When your child becomes a woman
A young girl should be taught women’s health and gynaecological issues when she gets her first period, writes Nadia Badarudin
It is important for mothers to discuss sexual and reproductive health issues with their daughters as soon as they reach puberty.
IF you are a mother of a teenage girl, one of the main things you will naturally be concerned about is her sexual and reproductive health. Some mothers may find it easy to discuss the journey of becoming a woman as soon as their daughters have their first period. But there are also those who avoid the subject because they feel embarrassed, they are not sure when to start talking about it, or they think adolescents are too young to understand.
In some countries, it is recommended that young girls see a doctor who specialises in women’s health as early as 13 years old.
For instance, the American College of Obstetrics and Gynaecologists recommends a first visit to an obstetrician and gynaecologist be between the ages of 13 and 15.
The first visit is mainly intended for girls to learn about body image, weight management and immunisation, among other things.
Full examinations are recommended, including pelvic examinations and pap smears, when girls reach 21.
When should a woman start to be concerned about her gynaecological health?
Dr Shilpa Nambiar, consultant obstetrician and gynaecologist at Prince Court Medical Centre in Kuala Lumpur says a woman should start to take care of her gynaecological health as soon as she starts to menstruate.
“It’s important for a woman to be concerned about her sexual and reproductive health early or as soon as she attains menarche or gets her first period. “When she can menstruate, it means that she can now reproduce. Thus, it’s important for
her to know what’s normal or what’s not about her reproductive health as well as take the necessary precautions to prevent any negative consequences she says.
“Living in a progressive society where information is easily accessible through a variety of information portals and social media, it’s definitely important for young girls to have parental guidance as well as access to right information and medical advice from specialists,” she adds.
According to Dr Shilpa, there are four common gynaecological issues that mothers and young girls should be aware of (and might warrant a trip to the doctor).
1. IRREGULAR MENSTRUAL CYCLES AND PAINFUL PERIODS
It is normal to have irregular cycles during the first two years of menstruation. However, having no period for three months or more may be a sign of a hormonal imbalance that needs investigation. Polycystic ovarian syndrome is a condition that is characterised by irregular and scant periods. Other hormonal issues like thyroid hormone abnormalities may also initially present with irregular periods
Some discomfort especially during the first two days of menstruation may be normal but pain that starts before a period and continues throughout menstruation, severe menstrual cramps that interfere with normal daily activities, chronic pelvic pain or heavy bleeding are not normal and could be a result of a condition such as endometriosis. A young girl who still hasn’t had her
Dr Shilpa Nambiar says a woman should take charge of her gynaecological health as soon as she starts menstruating. 2. SEXUALLY-TRANSMITTED INFECTIONS
The World Health Organisation estimates that one in four sexually active adolescent females has had a sexually-transmitted disease (STD), with many contracted after the first sexual encounter.
Sexually-transmitted infections (STI) such as chlamydia, genital herpes, HIV and AIDS, human papillomavirus or HPV and gonorrhea are dangerous because they can lead to infertility, chronic pelvic pain and other life-long health conditions.
They are passed on from one person to another mainly through sexual contact. Some STIs can be spread through the use of unsterilised drug needles, blood transfusions, from mother to baby during childbirth or from breastfeeding.
3. CERVICAL CANCER
Statistics show that cervical cancer is the second most common cancer after breast cancer among women in Malaysia. Here, a total of 4,000 new cases are reported every year since 2006, with five in 100,000 females diagnosed with the condition. Chronic HPV infection is responsible for more than 90 per cent of cervical cancer.
Cervical smear or pap smear is the main screening form for cervical cancer as it has been proven to reduce incidence by 43 per cent.
It is recommended for a sexually active female to have two annual normal cervical smears before reducing the frequency to once in three years. (For example, if she has a test in 2016 and another one in 2017 which are both normal, the next screening will be in 2020. It is important to note that they are normal because if the smear is abnormal, the frequency may be every 6 months or even warrant further treatment)
Vaccination is also another alternative to prevent the disease. Currently, the Health Ministry provides the HPV vaccination (given in a series of three shots) (reduced to two injections now) for free to all Form One girls. Those aged 13 who have left school can get vaccinated from a government health clinic.
4. POLYCYSTIC OVARY SYNDROME Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in females. In adolescents, infrequent or absent menstruation may raise suspicion for the condition.
Common symptoms are weight gain or obesity, increased hair growth on the face and body and skin tags. The exact cause of PCOS is unknown but early diagnosis and treatment can help prevent long-term complications such as type 2 diabetes, heart disease or cancer of the womb.