Category Archives: Medicines & Sciences

Features medical breakthroughs and the latest in healthcare through informative articles

Does Key Hole Surgery Hold The Key To The Future?

Mr. Low Kah Pin

Obstetrician & Gynaecologist
MBBS (UM), MObGyn (UM), MRCOG (UK), FMAS/ART (India), MSc BHARE (Spain)

Mr Low Kah Pin is an enthusiast in Obstetrics and Gynaecology with a soft spot for laparoscopy and fertility. An avid multi-sports lover with penchant for creative literature snippets, humor, art and the occasional minute dose of politics.

Key hole surgery is the laymen term for laparoscopy or minimally-invasive surgery where the surgeon makes a small incision of 5mm, usually at the patient’s belly button and puts a camera, called laparoscope, into the abdominal cavity to visualize the cavity via the television screen. The non-toxic and odourless carbon dioxide gas is used to create an air pocket within abdomen for the surgeon to operate. Additional small incisions are made, to insert surgical instruments into the cavity to perform the operation.


In my clinical practice, there are a few misconceptions by the general public. Laparoscopy is incorrectly regarded as “laser” surgery although no laser equipment is being used. Laparoscopic removal of ovarian cyst are being known as “sucking” out the cyst or the tumor, not knowing that the actual procedure requires surgical dissection of the lesion, extraction out from the cavity through the key holes and prevention of bleeding from the surgical site. It is not just sucking out the lesion like using a vacuum cleaner. Lastly, the public has the idea of laparoscopy being “incomplete” or “not clean enough” surgery as the incision is small, but in actual fact, the laparoscope camera allows the surgeon to view the entire abdomen cavity, which is impossible in open surgery. Washout and suturing can be done efficiently via laparoscopic instruments.


The glaring advantage of laparoscopy, as compared with traditional large incision surgery is less postsurgery pain. Hence, patients have less discomfort, use less painkillers, better cosmesis and able to resume activities much earlier. Indirectly, patients will less likely to develop blood clots in vessels or pneumonia as patients are ambulated earlier. Some laparoscopy surgery can be done as daycare surgery, meaning no overnight hospitalization is required. Patients are being admitted to ward in the morning, to be operated in the afternoon and walk back home in the evening.

The other benefits of laparoscopy include rare occurrence of hernia from incision and less likely to have wound infections. Therefore, patients can lift or carry objects earlier. The incisions are closed with dissolvable sutures or held together with small dressings without going through the discomfort of removal of stitches or staples.


Laparoscopy requires patients to undergo general anaesthesia requiring patients to be put to sleep on the breathing machine during the operation. This may cause sore throat and nausea. Air pockets within abdomen cavity may lead to the feeling of belatedness and occasional neck and shoulder pain, especially when the air pockets are trapped under the diaphragm (muscle between chest and abdomen cavity).

Thus, laparoscopy surgeries are off limits to patients with severe heart or lung disease as surgeries should be safely performed in open surgery with regional anaesthesia. Laparoscopy should be done in caution for patients with multiple prior operations as built-up of previous scar tissues increases the difficulty of laparoscopy surgery as well as the risk of complications.

Evolution and the future

The first laparoscopic procedure was performed in dogs by Georg Kelling of Dresden, Germany in 1901 and in humans by Hans Christian Jacobaeus of Sweden in 1910. More than a century later, by today, laparoscopy had evolved greatly. Key hole surgery can even be performed during pregnancy ie removal of ovarian cyst. Personally, I had removed large cyst of more than 10 centimeters ie mucinous cyst, endometriotic cyst, dermoid cyst with pregnancy unaffected and progressed normally postoperatively till delivery. Laparoscopic surgeries are usually done with at least 3 small incisions, but currently many surgeons are trained in single port laparoscopy where only one incision is required or key hole surgery through natural orifices such as removal of ovarian cyst through incision in vagina, hence the incision are hidden and appear scarless! 

Living with Parkinson’s

Dr. Tan Kenny

Neurologist & Physician (Subspecialty in Parkinson’s Disease & Movement Disorders)
MD (UKM), MRCP (UK), Fellowship in Neurology (Mal.), Fellowship in Parkinson’s Disease & Movement Disorder (Northwestern University, USA), CMIA (NIOSH)

He is a Neurologist and Physician at Loh Guan Lye Specialists Centre. He has vast experience in diagnosing and managing various neurological conditions. He has special interest in treating Parkinson’s disease and movement disorders including tremors, involuntary movements and gait disorders. He is committed in creating awareness and education and holds the position as the Medical Advisor for the Penang Parkinson’s Disease Association, Honorary Lecturer for Penang International Dental College and Penang Medical College.

What is Parkinson’s Disease (PD)?

PD is a slow progressive nerve cell degeneration disease causing reduced production of dopamine, a brain chemical that is responsible for brain cell signal transmission. Lack of dopamine will cause PD symptoms like tremor, stiffness, slow movement and other associated complications like constipation, mood disorders (depression, anxiety), sleep disorders (insomnia) and memory decline (dementia).

There is an estimate of 10 million people worldwide having PD. It is the second most common neurodegenerative disorder after Alzheimer’s disease and it affects 1% of people above the age of 60. It may also affect younger individuals as approximately 4% of people with PD are diagnosed before age 50.

How to recognize PD? How does it affect people with PD?

The diagnosis of PD is a challenge as currently there is no lab investigation or imaging to confirm it. PD is a clinical diagnosis requiring specific neurological assessment skills to accurately identify the cardinal symptoms i.e. tremors, slow movement (bradykinesia) and stiffness (rigidity).

In the early stages, PD may be difficult to diagnose as symptoms are subtle like mild hand tremors, lack of facial expression and stooped posture. As the disease progresses, other symptoms may set in i.e. stiffness in the arms, difficulty getting up from bed and slow small steps when walking. Simple routine activities of daily living like eating, dressing and driving may become challenging as response and movements become slower, affecting dexterity as the disease progresses. At late stages, balance might be affected posing dangers to falls and injuries.

