Rithy Sak’s, popularly known as Heng Pitou, a more-than-a-decade long career in the entertainment industry so far has been a story of great interest. His latest original songs have been a talk-of-the-town nowadays. While there are numerous rising stars in the country today due to renowned franchises of international singing competitions, Pitou never shied away from the challenge of bringing new tracks the Cambodian public. Healthwise Digest took a chance to interview the star and inquired how he kept his dream alive and his health vigorous.
On his personal life
Born in Phnom Penh with two siblings, Pitou graduated from high school in 1997 at the Anuwat High School. He joined the country’s entertainment industry in 1994 and began his formal singing career in 1999. A former professional stage dancer, Pitou has also been a member of the MKS Group for 3 years. After the group’s disband, he started singing in clubs and made his way in the singing stratosphere through his friend’s compositions which inspired him to continue singing. Though his parents first disagreed with the decision of entering the industry, he made sure that they get to see how he loved his job, which eventually led to them fully supporting him.
“The first production that I was singing for is Spark Music in 2005 where I recorded about 10 songs. Afterwards, Big Man Production asked me to join where is had my first two famous songs—Barom Sorng Sa Kmeng and Sro lanh Knea oy Slap chos thlai. This paved way to my popularity,” Pitou stated.
“The reason I started to enter this industry is that I want to fulfill my passion. I do these from the bottom of my heart and ever since I was young, I used to dream that will be famous one day. I am getting older now but I still can continue because I am greatly supported by my fans and I owe this to them. I recall a proverb saying that trying hard will always bring someone better opportunities in the future. Hence, my dream came true.”
On his career
“I admire those new singers who have risen to fame so quickly since I had a hard time achieving my dreams. In reality, people who don’t really love their job give up and venture in other business. In the beginning, it was difficult because I never had been trained professionally in singing or composing but I strived hard practicing. Another difficulty I experienced is mostly about the compensation we, singers, receive. At times you will think if our commitment deserves the kind of compensation we get since in other foreign countries, being famous like this equates to being rich,” Pitou stressed.
On his health
Oftentimes, I acquire nasal allergy and flu. The worst health condition I experienced was when I was 21 and I had hepatitis. Fortunately, I received treatment on time and was totally cured. Since I was young, my health was not good. I've been infected with various diseases such as Dengue Fever and Typhoid fever. However, I always remind myself to be healthy. I always hit the gym for 1 hour to 2 hours every morning and regularly play football, 2 to 3 times a week. Though this month was a busy time for me due to several provincial tours, I see to it that I watch my diet by eating nutritious food that provides a good benefit to my health and body.
*Photo courtesy of Heng Pitou
More and more women are unaware of them having PCOS - polycystic ovarian syndrome. Currently the condition has been tagged to be having high prevalence in South Asia (Chandrika N. Wijeyaratne, et. al., Phenotype and metabolic profile of South Asian women with polycystic ovary syndrome (PCOS): results of a large database from a specialist Endocrine Clinic).
PCOS is a common endocrine lifestyle disorder among women that is characterized by hyperandrogenism (excessive level of androgens in the body) and hyperinsulinaemia (excess levels of insulin circulating in the blood relative to the level of glucose).
Presently, there are two common risk factors why women acquire PCOS: genetics and obesity. While About 20-40% of female first degree relatives of women with PCOS also have this condition, fat tissue dysfunction also contributes to risk of hyperandrogenism. Adipose dysfunction (obesity) contributes to development of insuli resistance and hyperinsuliaemia. Obese women with PCOS are also at greater risk of anovulation and subfertility.
Women who are suffering from PCOS may encounter severe acne, development of unwanted facial hair or body hair, irregular or missing periods, lack of ovulation and infertility, weight gain or difficulty in losing weight.
Although the present symptoms of PCOS is in nature worrisome, physicians have placed a great concern regarding women’s ability to properly use the insulin they produce, which in turn could put them in an increased risk for diabetes and heart disease.
Women with PCOS should start learning about healthier habits and routines. Having the right dietary routine and constant exercise helps manage PCOS. The combination can lower blood sugar and help to balance hormones, which sequentially helps people lose and manage their weight.
