Monday, December 7, 2009

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Your daughter's first gynecological exam By SHAVAUGHN MOSS ~ Lifestyles Editor ~ shavaughn@nasguard.com: When should a female have her first visit with a gynecologist? That's a question 21-year-old virgin Agnes Rolle, has been pondering for a few months, but conflicting advise from friends and colleagues, and even her mother who is a nurse, has so far kept her out of the office. Some told her she should have already have had a pelvic exam done, but others including her mother say because she is not having sexual intercourse, she's okay. Rolle has listened to all sides and made up her mind on that and hopes to have her first gynecological visit before the end of the year. "I'm very curious about the process," she said. "I just want to ensure that everything's okay, because I know that even if you're not sexually active, problems can arise." She also admits to feeling nervous about her initial visit because she's heard a number of people talk about how uncomfortable it is. As she builds up courage to make her first appointment, she's asked around about a number of doctors. According to Dr. Carnille Farquharson, a family medicine specialist at the Holistic Family Medicine Centre, Tonique Williams-Darling Highway, Rolle is on the right track. "For the most part, and these are more recent guidelines now, it is usually recommended that all females have a pap smear by the age of 21 whether they're sexually active or not. Prior to that if [they are] sexually active [they] should get a pelvic exam and be tested for any form of sexually transmitted disease [STD]," she said. The gynecological exam is an important part of health care for all women as it evaluates the size and shape of the uterus (womb) and ovaries While Rolle's mother never took her for early examinations, Selia Miller who is just seven years old, could, in another five years possibly be making her first visit to a gynecologist, as her mother Nikkita, says if doctors say her daughter needs a pelvic examination during her early teenage years she would consent to it. "I would want to know why first, and then according to the answer go from there," said Miller who is in her early 40s "but if it's important that she have it done I would let them," she says. Miller herself isn't one of those persons who was taken by their parent to the gynecologist. She says as an adult she went for her first visit by herself. "Going to the doctor was not a normal routine in my family coming from the Family Island. People only went to the doctor if they were sick But I do my annual physical, so that's something I want to pass on to her." To get Selia comfortable with the doctor, Miller says she would start taking Selia from the time she hits puberty, so that it doesn't feel like a strange thing happening to her. "By going every year and doing the physical [the doctor] may say it's time now . . . so I would be following a medical decision, to ensure that nothing's wrong." Like Miller, Dr. Farquharson says more Bahamian mothers are receptive to bringing their teen daughters to their first gynecological visit and pelvic examinations, but do so under the guise of saying they want to ensure that everything is okay. She says more often than not it's usually because they just want the doctor to check whether their daughters are sexually active. But she says lots of mothers do bring their daughters and request pelvic exams. That she says also has its drawbacks, because it means the mother is not trusting of the daughter's behavior for whatever reason, as she believes the daughter for whatever reason is not truthful to her. Dr. Farquharson says a situation like this can make for a "sticky situation" with the doctor being caught in the middle, and having to do a lot of counseling. She admits that first gynecological visits can be traumatizing if they're not mature enough to handle it. She says a first gynecological visit is very emotional, and that with the mother there, it can make for a tense situation. The medical practitioner says if this happens the doctor should do his best to calm down both parties as much as possible and rethink whether the exam has to be done at that point, whether the child can come in at another time for a regular full physical and determine at that point whether the daughter would require a pelvic exam. As long as your daughter is not sexually active, nor having any problems, her periods are regular and she's healthy, Dr. Farquharson says they can have their initial pelvic examination or pap smear when they are 20 or 21 years of age. She says if your daughter is sexually active and having symptoms like a discharge, odor, pelvic pain you would want to have them checked out. If you do have to take your teen to the gynecologist, Dr. Farquharson says you should prepare your daughter for the visit, which she says can be traumatic, especially if it's occurring under a very emotional situation such as the mother just wanting to have her daughter checked out. The medical professional says females who are lesbians are sometimes of the opinion that they don't need a pap smear or pelvic exam because they have not been with a man, but she says sometimes just one of the lesbian partners having been with a man for just one intercourse experience is sufficient to pass on the virus, and that lesbian females should also have pelvic exams and pap smears done. With a pelvic exam, the doctor looks at the cervix for any lesions, discharge, or bleeding. Ovaries are checked to ensure that they're not enlarged or any tenderness. The uterus is checked to ensure it's a normal size and that nothing's abnormal. With a pap smear the doctor collects cells from the cervix itself, which is put on a slide, and sent to the lab to be examined to see if there are any abnormal cells suggestive of a viral infection or more specifically any pre-cancerous cells or cancer of the cervix. Dr. Farquharson says when a pelvic exam is performed, the hymen can be partially or completely ruptured, so that is always something that parents should always keep in mind. Monday, December 7, 2009