At times, people with PD may become socially withdrawn due to their motor limitations and PD features. They are often misunderstood as being inattentive or show lack of interest due to their limited facial expressions, slow responses and monotonous voice. Hand tremors and their slow, shuffling gait may cause psychological stress and embarrassment to both patients and their family especially when attending public functions. Some people with PD may concurrently have depression and anxiety that further inhibit their social circle.

What are the treatment options?

The treatment of PD needs to be individualized as no two patients are the same. Currently, there is no cure for PD but modern medicine aims at controlling symptoms to improve their quality of life. Besides oral PD medications, there are surgical options and advanced therapeutics with modern devices like deep brain stimulation for symptomatic control. With the help of advanced therapeutics, there can be better regulation of PD symptoms and less dependence on medications.

PD patients will require physiotherapy, occupational therapy and speech therapy as well. Some of the aspects that needs special attention include balancing, gait training, posture correction, fine motor skills for activities of daily living and speech training. These also include exercises to improve muscle strength, agility and stability.

Interestingly, new evidences show that some leisure activities can actually help to improve PD symptoms. Activities like dancing, cycling, tai chi and non-contact boxing are encouraged as they show promising results providing extra-benefits like relaxation, reduce falls, improve balance and coordination.

Any special diet required for PD?

There is no food restrictions or special diet for PD. Generally a healthy, balanced diet rich in vitamins, fiber and fluid help them stay energized and relieve constipation that is a common problem in people with PD. Adequate hydration is important to prevent dehydration as PD patients frequently experience low blood pressure which may cause dizziness or falls.

Both PD patients and their family members face daily challenges living with Parkinson’s. However, it is important to understand that PD is not a fatal disease as with adequate and appropriate treatment, they can have a normal and fruitful active lifestyle. 


by Dr. Mecherl Lim

MD (MA) Naturopath (ND), Holistic Kinesiology

Absolute infertility is where there are no eggs and no sperm. This is rare, so what most couples are really experiencing are partial or sub-infertility, or they can’t conceive within their proposed time frame.

A general definition of infertility is when a couple does not conceive after one or two years of regular, unprotected sex.  This assumes the couple are sexually active at the woman’s fertile time, which is typically from day nine (day one is when menstruation starts) to day 21 in a 28 -day cycle. The peak fertility day is usually 14 days before the beginning of menstruation (in a regular 28-day cycle) and at this time there are around three successive days of high female fertility where the vaginal mucus is clear and slippery or stretchy and there’s at least a sensation of lubrication.

The Website Infertility BBT Charts shows the correlation between all indicators of fertility. If it seems too complicated, or if you have an irregular cycle, discuss this with your GP or Naturapath Practitioner.


About 15 per cent of couples have difficulty conceiving and this figure doubles where the woman is over 35 years of age. In about 40 per cent of cases the infertility problem lies with the man, and in 40 per cent of cases with the woman. In 10 per cent there is a problem in both partners and in 10 per cent there is no known cause.

Some researchers say that in 25 per cent of cases there is a problem in both partners, and the majority of researchers say sperm quantity and quality are declining.


Sometimes couples get anxious because they can’t conceive when it’s suitable for them and they need reassurance. A medical diagnosis is needed to establish the cause of infertility, which may involve blood and sperm test, ultrasounds and laparoscopy.


  • In women and men
  • Ageing
  • Hormonal imbalances
  • Immune problems
  • Sperm antibodies (the body does not appropriately recognise sperm)

Contributing factors:

  • Poor general health and unhealthy lifestyle
  • Severe stress, including anxiety about conceiving
  • Insufficient restorative sleep

In Men

  • Low sperm count or problems with the shape or activity of sperm
  • Blocked spermatic cords
  • Testicular disease and infections

In Women

  • Endometriosis
  • Blocked fallopian tubes caused by infections, disease or tissue (Many natural therapies have successfully treated women who have been told their fallopian tubes are blocked, which confirms there are degrees of blockage).
  • Ovarian problems such as polycystic ovarian disease.
  • Disorders of the uterus such as polyps
  • Problems with the shape of the cervix or in the texture of the mucus.
  • Early menopause in young women.
  • Obesity.
  • Oral Contraceptive (over the years) I have seen a number of women who do not return to normal ovulation and menstruation and this seems to be linked to long term use of oral contraceptives).


Medical treatments depend on the cause of the problem.

Following a basic check, your doctor may refer you and your partner to a fertility specialist.

  • Hormonal pharmaceuticals may be prescribed.
  • Surgery may be recommended to remove polyps, cyst blocked fallopian tubes or endometriosis.
  • In Vitro fertilisation (IVF) involves a surgical procedure for collecting the egg, together with pharmaceutical hormones. It involve sperm or eggs from donors and the conception rate is about 20 percent. Before undertaking IVF, most centres organise a counselling session and provide written details so you know what to expect from the treatment, the cost involved and, the risks and outcome.



A combination of a few herbs such as Dong Qui for abdominal pain, False unicorn for bleeding, Paeonia if Oestrogen is known to be high, Ginger to improve digestion and circulation & Chaste tree is commonly prescribed. The capsule is named as SHE 18,  if you need more info, send a message to for more advice. The remedies are discontinued as soon as you know you are pregnant.

Caution: If you are taking pharmaceuticals there may be interactions and I would not advise self treatment with herbs in this case.

It is also a must to take a combination of Nutrition Supplements such as Multi-Vitamin /minerals, Fish Oil, B complexes and Folate. In a scientific study of 30 women who had been trying to conceive for 6 to 36 months, half were given a placebo and half were given a combination of Herbs & Nutrition Supplements. After 5 months 5 of 15 women taking the complete course were pregnant compared to the ones without.

As we know some women have a deficiency in B vitamins, especially B12, B6 & Vitamin E.

The trials confirm my clinical experience from 1989 when I began working as a Natural Therapist Practitioner. I was surprised at the number of middle age pregnant patients. They, too, were surprised, because most have teenage or older children and have not used any form of contraception for many years. I myself, had a baby boy at the age of 40. I concluded that pregnancies resulted from improved health and the high intake of correct prescribed nutrition.

Caution: Women, particularly those with vegan or vegetarian diets, may be infertile because of vitamin b12 deficiency, however deficiency symptoms may be masked by high folate diets or folate supplementation.