Overweight and Weight Management
Noticeably, most women with PCOs are overweight and have a difficult time losing weight and this is due to them having higher levels of hormone insulin in their blood. While insulin’s main task is control blood sugar, it also makes bodies store fat. Thus, an ultimate way to improve PCOS is to lose weight.
Although some people claim that eating every 2-3 hours is also ideal, spacing meals out more can help improve insulin sensitivity. Instead of having a small meal or snack every few hours, try to get used to eating a more substantial meal and then waiting 4-5 hours before eating again.
There are also vitamin supplements that women can use to complement their diet such as Vitamin D3. Studies have found that one in two women with PCOS have a significant vitamin D deficiency, especially those who develop abdominal obesity. Links were also found between the degree of vitamin D deficiency and levels of the hormones, LH and FSH which stimulate egg development.
Lack of vitamin D may therefore be the missing link that explains why some women with PCOS develop worsening symptoms, while others are only mildly affected (Kozakowski J., et al, Associations of vitamin D concentration with metabolic and hormonal indices in women with polycystic ovary syndrome presenting abdominal and gynoidal type of obesity).
Also, staying physically fit is of great help if you have PCOS. Physical activity can lower the levels of insulin in the body so find an activity or a sport that will be helpful in bringing down insulin after a meal. This also affects your mood and boosts your energy.
A combination of strength and cardio training should be done as both of these types of exercises give us different benefits. Cardio training causes your heart rate to rise and it uses energy, increasing your total calories used, which will help with weight loss. It has also been shown to lower the risk of cardiovascular disease in women with PCOS. Meanwhile, strength training, builds muscle which is important in raising your basal metabolic rate. Some fun exercises you could consider include Zumba, Pilates, Yoga, Aerobic classes, Cycling, Hiking or walking and Swimming.
The availability of oral contraceptives since the Sixties has contributed to families’ attaining their desired number of children as well as identifying the spacing of pregnancies.
In Cambodia alone, there is a twenty to fifty percent prevalence of women using some method of contraception among those 15-49 years old who are married or in a union (United Nations, 2011, World Contraceptive Use 2011). All health care centers in Cambodia provide at least three types of birth control methods, which include oral contraceptives (Birth Spacing in Cambodia, NRHP Cambodia).
According to the Total Market Approach for Family Planning Products and Services done by the USAID and Population Services Khmer (PSK), 68 percent of married women in the country of reproductive age who wish to limit or space their pregnancies—most of which have preferred oral contraception (pills – 43%) rather than using condoms (8%) and injectable (29%).
There are various benefits of oral contraception that do not only include pregnancy prevention among married individuals but also reduces infant mortality and adolescent pregnancies. By reducing rates of unintended pregnancies, there is also a decrease in abortion. There are at least two types of oral contraception available in the market—Combined (COC) and Progestogen-only (POP). Though both have high effectiveness in preventing pregnancies, both differ in the amount of active ingredient/s and function. While COCs contain two hormones (estrogen and progestogen), POPs contains only progestogen. Hormonal contraceptive methods prevents the release of eggs from the ovaries, and thickens cervical mucus to block sperm and endometrium thinness.
The facts about this prescription product are well known and agreed upon by family planning specialists and gynecologists all over the world.
However, myths and misconception around oral contraceptives remain ubiquitous. And when it comes to fighting these myths, women should clearly possess the right facts to veer them away from being scared of using this reliable method of contraception.
Peruse throughout this article and learn the four major truths about birth control pills.
Hormonal contraceptive methods and weight gain
Truth: Of all the common myths revolving around oral contraceptive, gaining weight upon taking them is the most general complaints that women have. There are no actual studies supporting this claim. In 2011, researchers at the Cochran Database System Review analyzed 49 studies that compared a variety of birth control methods with placebos and found no evidence that birth control causes weight gain.
A study revealed that by analyzing the daily weights of 128 women during four cycles of triphasic (three phases of ovulation) oral contraceptive use where the mean weight at the end of the fourth cycle of use was the same as baseline weight (the largest proportion of women, 52%, remained within 2 pounds (0.9 kg) of their starting weight, and 72% of women had either no weight change or a loss) it emphasized that there are is a lack of association of oral contraceptive usage with weight gain (Rosenberg M., 1998, Weight change with oral contraceptive use and during the menstrual cycle. Results of daily measurements).
