most commonly occurring cancer among women in Singapore. It is estimated that 1 in 13 women in Singapore may develop breast cancer over her lifetime. Breast cancer usually occurs in older women above 50 but can also affect men and younger women.

What is ovarian cancer? 

Ovarian cancer is a kind of cancer that occurs when abnormal cells in ovaries or fallopian tubes grow and multiply out of control.

Ovarian cancer in Singapore: Ovarian cancer is the 5th (and rising) most common cancer amongst Singaporean women. It can be fatal when it is detected in the advanced stages of development and spread. 

The Cancer Journey

Here are the moments that women may struggle the most in the cancer journey:

  • 1 - Before Diagnosis

    • Noticing a concerning symptom

    • Anxiously waiting for test results

    2 - Initial Diagnosis

    • Receiving the news of the diagnosis for the first time

    3 - Anticipating treatment

    • Waiting to learn about the recommended treatment plan

    4 - Leaving the hospital

    5 - Completion or adjustment of treatment

    • Fear of finishing a treatment course or

    • Adapting to a change in the plan

    6 - Awaiting follow-up results

    • Waiting for the outcomes of follow-up tests

    • Persistent guilt (about family, children, responsibilities)

    • Fear of recurrence

    • Diminished self-esteem

    • Problems with social acceptance and body image

    • Difficulty in re-entry into previous life

    • Perceived and actual loss of employment and insurance discrimination

    • Concerns about infertility

    • Increased hopelessness or loss of faith in recovery, treatment

As treatment goes on, distress heightens and prolongs with all the physical and social difficulties, and little relief. It is then no surprise that these can culminate into mental health conditions like anxiety, depression and PTSD.

Coping with Breast or Ovarian Cancer: Navigating the Emotional Challenges

Receiving a cancer diagnosis is never easy. The shock and distress can be overwhelming, and we might not know how to cope with the impact of such complicated emotions and thoughts.

Yet, how we feel, think and cope with the diagnosis and treatment can greatly affect our physical health, treatment progress, adherence and recovery.

So let’s take time to prioritise ourselves – physically and mentally. Here are ways to cope with breast or ovarian cancer:

Ψ Building a Support System

Find your support pillars. Lean on trusted friends and family, they tend to be the reasons we keep going even in tough times.

Many have also gone through the same journey, and we do not need to fight cancer alone. Consider the links below to find communities of like-minded individuals who may share the same struggles as you:

  1. Singapore Cancer Society

  2. OneHeart Support Group

  3. Women’s Emotional Health Service (WEHS)

  4. Breast support group (for breast cancer)

  5. NCIS Personalised Wellness Programme for Cancer Survivorship

 Ψ Look back within

How are you feeling? What emotions can you pinpoint exists? Was it fear, anxiety, shock, anger, regret, or hopelessness? What about your thoughts about this journey – from diagnosis to treatment?

What do your thoughts tell you about…

  • Cherished things and people

  • Personal hopes and dreams

Ψ Mindfulness and Cancer

We know we bring up mindfulness often, but bear with us. When time seems limited and more precious than ever, we often want to capture and “stay” in the moments we cherish the most.

This speaks to a part of us that wants more presence, and connection to what is going on around us. To do so, we need to pause, observe and engage.

Here’s our guide to being more mindful (general tips are at the bottom of the article). Stay present and connected in your journey.

Ψ Self-Compassion in Cancer Care

Your pain and suffering is valid. Your feelings are valid. The journey is not easy, and there is little that we can do to fight the facts of our reality.

Yet, how do we respond to our pain and emotions? What helps? Rather than wanting to lash out at the world?

 
 

Soothing. Like a mother soothing a child in pain, aim to soothe the pain and emotions within you. Always remember to show kindness to yourself in the face of adversities.

 

    • Cry it out

    • Calming music or smells

    • Visualise a place that is calming to you

      • Sunsets, starry night sky, pet café, comforts of a bed or bath

      • Focus on 5 senses

    • Repeat personal mantras

      • I can do this, I got this, this is hard, but this will pass

 

People differ in how they cope with difficult emotions and painful situations. There is no “best” method here, so find ways that you are comfortable with and personalise your recovery journey in your own way.

“It is during our darkest moments that we must focus to see the light.” – Aristotle

Perinatal Obsessive-Compulsive Disorder (OCD)

What if I harm my baby?

 

What is Perinatal Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterised by obsessive thoughts, and behavioural compulsions.

Ψ Obsessions are intrusive, unwanted and persistent thoughts and mental images.

Ψ Compulsions are repetitive acts, including avoidant behaviours, that aim to reduce the distress associated with the obsessive thoughts. They could look like cleaning rituals, repeated checks, counting, saying a particular word or phrase, or avoiding certain places or activities.

Perinatal OCD occurs during pregnancy or a year after childbirth. It could be another manifestation of existing OCD or a sudden onset of a new condition.