Don’t leave it till it is too late to try to conceive. It will actually be quite difficult for the egg and the sperm to get together. You may have many competing needs such as careers and financial security, but nature may not coincide with these.

Before investing time and money in extreme fertility processes, get your body as healthy as you reasonably can so you will be able to create a healthy baby. However, no amount of healthy living will achieve conception if the sperm are absolutely dead or both fallopian tubes are completely blocked.

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by Dr. Mecherl Lim

MD (MA) Naturopath (ND), Holistic Kinesiology

Endometriosis occurs when tissue comparable to the lining of the uterus is found in other areas of the body such as on the ovaries, fallopian tubes, bladder, bowel and vagina.  The misplaced tissue may grow and is occasionally found on the organs and other parts of the body. Endometriosis affects 10 percent of women of childbearing age. 


  • Pain before and during menstruation, at ovulation (midway between periods) and during intercourse.
  • Painful urination and pain in bowel movements during menstruation.
  • Bladder discomfort and urinary frequency.
  • Gastrointestinal upsets such as irregular bowel motions, flatulence and bloating.
  • About 30 to 40 per cent of infertile women have endometriosis- commonly because the fallopian tubes are blocked. Sometimes infertility is the only symptom.
  • Heavy or irregular bleeding, sometimes with large clots.
  • A number of women have endometriosis but no symptoms and occasionally there may be unusual symptoms such as sciatica- caused by pressure of the endometrial growth.  Some women may experience fatigue, especially if they are bleeding heavily and become iron deficient.


Diagnosis is by laparoscopy; That is, under anesthetic a small telescopic instrument is inserted into the abdomen.


Basically, the misplaced tissue behaves like the lining of the uterus and each month it swells, breaks down and sheds. This may cause inflammation, pain, pressure, internal scar tissue formation and abdominal problems such as bowel congestion.  In severe cases bands of scar tissue (adhesions) may develop.  There are no known causes of the misplaced tissue and below are some of the suspected causes:

  • Menstrual back flow, either via the uterine wall and blood circulation or via the fallopian tubes.  Some suggest tampons may encourage back flow, so it may be wise to use external pads, at least during the night.
  • Hormonal imbalances, especially high oestrogen levels or inappropriate oestrogen metabolism. It can recur or start when postmenopausal women go on hormone replacement.
  • Other possibilities include genetic predisposition, immune imbalances, following abdominal surgery, or the body may reactivate some “embryonic ability” to make new tissue.



These may include painkillers, progesterone, anti-progesterone, and testosterone derivatives such as Danazol. GnRH agonist (such as nafarelin) suppresses the body’s production of reproductive hormones and reduces symptoms, but has many potential adverse effects, including pseudo-menopause. Other analagesics may be used for pain relief. Hormone therapy that disrupts the secretion of estrogen and may be employed to limit growth is also used. Currently, prescribed pharmaceuticals rarely help  endometriosis.


The type of surgery now available varies from minor “day surgery” to cauterization of endometriosis spots, laser technology and extensive removal of scar tissue and microsurgery. If it is possible to remove all endometrial tissue, regrowth is unlikely to recur or cut out visible growths, and to reduce adhesions between pelvic organs.


There is not one single remedy that will significantly improve the symptoms of endometriosis.  You should find a practitioner experienced in treating the problem, that is, a herbalist, Naturopath, Traditional Chinese Medicine practitioner or Homeopath.


You can use chamomile and ginger, both of which help reduce inflammation. Simmer finely chopped ginger root in water for about 5 minutes. Use half to 2 teaspoons of ginger per cup of water, depending on your taste. Then add the chamomile and let it stand covered for a few minutes. For bloating, try combining peppermint and lemon balm tea.


Effective results in the treatment of endometriosis involve replacing saturated fats in membranes with EFA. This is a slow process and can take months to reverse the concentrations of fatty acids in the membranes. Because of this, it may be necessary to take GLA for about 6 months before reasonable effects are observed.

Fish Oils can also be used for their PGE3 anti-inflammatory effect. The activity of Delta-6-Desaturase Enzyme can be increased with nutrients such as : Zinc, B6, C, and Magnesium, whereas vitamin A and copper will inhibit Delta-5-Desaturase Enzyme thereby inhibiting PGE2 and arachidonic acid production.

Oestrogen receptor density may be increased in hypothyroidism. Therefore, women should be checked for hypothyrodism or decreased utilisation of thyroid hormones.

SUPPLEMENTATION such as DrMecherlHerbs SHE 18, (TCM herbs) Thyroid 17 (TCM) has been shown to decrease oestrogen effects and promote progesterone effects via anterior pituitary regulation which will regulate cell surface receptors that will benefit in these women. SHE 18 is also traditionally used in dysmenorrhoea, ovarian and uterine pain as an anti inflammatory and spasmolytic.


If you have high oestrogen levels, a diet rich in Phyto oestrogens may “crowd out” at least some of your stronger oestrogens- such as DrMecherlHerbs PhytoNutrients plus Soya food, linseed, sunflower seeds and an intake of whole grain food twice daily.


According to a scientific survey, women with a higher consumption of green vegetables and fresh fruit have a 40 per cent relative reduction in the risk of endometriosis while those with a high intake of beef, other red meat and ham have an 80 to 100 per cent increase in risk.

  • Reduce your meat intake, have two fish meals weekly and some nuts and seeds, as these foods provide essential fatty acids and help reduce inflammation.
  • Have a salad or soup with lunch, including green vegetables.
  • Include cooked vegetables with your evening meal.
  • Eat at least two pieces of fruit daily.


Endometriosis is a difficult and complex problem. Do your best to follow the dietary and lifestyle advice and get a practitioner ‘sadvice for specific treatment.

Dr Mecherl Lim

An Intuitive Medical Practitioner in Alternative Medicine (MD) (MA), Naturopath (ND), Holistic Kinesiology (HK), and Functional Medicine (FM)

Next  No 54 Issue : INFERTILITY

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by Dr. Mecherl Lim

MD (MA) Naturopath (ND), Holistic Kinesiology

Vaginal candida (genital candidiasis, or thrush) is an overgrowth of Candida Albicans, a yeast-like fungus that affects the area in and around the vagina, vulva and rectum.  In severe cases, the rash can spread to the thighs and buttocks.  About 30 percent of reproductive -age women have some candida in the vagina but only half of them have symptoms and around five percent have recurrent problems.