If there is really a high concern regarding your weight, a health care provider can easily stress out that highly effective and safe form of contraception should not be ignored due to complaints of weight gain. S/he may provide the best option and dosage for you.
Taking one regularly results to infertility
Truth: It’s not a surprise that it is really possible to get pregnant as soon as you stop taking birth control. According to a study, although oral contraceptive usage was related to temporary delay in fertility, there is no found evidence associating long-term usage to permanent infertility (E. Mikkelssen, et. al., 2013, Pre-gravid oral contraceptive use and time to pregnancy: a Danish prospective cohort study). Elizabeth Hatch, BU School of Public Health professor and co-author of the study even cited that that “longer-term use of oral contraceptives actually improved the chances of pregnancy, with women who had taken the medications for more than four or five years more fertile than those who had used them for less than two years. Even women who used oral contraceptives for more than 12 years had higher rates of conception”.
As such, women should not be fearsome in exercising their rights to oral contraception just because people say it affects long-term fertility, which in-fact is not.
Oral Contraceptives affect women’s libido
Truth: The pill really doesn’t affect women’s sexual drive. According to the study “Oral Contraceptives and libido in women by Davis AR and Castaño PM, there is little known effect of the pill on women’s sexual functioning. The paper, which reviewed 30 original research studies, discovered that most women even reported an increase and/or little change in libido during their usage of oral contraceptives. Contrary to this common misunderstanding, there are many causes of decreased sex drive, which includes lack of sleep and incorrect lifestyle. Gynecologists recommend taking multivitamin/mineral, especially those that are rich in the B vitamins. The hormones in the pill can change a few of your body’s metabolic functions so regularly taking a good multivitamin/mineral provides your body enough nutrients to function well.
Oral Contraceptives increases your risk to Ovarian Cancer
Truth: Forget what you heard about oral contraceptive linking to ovarian cancer. In reality, the combined contraceptive pill protects you against ovarian cancer. The protection comes from the pill suppressing hormones that naturally rouse the ovaries. It seems that the longer you take the pill, the lower your risk of ovarian cancer. A specific study that reviewed with 6,476 citations showed significant reduction in ovarian cancer incidence in users of oral contraceptives compared with those who do not. There was also a reduction in cases of more than 50% of women using the prescription product for a decade or more years (Havrilesky, LJ et. al., 2013, Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis).
Conclusively, the relative risk of ovarian cancer for women who had used oral contraceptives for at least a month, as compared with women who had never used them, lowers their risk of developing ovarian cancer. A premise suggests that the protection is achieved by blocking ovulation. Exposure to progestogen is higher while on oral contraception than in normal cycling and this could explain the protective effect (University of Southern Carolina, Why OC prevents Ovarian Cancer?).
Since all oral contraceptives on the market are basically equally effective in preventing pregnancy, selecting the right pill for you really comes down to what side affects you personally get from each pill, and which you want to tolerate. Talk to your gynecologist about the side effects you’re having and consider transitioning to another pill option.
Below-the-belt itching, or some may commonly call plainly as vaginal itching, has been a major predicament among teens and women.
This may be easily pointed out towards vaginal infection that’s been transmitted during a sexual contact or simply having an unhygienic lifestyle where little priority in cleaning is given to that “down-under”.
Well, ladies who have felt a certain pain, burning or irritated feeling with their “honeypot”, could certainly make use of a quality time with their gynecologists. This because the problem could range from benign to a more is complicated sexually transmitted infection.
Vaginal itching can be caused by something as simple as the daily feminine wash products and in other cases, can be a symptom of a more serious issue. Here are certain issues why ladies might get that itch:
A. Lichen sclerosus
Lichen sclerosus is a serious condition that appears as white spots on the skin that could be brought by overactive immune system and hormone problems. Lichen sclerosus of the genital skin should be treated immediately. Even if it isn't painful or itchy, the patches can scar. This can cause problems with urination or sex. There is also a very small chance that skin cancer may develop in the patches.