Find out more about Obsessive-compulsive disorder

Symptoms of the condition often centre around the baby. They are associated with fears that the baby would be harmed, such as through contamination, inappropriate handling, etc. While individuals with perinatal OCD probably recognise that their obsessive thoughts and compulsive behaviours are irrational, they feel consumed by those thoughts and unable to break free from the rituals.

Often Undetected and Unspoken

Having a baby is stressful and overwhelming. As parents, it’s normal to feel anxious about caring for a young child, and worried that they will harm the child. This anxiety, at manageable level, could actually be helpful in ensuring that you avoid potential risks to your pregnancy and child. 

While many parents have that fear, people who suffer from perinatal OCD give undue importance to those thoughts, and believe that they are capable of causing harm.

These parents may be reluctant to disclose their anxious thoughts for fear that they may be regarded as the potentially dangerous and harmful parent.

Parents may also not be aware of the condition or recognise it as an illness. They may see themselves as an unreliable and unfit parent, or attribute their fears as “going crazy”. 

Failure to detect and address perinatal OCD can result in persistence of the distressing thoughts, and affect the relationship the parent has with the child and their family members. New fathers and mothers (or even those without children) with perinatal OCD may struggle to enjoy moments and bond with the child.

Depending on the severity of your condition, it can also impact your confidence in caregiving and overall quality of life as you spend the day worrying about your child being harmed.


How can I Cope with Perinatal OCD?

Ψ Learn more about OCD

Find out more about the condition. Understand that it is not your fault, and that you are not going mad.

It is often comforting to find an explanation for what you are going through. With better understanding of the condition, you could also make sense of the consuming thoughts and compulsions that you have.

Ψ Learn about your symptoms

Everyone’s triggers and symptoms would look different. It is always a good idea to note how your symptoms present and when they present. This give yourself and ideally your therapist a clearer idea of your presenting difficulties and how to manage them.

Ψ Talk to someone

Reach out to a loved one and share with them what you are going through. It can be relieving just to tell someone your feelings. It could be helpful to first write down your thoughts and feelings before you bring this up with someone.

It can be also reassuring to hear that similar anxious and distressing thoughts are experienced by other people too. Connect with support groups online or in your local community (e.g, OCDNetwork) to receive the emotional support much required in this journey.

Ψ Get practical support

Your anxiety may make you unavailable to care for your child for the time being. Reach out to your family and friends to help with the caregiving tasks.

Let them know how they can help (e.g., could you help to change the baby’s nappy)

Ψ Seek professional help

OCD can be managed with psychological therapy, and sometimes with the additional help of medication. Typically, Exposure and Response Prevention Therapy (ERP) and Acceptance and Commitment Therapy (ACT) are used to help individuals with OCD. They involve exposure to anxiety-provoking situations and accepting the intrusive thoughts while engaging in value-aligned behaviours respectively.

Your therapist will work with you to develop a management plan that best supports you. Things would get better, however overwhelming they seem now.

 

Supporting a Loved One Who is Struggling with Perinatal OCD

Many individuals who experience perinatal OCD worry that they get ostracized when others find out. Do not criticise their compulsions. Assure them that you are there to support them if they ever need it. 

Learn about the condition. With greater understanding of the condition, it may be easier for you to see why your loved one is acting the way they do. You would also realise that providing assurance (e.g., “I’ve sterilized the milk bottle”, “the baby is still breathing”) might not be the best form of support for them – counterintuitively it may sound. Instead consider staying by their side as they experience the discomfort rather than reinforce their rituals.

If you are concerned that you or someone you know is struggling with perinatal OCD, seek professional help. Feel free to reach out to us for support with coping with OCD.

Menopause: More Than Just Hot Flashes and the End of Periods – How You Can Cope

What is Menopause?

“It only happens to OLD women.” 
“It only lasts a few weeks, and then it’s over.” 

Oh no, no, no! These are just some of the many myths about menopause!  

Menopause refers to the end of the menstrual cycle, which is formally 12 months after a woman’s last menstrual period.   

Leading up to this point is a transitional phase called perimenopause, during which women may experience changes in their menstruation – irregular periods, heavier or lighter flow, shorter or longer periods, and symptoms that resemble menopause. During this time, the body reduces production of the hormones estrogen and progesterone.

It’s a natural part of ageing, though not always an easy one. And menopause isn’t just triggered by age. It can also occur due to the surgical removal of the womb or ovaries. 

 

Frustration with Menopause: The Symptoms

An inevitable transition with legitimate frustration. 

Menopause is a complex journey and affects each woman uniquely and in many ways.     

The body undergoes a big change, possibly experienced as weight gain, weaker bones, body aches, weaker bladder and reduced sex drive.   

Life on a day-to-day basis may involve hot flushes which can be intense enough to cause fatigue and disrupt sleep, and it can last for years after menopause! Sexual intercourse may also become painful or uncomfortable.   

Some women may experience irritability, moodiness or even depression. It might also be frustrating when they struggle with concentration and memory. Major bodily changes also affect their confidence and self-esteem.   

 Here’s the thing: every woman’s experience is unique. So, while one person might breeze through it, another may face significant challenges. 