The early symptoms are redness, swelling and irritation.  In severe cases, the rash areas can become cracked, itchy and burning,m with a whitish or slightly yellow discharge and occasionally a sour milk odour.  There may be pain when urinating and during intercourse.  Men often carry the infection on the penis but may not have symptoms.  Symptoms in men usually include soreness, redness, itching and fissuring of the penis.


A doctor takes a swab which is then examined in a pathology laboratory.  There is an also a medical blood test to see if the candida has spread throughout the body (known as systemic candidiasis) but my experience is that this test  is not conclusive and candida fungi may live in the human body without causing any apparent problems.


The cause is primarily an overgrowth of Candida albicans, and it’s an increasing problem, with significantly more case caused by other species of Candida.

Conditions associated with candida include diabetes, pregnancy, suppressed immune function and the use of antibiotics or cortisone drugs.  Hormone changes tend to make women more susceptible to infection, which explains why candida occurs during pregnancy and with some oral contraceptives and hormone replacement therapy Temmerman  MI, Nelis HJ, ‘Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women’ American Journal of Obstetrics and Gynecology 187: (2002): 569-74.

Candida seems to occur more frequently among wearers of pantyhose and those who use marijuana, malnutrition, alcoholism, bath additives and vaginal deodorisers may increase the risk.  Sometimes women seem to get candida when they are severely stressed, depressed or not eating properly.  I have seen cases that may link to antacids and antidepressant drugs.

You can pass on the infection to your partner and this may cause him to reinfect you, even if he doesn’t appear to have any symptoms. Condoms should be used when infections are present.

Various resistant strains may result from the increasing use of short course antifungal medications, but I don’t know if resistant strains occur as a result of ineffective natural treatments. See your practitioner if you are experiencing side effects from any treatment or if the condition is worsening, otherwise, it’s generally advisable to complete the prescribed course.


Medical/pharmaceutical treatments include over the counter and prescribed topical antifungal creams pessaries and ovules. Oral antifungal pharmaceuticals are prescribed when topical remedies have not been successful but these may not give a permanent “cure” in the majority of recurrent cases.

Boric acid pessaries. Basically, the treatment is 600mg of boric acid in a size of 0 gelatine capsule inserted in the vagina last thing at night for 10 to 15 days.  This treatment is 80 percent successful in eradicating Candida glabratta, a resistant strain.  Boric acid is a lethal poison at a dose of 15-20g and is never taken orally.  You absorb a little through the vaginal wall.  A pharmacy may be able to order in a course of boric acid pessaries.  This treatment  may irritate the area around the vagina and you may need to apply a soothing cream or almond oil externally just after inserting the pessary.


First, get a medical diagnosis, because some similar symptoms occur in eczema and various infections.

  • Oral, antifungal medicinal
  • Oregon grape herbs
  • Grapefruit seed extract
  • Pau d arco
  • Goldenrod
  • Thuja
  • Myrrh
  • Echinacea
  • Aloe
  • Green Walnut Hulls
  • Goldseal
  • Corn Silk
  • Olive Leaf

Herbalists generally prescribe a selection of these and may include herbs to strengthen the immune or nervous systems, such as astragalus, cats claw or ginseng.


Various natural pessaries and ovules are available, including tea tree oil, golden seal, calendula or lactobacillus.

Caution: Topical medical and natural remedies can aggravate, so always test everything- first on the inside of the elbow and, if this is OK, apply a tiny portion around the vaginal area. I don’t recommend douching because this depletes natural vaginal secretions and may upset the bacterial balance. Do not persist with natural therapies if they don’t work within one week because, aside from the pain and stress, you develop a secondary infection.


Candida feeds on sugars and like warm, dark, moist places.

  • Avoid all refined sugars and obviously high-sugar foods such as cakes, fruit juices and dried fruits.
  • Wear cotton undies and avoid tight jeans and trousers.  Very tight trousers cause heat and may rub the vaginal tissue, causing slight damage and making it more prone to infections. (Very tight clothes can also cause a backache and may contribute to pelvic congestion and varicose veins.) Perhaps at home wear a skirt and no undies to keep the area reasonably cool and reduce sweating.
  • Wipe from front to back after going to the toilet.
  • Urinate before and after sex.
  • Use minimal soap in the vaginal area, buy a product that is unscented and ph balanced.
  • The incidence of candida is higher in the tropics, so perhaps plan cool climate holidays.
  • If you are taking antibiotics ( a common cause of candidiasis), use Dr Mecherl PROFLOR A, contains Lactobacillus GG, Lactobacillus Plantarum, Lactobacillus acidophilus NCFM, & Rhamnosus LGG, Colostrum.because these strains seem to work more effectively to offest antibiotic side effects.  I suggest two or three doses daily of the Proflor A as far away in time as possible from the doses of antibiotics. The will ensure that a least for part of each day you have some healthy bacteria in your system. Continue with the Proflora A for a week after you finish the antibiotics.  One trial indicated that Lactobacillus was not effective, but this is not my experience and it may depend on the strain.  Two trials have indicated plain yoghurt may be helpful as preventive but check the labels for sugar content.


Some of my patients advise they have overcome recurring vaginal candida by following a strict diet that avoids not only sugars but also all the following foods.

  • All yeast bread, rolls, doughnuts and any product or supplement that contain yeast.
  • All cheese, including cottage, ricotta and soy cheese
  • Pickled and smoked foods, including corned beef and bacon
  • Beer, wine, ginger beer, sherry, port
  • Vinegar and any food that contains vinegar
  • Mushrooms
  • Soy sauce, tamari, miso, tofu
  • Vegemite, Marmite, Bonox, stock cubes
  • Dried and canned fruit
  • Melons and peanuts (because of their natural moulds)
  • Leftover foods.