B. Contact Dermatitis
One of the most common causes of vaginal itching is the skin irritation caused by allergies to certain products. This may be acquired from genital products that have perfumes or additives, including condoms and lubricants. The skin of the vulva can be very sensitive and is subject to irritation from products such as laundry detergent, fabric softeners, body soaps, deodorized tampons or pads, and feminine hygiene products. Aside from the usual itching, redness, swelling, and skin thickening may also be present.
Gynecologists recommend that women remove irritant in their daily cleaning lifestyle. Apply steroid ointment if prescribed. Steroid ointment decreases redness, swelling, itching and burning. D-I-Y home treatments could also be used. A lukewarm bath with 4-5 tablespoons of baking soda will help soothe vulvar itching and burning.
C. Yeast Infections
A yeast infection is frequently the result of a change in vaginal pH. Yeast live in the vagina all the time in small, harmless numbers. But when these fungi grow out of control, the resulting itchiness, burning, and redness are extremely uncomfortable. This can happen randomly following the use of antibiotic, or exposure to stress, sex or a change in diet. Aside from the simple itchiness, women could experience white or thick discharge almost like cottage cheese-like.
Gynecologists mostly recommend an oral antifungal with OTC (over-the-counter) creams. Studies show that women with a history of recurrent episodes took an oral antifungal fluconazole weekly for 6 months; during that time, the rate of recurring infection dropped 90%. Six months afterward, 43% were considered cured, compared with 22% of those taking a placebo (Wayne State University of Medicine). Since then, Cambodia has seen many new emergences of anti-yeast drugs that cure patients, to be taken from 3 days to 6 days in duration. Most importantly women need to know before buying OTC vaginal infection drugs that they are sure what they are suffering from (is it really a yeast infection OR other infections). Best is to get the Broad spectrum anti-infective drug with a broad range of antimicrobial activity against all relevant germs of vaginal infections such as Dequalinium Chloride 10mg.
Probiotics could also keep the vagina healthy. Many yogurts contain the same type of probiotics that are present in the area. A recent Italian study stated that women with chronic yeast infections who placed a probiotic tablet directly in the vagina (once a night for 7 nights, then every 3 nights for 3 weeks, and then once a week) saw their rates of yeast infection drop by 87%.
D. Bacterial vaginosis (BV)
Bacterial vaginosis may be the most common reason for vaginal itching and is somewhat similar with yeast infection due to vaginal pH change. However, the discharge women experience are more watery and usually odorous. Simply an overgrowth of bacteria in the vagina, bacterial vaginosis can be treated in several ways. Oral Pills are commonly prescribed otherwise an OTC cream can be applied. The risk of acquiring BV is lowered when women or girls refrain from douching (water squirting or othe fluids into the vagina), abstaining from sex or otherwise limiting the number of sexual partners.
Home Remedies for that persistent itching
Here are 4 of the easiest home remedies ladies can use to treat itching (earthclinic.com, vaginal itching cures)
a. Apple cider vinegar is a good remedy for treating vaginal itching due to its antibacterial and antifungal properties. It also helps restore the natural pH balance of your vagina. Add 2 tablespoons of raw, unfiltered apple cider vinegar to a glass of warm water. Use this solution to wash your vagina twice daily for a few days.
b. Plain, unsweetened yogurt with active cultures is another good remedy to stop itching and burning in and around your vagina. The active cultures can control the spread of infection in the body. It also helps kill yeast and bad bacteria in the vagina and promote the growth of good bacteria.
c. Enjoying a salt-water bath can also relieve vaginal itching. Salt will control the growth of the microbes causing the infection and in turn reduce itching and other discomforts.
d. Use a cold compress to get instant relief from vaginal itching. It will help numb the area and reduce the itching and inflammation.
Remember that vaginal itching is not a problem that should be taken lightly. Untreated and undiagnosed infections increase a girl’s chances of acquiring health conditions such as herpes, chlamydia, gonorrhea and even HIV. There is also an issue of pregnancy complication such s premature birth, low birth weight, infection and even miscarriage. We don’t want that plain itching be in the way of us getting a healthy and active life, right?
Daily tasks can always trigger angina and for people who are well aware of this condition, the fear of experiencing it on-the-spot prevents them in accomplishing their daily tasks and job.
