DR FLO: How to get rid of belly when sit-ups don’t work

Dr Flo, I am 40 years old. I gave birth via Caesarian section 10 years ago and since then, my stomach has never returned to a normal size. It is big and it hangs. I have tried doing sit-ups and going to the gym but it hasn't helped.

I end up losing weight everywhere else, yet my aim is just to lose the potbelly and not my curves. I have also tried taking slimming tea but it just made my stomach run, not smaller. Please give me a remedy, bearing in mind that I can't afford surgery (nip and tuck). Concerned Lady

Dear Concerned Lady,

The abdominal wall has several muscle layers. The ones closest to the skin, the “six-pack” muscles (Rectus abdominis), are two sheets of muscle on the left and the right that run from up to down and meet in the midline.

During pregnancy, the abdominal muscles and tissues expand because of the growing baby, and because of pregnancy hormones.

In many women (three out of five), this expansion during pregnancy or during labour leads to separation of the left and right rectus muscles (diastasis recti). This causes a pooch or bulging of the tummy. The bulge is more visible when you strain your abdominal muscles. You may also develop back pain, pelvic pain, urine incontinence or constipation.

As the muscles regain strength after birth, the gap starts to shrink. In some people, however, the separation does not correct completely. To check if you have the separation, lie on your back, legs bent, feet flat on the floor, then raise your shoulders up off the floor, supporting your head with one hand, and look down at your tummy.

Move your other hand above and below your belly button, and along your midline muscles and see if you can fit any fingers in the gaps between your muscles. A physical therapist can also check if there is separation and check the width using calipers. An ultrasound scan can also check the separation.

You need a skilled personal trainer to guide you to do exercises that are specific for the issue. Exercises that make the tummy bulge out like sit-ups and crunches may actually worsen the situation.

In cases where the separation is severe, surgery can be done to correct it.

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Dr Flo, I am 24 years old. I have been struggling with vaginal itching related to urinary tract infection for three years. I have tried all sorts of medication including Femicare, but it keeps coming back. When I am on my periods the itching goes away and comes back afterwards. What should I do? Kerrie

Dear Kerrie,

Vaginal itching is caused by abnormalities in the vagina, which is part of the reproductive tract. This is different from a urinary tract infection that affects the kidney, ureter, bladder or urethra.

In women, the reproductive tract and urinary tract are separate, though sometimes when you have a vaginal infection, it can cause symptoms in the urethra.

Vaginal itching is most likely due to infection. You may also have a foul smelling discharge that is watery, thick or chunky, or that is an abnormal colour (yellow or green).

The infection may be caused by fungi, bacteria or other organisms. To know the actual cause of the recurrent itching, it would be advisable to visit a doctor, so that a sample of the discharge may be taken and examined.

The doctor may also ask for a urine test. Once the diagnosis is established, you will be put on medication, and given advice on what to do in the future.

Vaginal infections are recurrent in quite a number of people. In fact, some women have to take antifungal tablets every month at the start of their periods.

The infections can be triggered by taking antibiotics, hormonal changes at particular times of the menstrual cycle or due to pregnancy, uncontrolled diabetes, weak immune system or even eating a lot of sugary foods.

To avoid infections, keep the area clean, wipe from front to back when you use the toilet, wear cotton underwear, avoid excessively tight underclothes like tights and bikers, and avoid use of scented soaps, feminine products and douches.

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