However, this dietary program doesn’t make sense to me because there’s no evidence that one particular fungus, mould or fermentation process will cause a detrimental overgrowth of another fungus. In fact, some practitioners recommend yoghurt, miso, a little vinegar, olives and traditional coleslaw as part of a preventive program.  However, if you are desperate you may want to try this avoidance program for one month, evaluate, and then reintroduce the items one at a time in small quantities. Some women report they can tolerate some of these foods in small quantities.


  • Use wholegrains because these are not readily converted to glucose and have other advantages: rice fibre, for instance, contains gamma-oryzanol, which is somewhat antifungal.
  • Some culinary herbs have antifungal properties, so use these generously in your cooking. The list includes cinnamon, thyme, turmeric, rosemary, garlic, mustard, oregano, lemongrass and winter savoury.
  • Foods in the cabbage family are recommended.


For persistent or severe vaginal candida get practitioner help because the infection needs to be eradicated.

Dr Mecherl Lim

An Intuitive Medical Practitioner in Alternative Medicine (MD) (MA), Naturopath (ND), Holistic Kinesiology (HK), and Functional Medicine (FM)

Next  No 53 Issue : ENDOMETRIOSIS

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Women’s Reproductive Health


by Dr. Mecherl Lim

MD (MA) Naturopath (ND), Holistic Kinesiology

This is lower abdominal pain that commences just before or during menstrual flow, the first 24 hours being the most painful. 

About 70 percent of women experience some degree of menstrual pain.


The pain may be gripping, cramping or a constant ache, and it ranges from mild to severe.  Sometimes it spreads to the back and down the legs.  Period pain may sometimes be accompanied by scanty or heavy flow with clots, headaches, nausea, vomiting, constipation, diarrhoea, sore breasts or dizziness and fainting.


A medical diagnosis is required to find out if the pain is menstrual or something else.  Primary dysmenorrhoea is normal menstruation that is accompanied by pain.  Secondary dysmenorrhoea is linked to a cause such as endometriosis, fibroids or polyps.


Primary dysmenorrhoea is caused when the uterus contracts to eliminate its lining.  Women with period pain probably have high levels of prostaglandins and these compounds over stimulate the uterus.

Secondary dysmenorrhoea has a medical cause such as fibroids (obstructive internal uterine growths) that cause the uterus to contract more powerfully than normal.  Intrauterine contraceptives are also linked to period pain.


Primary dysmenorrhoea

  • Painkilling drugs, such as paracetamol
  • Prostaglandin inhibitors, such as ibuprofen
  • Oral contraceptives often eliminate period pain

Secondary dysmenorrhoea

The medical treatment depends on the cause and may involve hormones, anti-inflammatory pharmaceuticals or surgery.


All drugs have a long list of cautions and adverse effects, as you will see from package inserts or by looking at the MIMs Annual in your library.  Not everyone experiences side effects and you may need to take a strong, quick acting medication for severe symptoms and particularly for pain. If a few over the counter painkillers, such as paracetamol, prevent period or other pain, then that’s the simplest most effective and economical treatment-and it’s unlikely that you will experience side effects from taking, say, two to six tablets a month.


Bed rest with abdominal heat (such as a hot water bottle) is a standard recommendation. This works better if you gently massage about six drops of lavender oil onto your abdomen before applying the heat and lie on your back with a large pillow under your knees.  A combination of eucalyptus and peppermint oil also helps some women and this combination may prevent a headache if you put a few drops on the back of your neck and one drop on the end of your nose.

Herbs : Specific herbs such as cramp bark and wild yam, Chaste tree, Dong Quai, Red Raspberry leaf, False Unicorn, Feverfew, Cinnamon helps to relieve pain and inflammation and reduce the need for pharmaceutical painkillers.

You can also use Dr. Mecherl SHE 18 which is already a combination of the above herbs and you can also see the tea recipe under “Endometriosis” Supplements.

A combination of evening primrose and fish oil works well (and even more so if vitamin E is in the formula), such as Dr Mecherl Femi Vita M or Femi HH.  Neuromous (Magnesium) is sometimes helpful,  I recommend these daily for three months, and if effective relief is relieved, reduce the dose to two weeks, then re-evaluate every few months to find the lowest helpful dose.

This type of schedule works for a number of natural remedies and the aim is to find the lowest helpful dose that works in your case. Subsequently, some women stop taking all remedies, although their pain may recur following illness or major stress.

Other remedies are exercise such as easy yoga may help ease abdominal tension and improve blood flow and therefore reduce pain.  Some women say a glass of wine or a nip of brandy helps!


Regular exercise throughout each month generally relieves congestion and stress.  Also, you will see under “Premenstrual syndrome (PMS) that a scientific trial showed that a vegetarian diet helps reduce period pain.


Always do something about pain, because it increases inflammation, prevents sleep, may cause depression and blocks enjoyment.


Next No 52 Issue : CANDIDIASIS
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Why are we so afraid of Infertility? Dispersing the taboo of infertility 为何我们对不孕症如此恐惧? 解开不孕症之谜

Dr Ng Peng Wah

Fertility Specialist, Obstetrician and Gynaecologist Royal College of Obstetricians & Gynaecologists in United Kingdom

We sat down with Dr Ng Peng Wah from Genesis IVF and Women’s Specialists to discuss infertility and the taboo surrounding it. Genesis IVF is Penang’s premiere IVF centre aimed at providing effective infertility treatments with world-class facilities to help patients deliver their dreams of having a baby.

我们与起源妇产助育专科中心(GenesisIVF)创立者兼妇科专家伍柄华医生(Dr Ng Peng Wah)讨论不孕症之谜。Genesis IVF 是槟城首屈一指的资深人工试管婴儿(体外受精联合胚胎移植技术)专科医疗中心,旨在提供先进的助孕治疗技术和世界级的硬体设施,协助患者实现生育梦想。

Q: What is infertility and what are the steps someone who has problems conceiving should take?

NPW: Infertility as defined by World Health Organisation (WHO) as the inability to achieve pregnancy after trying for 12months without using contraceptives. If female patients are above the age of 35, they are considered suffering from infertility if they have been trying for 6 months.