A teenager typically gets her first period between ages 12 and 14. While a few can start menstruating as early as 9 years old, others won’t have their first period until they’re into the blossoming age of 16 years of age. This is attributed to the pace of a teen’s adolescent development. However, girls feel agitated when they miss their periods. Missed periods and irregular periods can be normal in teenagers. In the first two years after menstruation onset, an irregular menstrual cycle may be experienced. This is due to the bodies’ growth and development and thus is influenced by the level of hormones that the body is producing.
Most females bleed for 2–7 days during their first menses (Flug D, Largo RH, Prader A. Menstrual patterns in adolescent Swiss girls: a longitudinal study). Immaturity of the hypothalamic–pituitary–ovarian axis during the early years after menarche often results in anovulation and cycles may be somewhat long; however, 90% of cycles will be within the range of 21–45 days (World Health Organization multicenter study on menstrual and ovulatory patterns in adolescent girls. II. Longitudinal study of menstrual patterns in the early postmenarcheal period, duration of bleeding episodes and menstrual cycles), although short cycles of less than 20 days and long cycles of more than 45 days may occur. By the third year after menarche, 60–80% of menstrual cycles are 21–34 days long, as is typical of adults.
Still, a number of medical conditions can cause abnormal uterine bleeding (AUB), or commonly called as disorders of menstruation that includes absence of bleeding, irregular bleeding, abnormally heavy bleeding, and bleeding in between periods. AUB is characterized by unpredictable timing and variable amount of flow. Indeed it is common in adolescence to have long interval between cycles however it is uncommon for them to remain amenorrheic (relating to absence of menstruation) for more than 3 months.
Aside from the common thinking that missing a period only points to possible pregnancy, abnormal uterine bleeding may be caused by ovulatory dysfunction, and bleeding patterns can range from amenorrhea to irregular heavy menstrual bleeding. There are also hypothalamic–pituitary–ovarian axis disturbances, such as polycystic ovary syndrome and thyroid disease, as well as mental stress and eating disorders.
Lesions of the cervix or vagina (benign and cancerous), chronic infections of the endometrial lining (endometritis), scar tissue (adhesions) in the endometrium, and the use of an intrauterine device (IUD) also may be associated with abnormal uterine bleeding. Additional causes of abnormal bleeding include medications that can affect the normal release of estrogen and progesterone; chronic medical problems such as diabetes mellitus or disorders of the liver, kidney, thyroid gland, or adrenal glands; or other medical problems that can affect the production and metabolism of estrogen and progesterone (AUB, 2012, A Guide for Patients Revised).
Women who experience signs of abnormal uterine bleeding should be evaluated immediately. A medical history, discussion of possible contributing factors, and a detailed physical exam are basic requirements in assessing the condition. However, there are a variety of diagnostic techniques used in determining the cause of AUB:
A. Ultrasound (sonogram) is a procedure which uses high-frequency sound waves to produce a picture of the pelvic structures. This is the most commonly used imaging method for the pelvic organs and does not involve the use of radiation. The ultrasound is frequently performed both on top of the abdomen and pelvis as well as from within the vagina.
B. Hysteroscopy is another procedure that uses a thin telescope-like instrument that is inserted into the cervix into the uterus which allows visual inspection of the entire uterine cavity. It allows identifying specific areas of the endometrium that may be biopsied or removed with special instruments
Age, desire to preserve fertility, coexisting medical conditions, and patient preference are essential considerations. For each of the suggested methods, the patient should be aware of the risks and contraindications, to allow informed choice. The degree of patient satisfaction may be influenced by efficacy, expectations, cost, inconvenience, and side effects.
In a review of 21 randomized controlled trials, NSAIDs taken with menses decrease menstrual blood loss by 20 to 50% (SOGC, 2001, Guidelines for the Management of Abnormal Uterine Bleeding). Non-Steroidal Anti-Inflammatory Drugs inhibits cyclo-oxygenase and reduce endometrial prostaglandin levels. Women with heavy menstrual bleeding have elevated endometrial prostaglandins. Progestins may also be useful for women with irregular cycles and with anovulatory cycles when given for 21 days of each month.