The Menopause Journey

Menopause and Mental Health 

It’s not just the body that feels the shift, the mind can be deeply affected too. 


While external factors like ageing, stressful life events, or limited social support can contribute to mental health struggles, fluctuating hormones are a major player. 

Estrogen, in particular, has profound effects on mental functioning. It influences emotions, memory, cognition, and is a mood-regulating neurotransmitter. The result of reduced estrogen? An increased risk of depression and anxiety during this time. 

Depression
Mood swings are common during menopause, but when a low mood persists for over two weeks, it may indicate depression. Unlike typical emotional dips, depression is more intense and long-lasting. If you’re wondering whether it’s depression, it’s worth exploring the signs further (check here for more information). 

Anxiety
While depression takes the spotlight, anxiety also makes its cameo during menopause. Anxiety attacks can feel a lot like hot flashes. Both can cause racing heart, sweating, and a sense of heat. But here’s the key difference: anxiety can cause shortness of breath, while hot flashes don’t. You may check other symptoms here.

Tips to Manage Menopause


Navigating menopause can feel overwhelming, but there are ways to cope: 

Ψ Mindfulness 

Mindfulness is simply awareness. Pay attention to the difficult emotions and physical symptoms arising from menopause – the resentment, low mood, hot flushes and body pains. Notice your thoughts – are they kind or critical? Allow yourself to feel them all. Take a back seat and just observe them as they are, without judgement.   

It may also be helpful to take note of the things that trigger your hot flushes or mood swings so that you can avoid them or take steps to mitigate the effects.  

You may refer to our Guided Therapies for some mindfulness practices to increase your awareness to the present with your thoughts, feelings and bodily sensations. 

Ψ Radical acceptance 

Radical acceptance is about accepting life as it is instead of fighting reality or getting stuck in negative thoughts like “I hate being a woman”, “why do women have to go through this”, “this is so unfair”. It does not mean begrudgingly resigning yourself to fate or seeing yourself as helpless. It is the complete acceptance that the situation is beyond your control, even if it is not how you want them to be.

Accepting the reality will not remove your pain. Your hot flushes and body aches are still going to bother you. But when you choose to radically accept things that are not within your control, you avoid getting stuck in bitterness and despair. This frees up your energy to make changes in aspects of life that you can control, like finding ways to make life more comfortable or exciting for yourself and pursuing what truly matters to you in life.  

Ψ Relaxation 

Pursue your interests and hobbies, basically any activity that brings you joy. Given that menopause is a very personal experience, you would need to try out various options to see what works for you. Maybe it’s a walk in the neighbourhood, baking, or spending time with your friends and family.  

Getting adequate sleep can be a challenge for women going through menopause. This sets them up for frustration and stress. Some simple sleep hygiene tips include keeping our sleep environment cool and dark, and avoiding caffeine, nicotine and alcohol from late afternoon onwards. 

Ψ Professional support 

General practitioners (GPs) or OBGYNs are excellent first stops for tackling physical symptoms. They can provide guidance on treatments like Hormone Replacement Therapy (HRT), which may ease issues tied to declining estrogen levels, including mood changes and depressive symptoms. 

When hot flashes aren’t the only thing keeping you up at night—think constant worry, low mood, or feeling like you’re losing control, it might be the time to consider a psychologist especially if these challenges start affecting your relationships, work or overall quality of life. Psychologists aren’t just for “serious cases”; they offer invaluable support to women navigating the emotional, mental, and relational hurdles that menopause can bring. Whether it’s managing mood swings, addressing depression and anxiety, or navigating changes in relationships, psychologists provide a safe space to unpack what’s going on and strategies to move forward. 

Therapeutic approaches psychologists may use include: 
Ψ Cognitive Behavioural Therapy (CBT) 
Ψ Acceptance and Commitment Therapy (ACT) 
Ψ Mindfulness-Based Interventions 

  How to Support a Loved One Going Through Menopause? 

Ψ Be an active listener 

“How do you feel?” as simple as this question may sound, it provides them an opportunity to talk about their feelings. Be sure to express compassion and empathy. They are grappling with this major life transition that is foreign and overwhelming to them. Do not dismiss, criticise or guilt-trip them when they share about their discomfort or ask for help.  

As much as you want them to feel better, do not rush to offer advice or problem-solve. We most probably cannot imagine their pain and discomfort so let’s not try to be an expert in their condition. Instead, take a curious and empathetic stance, ask them about how they feel and acknowledge that it is as bad as it feels to them. Be with them in the pain rather than trying to pull them of the pain. 

Ψ Provide practical support  

Learn more about menopause to understand what they are going through. Let them know that you are keen to help and ask how you could be of help. For instance, you could offer to run errands for them or help out with chores or simply being available. 

Ψ Reassure and uplift

Menopause can make women feel stuck in a box of frustration and loss – loss of attractiveness, health, or roles within work and family. Reassure them that their identity isn’t solely defined by these challenges. Highlight their strengths and achievements and remind them of the areas in life where they excel or have control.