The best action to take is also the most direct one – patients should come to see a fertility specialist so that the cause of infertility be identified so that a proper treatment can be attempted.

Q: What are some common causes behind infertility and the treatments to overcome it??

NPW: Infertility causes are varied but it can equally be male or female factors.

A common problem for male infertility is the inability to produce an adequate amount of viable sperm due to endocrinal, physical, chromosomal or other issues.

One of the most common female infertility problems is caused by ovulation. Ovulation problems are often caused by polycystic ovarian syndrome, which is a hormone imbalance problem that causes infertility. Another common ovulation problem is primary ovarian insufficiency (POI), which occurs when a woman’s ovaries stop working properly.

A woman’s age plays an important role in infertility as it has been statistically proven that women over the age of 35 face increased infertility problems. One of the most effective methods is In-Vitro Fertilisation (IVF) in conjunction with other technologies to augment a patient’s pregnancy rates. The beauty of IVF is that it helps overcome many infertility problems including: Blocked tubes, polycystic ovary syndrome, endometriosis, premature ovarian failure as well as low sperm quality.

Q: What are the technologies that can augment a patient’s pregnancy rates?

NPW: We employ techniques such as Intra Cytoplasmic Sperm Injection (ICSI) for patients suffering from low sperm quality to overcome male infertility by manually injecting a sperm into the egg to eliminate the problems of low motility sperm.

Additionally, we have Preimplantation Genetic Screening (PGS) offered to patients to ensure only chromosomally normal embryos are transferred into the mother’s womb. Embryos with abnormal chromosomes usually do not survive pregnancy; even if the pregnancy is successful, the child born with chromosomal abnormalities will be born syndromic such as Down Syndrome, Edwards Syndrome, Patau & Klinefelter. Chromosome defects are one of the most common causes for miscarriage, especially for women over the age of 35.

Q: Before we end do you have any advice for couples facing infertility?

NPW: As a fertility specialist, it is our duty to advocate and educate the public that Infertility is a disease and like any other diseases, couples with infertility should seek out treatment to overcome this disease.


NPW : 世界卫生组织 (WHO) 所定义的不孕不育是指在没使用任何避孕药具,备孕12个月后依旧无法怀孕。如果女性患者年龄在 35 岁以上,已经尝试了6个月仍无法怀孕,就会被认为是不孕症。最佳也是最直接的措施——患者应该咨询生育专家,这样除了可确定导致不孕的原因,还可进行适当的治疗。


NPW : 不孕的因素多种多样,皆可发生在男性或女性身上。男性不孕常见原因是由于内分泌、生理、染色体等问题而不能生产足够数量的精子。而导致女性不孕的常见原因之一是排卵问题,通常由多囊性卵巢综合征,激素失衡而导致不孕。其它的排卵问题原发性卵巢功能不全 (POI),这种病例是卵巢停止正常运转。而女性的年龄在不孕因素中有着关键联系,统计数据证明,35岁以上女性面对不孕问题的机率较高。试管婴儿或体外受精 (IVF)是最有效疗法之一,结合其他的技术将可提高患者怀孕率。试管受精的好处在于可协助克服许多不孕问题,包括:输卵管堵塞、多囊卵巢综合征、子宫内膜异位症,卵巢早衰以及精子质量不理想。


NPW : 我们对精子质量不理想的患者采用单精子注射 (ICSI) 等技术,朝卵子中注入精子,解决精子活跃度低下的问题,克服男性不孕。此外,我们还为患者提供移植前基因检测 (PGS),确保只有染色体正常的囊胚被移植到母亲的子宫中。染色体异常的胚胎通常不能存活;因为即使成功怀孕,染色体异常的孩子也会出现如唐氏综合症,Edwards Syndrome, Patau & Klinefelter 等综合征。染色体缺陷是导致流产的常见原因之一,尤其是35岁以上的女性。


NPW : 作为一名生殖课专家,我们有义务向公众宣导和传达其实不孕症是一种病症,就像其他疾病一样,不育夫妇应该寻求医生进行治疗。


by Dr. Mecherl Lim

MD (MA) Naturopath (ND), Holistic Kinesiology

I would like to overview 5 common women’s reproductive health problems and aim to assist you in making informed decisions about treatment options and to suggest ways you can incorporate practical preventive strategies into your lifestyle.

Fortunately, we live in a time when women’s  health issues are more openly discussed and it’s our hope you’ll perpetuate the wisdom gleaned from the following pages by sharing this with the women-men-in your life.

PREMENSTRUAL SYNDROME (PMS) – A disorder associated with a cluster of symptoms is classed as a syndrome. About 90 percent of menstruating women experience mood changes, fluid buildup and various other problems two to 14 days before menstruating. These symptoms may disrupt everyday life in about 10 to 20 percent of women.


More than 100 different symptoms of PMS have been reported.

The most common:

  • Irritability or aggression,
  • Depression and low self-esteem,
  • Insomnia,
  • Sore breasts,
  • Abdominal bloating/constipation,
  • Headaches.
  • Food cravings and binge eating,
  • Back and muscle pain,
  • Pelvic discomfort &
  • Reduced concentration, “fuzzy” brain.


A diagnosis is based on the pattern of symptoms experienced by women.  Sometimes medical hormone test is used.


Australian medical experts say the cause of PMS is unknown but there is some link to emotional, physical and hormonal factors.


  • Reproductive hormone imbalances may relate to relative levels of estrogen, progesterone, prolactin, and testosterone – or their breakdown products (metabolites). It is possible to have a normal level of a particular hormone but it may be blocked because it interacts with something else.
  • Cortisol, the stress hormone, increase blood sugar levels, which gives you a boost. However, when the levels decrease, you may feel tired and crave sugary foods.
  • Aldosterone, another adrenal hormone, affects the minerals  (electrolytes) and fluid balance.
  • Stress affects reproductive hormones, and your hormones may fluctuate more than “normal”. All changes are somewhat stressful and one theory is that when the levels of any hormone drop, you may experience “withdrawal”.
  • Other causes may be nutrient deficiencies or excesses, prostaglandin deficiencies or excesses, lowered natural opiates or neurotransmitters and live /intestinal malfunctions.


Current medical options include hormone therapy, oral contraceptives, antiprostaglandins (for pain), antidepressants, diuretics, and bromocriptine. Natural progesterone is probably the safest medical option, but scientific trials show it’s no better than placebo (Wyatt K, Dimmock P, Jones, et al, “Efficacy of progesterone and progestogens in management of premenstrual syndrome: a systematic review” British Medical Journal 323 (2001) : 776-80.

In a scientific study of isoflavones (which are commonly isolated from red clover or soy) for periodic breast pain (cyclical mastalgia), after three months of treatment nine out of 12 women had less pain compared with two of six on placebo. The researchers stated the isoflavones act as weak anti-estrogen and have no side effects. I suggest a more economical way of getting a good dose of isoflavones is to have a quarter of a cup of (phyto Nutri) alfalfa, mung beans or other sprouts daily


  • Chast tree produces a significant decrease in PMS symptoms compared with placebo and this has been verified in the least 15 scientific trials. Most trials lasted about three months and used low dose, guaranteed potency or standard products. example Dr Mecherl SHE 18.
  • St John wort, if the main symptoms are depression.
  • Ginkgo, for reduced concentration and breast tenderness.
  • Feverfew, to help prevent headaches.


  • Vitamin B6 (pyridoxine) and magnesium have helped women more than placebo, although vitamin B6 alone is not as successful as a chaste tree (She18). (Common doses are 50mg of pyridoxine and 20mg of magnesium.) *Evening primrose oil is helpful when women are deficient in essential fatty acids or have problems with oil metabolism.
  • Calcium maybe helpful but depends on diet and absorption. Some women consume six serves of dairy foods daily (equivalent to about 3000mg of calcium), which is excessive and likely to interfere with other nutrients as well as being too alkaline.
  • Taking a multivitamin/mineral supplement improves symptoms in 17 out of 23 women. This is not surprising because when women with PMS are tested, they invariably have low levels of a number of vitamins and minerals compared with women who have minimal or no PMS.


In a dietary trial for premenstrual symptoms (PMS) and period pain, 33 women followed a low-fat vegetarian diet for two menstrual cycles. The diet consisted of grains, vegetables, legumes and fruit with no restrictions on quantity. (Animal products, added oils, fried foods, avocados, olives, nuts, nut butter and seeds were eliminated.) The symptoms and pain fell significantly.

This diet would provide a high level of phytoestrogens and fiber and consequently, the body’s own estrogen uptake would be lowered and constipation/ bloating would be reduced. However, in the long term, it would cause vitamin B12 deficiency unless a supplement was taken. Eggs, lean meat, yogurt, olives, avocados, nuts, and seeds are health-enhancing foods that should be eaten regularly in moderate quantities (besides, they re enjoyable to eat and also allow you to socialize normally!).

Dietary surveys indicate women with PMS tend to eat significantly more junk food, notably sugary, fatty and salty foods. Perhaps this indicates a need for energy or consolation? On the other hand, dieting makes you hungry, lowers your blood sugar, your brain doesn’t work properly, you feel tired and you grab foods to give you quick relief. You need energy before you can achieve anything. Have a large mixed vegetable salad or soup with lunch and plenty of cooked vegetables at night to help fill you up and to avoid weight gain.


  • Have varied, non-restrictive diet using foods in a natural a state as possible.
  • Avoid refined carbohydrates (sugars, white flour and so on) and fad diets.
  • Lack of essential fatty acids is linked to PMS, weight gain, excessive mood changes, lowered concentration, joint and muscle pain, food cravings, fatigue and breast tenderness. The best way to get essential fatty acids is from foods such as fish (especially herring, sardine, and salmon), nuts and seeds, virgin olive oil and avocado.
  • Don’t use foods for reward or consolation.  Find other strategies such as outings, music, aromatherapy, massage or books.
  • A study showed that jogging or walking about 2.5 kilometers daily for six months give significant reductions in fluid retention, breast tenderness, and the overall symptoms picture. If you are jogging or doing aerobic exercises, make sure you wear a firm support bra or you may aggravate breast soreness.


A whole food diet (with occasional treats), regular exercise and enjoying your life are basic PMS treatments.


Dr Leong Wai Yew, Dr Haris Hamzah, Dr Tan Chong Seong, Dato’ Dr Colin Lee Soon Soo

Alpha Fertility Centre (AFC) is set up and run by leading medical specialists and embryologists responsible for numerous fertility achievements both in the regional and global arena. This purpose-built advanced fertility centre located in Selangor, Malaysia is fully equipped with modern comprehensive range of fertility treatment options; including but not limited to PGD/PGS with Ion Torrent NGS, Embryoscope+, Embryo Freezing using Cryotec® that gives 100% post thaw survival rate, Egg donation program, and many more (refer to website :

As the name ALPHA suggests, the Medical Specialists and Staff at ALPHA have successfully innovated numerous fertility treatment procedures that led us to achieve many FIRSTS!

In addition to achieving numerous fertility achievements in Malaysia and Singapore, we have also achieved and innovated many world’s FIRSTS.

In the tradition of FIRSTS, we are committed to put You and Your Fertility needs as our FIRST PRIORITY. We do this by treating every couple individually; crafting truly personalised, tailor-made patient care IVF treatment programme to cater for Your specific needs.

Let us be Your dedicated partner in making Your fertility journey a successful one, leading to a bundle of joy for You and Your Family!

Alpha Fertility_Lab.jpg

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Chemical Sensitivity

There are numerous factors that may participate in the development of hypersensitivity, to even minute levels of toxic and generally non-toxic chemical substances. Normal responses to subtoxic doses of chemical substances may be affected under the following conditions.

Genetic and individual abnormalities in enzyme and protein synthesis. Approximately 50% of the population are slow acetylators, example : they detoxify some chemicals slowly and thus are at risk to chemical sensitivity.

  • Poor diet and deficient nutritional states
  • Obesity and or increased fat / muscle ratio.
  • Age extremities-elderly and new born
  • Disorders of kidney and liver function
  • Gender of the individual.
  • Unstable hormone status.
  • Environmental stress conditions-heat, cold, dehydration, deficiency of oxygen (asthma), noise.
  • Achlorhydria is common in many chemical sensitive individuals and hence Vitamin B12 absorption may be impaired.

Chemical sensitivity or the allergic tendency of an individual can be inherited. However, allergic tendency, with no previous family history of allergy, can also be acquired in a number of ways. Hypersensitivity may follow viral infections such as mononucleosis or viral pneumonia, or severe emotional reactions such as grief. The most common incitement appears to be low grade, long term chemical exposure, although a short term high level exposure, such as seen in industrial accidents, may produce similar effects.

There is apparently no consistent pathway by which the immune system mediates chemical hypersensitivity or loses its control mechanism and begins to sensitize inappropriately to chemicals. The pathways used by the immune system to develop this phenomenon not only vary from chemical to chemical but from exposure to exposure, and certainly differ from individual to individual.

There are also the secondary effects or pathways of allergic inflammation to be considered, for instance, gastrointestinal symptoms range from vague indigestion to full blown colitis (inflammation of the colon). These may result in nutritional deficiencies.

The deficiencies begin with increasing the sensitivity of the immune system to food. Generalised inflammation of the gastrointestinal tract secondary to food sensitivity often causes poor nutrient absorption that leads to vitamin and mineral deficiency. Eventually the individual may become deficient in digestive enzymes, which in itself will initiate food intolerance or sensitivity.

With increasing vitamin and mineral deficiency and enzyme deficiencies, the end result is an inability to detoxify chemicals giving rise to more food and chemical sensitivities. Thus a vicious cycle is set that will only be overcome by judicious supplementation of vitamins, minerals and digestive enzymes.

Common Chemical Exposures that Cause Chemical Sensitivity

  • TERPENES – These are natural, volatile chemicals released from plants. They normally give the characteristic odour or scent of the plant, e.g., odour of fresh pine needles, orange, eucalyptus, cloves, jasmine. The level of terpene exposure depends on the time of year, highest concentration occurs during the warmest part of the year.
  • HYDROCARBON FUELS – natural gas, petrol fumes, coal gas, kerosene. Gas stoves or ranges can be a source of gas leakage in homes. Parking station attendants and petrol station attendance are in the high-risk group for this type of sensitivity.
    SYNTHETIC Synthetic ripening of fruits – such as bananas may liberate potentially harmful residue of the ripening gas ethylene. Commercial coffee that is gas roasted is another example.
  • FORMALDEHYDE PRODUCTS – are notorious for their adverse reactions in sensitised individuals. Hidden sources of formaldehyde exposure are plastics, chipboard, home insulating material (foam type), nylon carpets, mouth washes, wood veneer, latex paints, detergents soaps, hair setting solutions and shampoos.
  • PERFUMES – heavily scented cosmetic, deodorants, sprays, tobacco, scented soaps, nail polish, strong cleaning solvents and synthetic clothing or garments have all been implicated in chemical sensitivity. Beauticians and hairdressers should be aware that some of their symptoms such as headaches, irritability and fatique may be due to scented products.
  • PESTICIDES – weedicides and agriculture chemicals must also be considered as potential problems in some individuals.
  • ARTIFICIAL – colourings and flavourings.
  • CHLORINATED WATER – is also a common culprit.Symptoms of chemical sensitivity vary quite widely and include headache, irritability, fatigue, hyper or overactivity, restlessness, anxiety, sluggish thinking, malaise, muscle pain, arthritis etc.

Nutrients That Decrease Chemical Sensitivity

  • Molybdenum are enzymes involved in the detoxification of various aldehydes, sulphites & nitrates.
  • Glycine, Taurine, BCAA, Methionine, are amino acids associated with the removal of toxic chemicals and metabolites from the body.
  • Thiamine (Vit B1) helps those excess intake exposure to formaldehyde, alcohols, glycols and it is also important in energy production. A relative deficiency will cause tiredness, weakness and anxiety.
  • Pyridoxine (B6), 60 percent chemically sensitive patients are deficient in B6, which is pyridoxal – 5 phosphate, which can be overwhelmed by exposure to aldehydes. Drugs such as contraceptive pills, amphetamine, chlorpromazine can all lead to a relative B6 deficiency.
  • Choline – ingestion of a diet deficient choline has major consequences that include hepatic, renal, memory impairment and growth disorders. All are seen in some chemically sensitive patients.
  • Folate B12 – chemically sensitive individuals are low in folate and 15% are deficient in Vit B12. Many medications such as aspirin, oral contraceptive and anti-convulsant interfere with absorption and metabolism.
  • Magnesium – Approximately 40% of chemically sensitive individuals are magnesium depleted. As magnesium involved over 500 enzyme systems.
  • Substances that deplete magnesium are pollutants, alcohols, diuretics, steroids, glucose, phosphate depletion and pesticides.

Nutritional Advice

  • Filter or boil all drinking water
  • Use toxic cleaning products sparingly
  • Reduce use of plastics, toxic paints and varnishes. When painting use odourless alkali based paints
  • Do not to wear synthetic under garments or clothes. Cottons & woollens are usually safe.
  • Do not use kerosene heaters, heating should be solar based or electrical.
  • An electric stove is preferable to a gas stove, and if not possible, ensure adequate ventilation within the cooking area.
  • Insulation material and floor coverings should be inert. Preferably hard, inert materials such as stone, terrazzo, hardwood, cement, brick and terracotta tiles should be used for flooring. Be careful of wool carpeting with latex or rubber backing.
  • Soft plastics, such as plastic bags, wrapping, plastic containers, and other plastics should be removed from the home. Use glass containers.
  • Remove any synthetic or rubber furnishing in the bedroom. Use cotton pillows, mattresses. Electric blanket should not be used. Cane hardwood, leather, wool or other fibre should be used in furnishings.
  • Other sources of chemical exposure are from chemicals released from glued parts and grouting, particularly when heated, chemicals used in hobbies such as photo copying machines, pesticides used indoors or in the garden, timber impregnated with chemicals, tobacco smoke.
  • Avoid all formulated foods or drugs that contain artificial flavourings, colouring or chemicals.