By Mary Jane Minkin
With heat and figuring out, Dr. Minkin and coauthor Carol V. Wright reply to questions about the gynecological concerns that challenge girls this day, together with sexual intercourse, birth control, and family members making plans. Readers of The Yale consultant to Women’s Reproductive health and wellbeing will learn how the feminine physique works, what difficulties could come up, and what suggestions are available—in brief, they are going to develop into greater ready to take part of their personal overall healthiness care and to make fit decisions.
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Additional resources for The Yale Guide to Women's Reproductive Health: From Menarche to Menopause
A pathologist centrifuges the solution to gather the cells and puts the concentrated cells onto a glass slide. This is called a thin-prep or autocyte Pap test; its advantage over the older method is that the sample contains more cells for examination. For the last ﬁve or six years, insurance companies have been willing to pay for this test, which costs between twenty-ﬁve and ﬁfty dollars. After the Pap test and possible sampling of cervical secretions, your doctor will remove the speculum as gently as possible.
Sometimes women ask me if it is absolutely necessary to use the stirrups; unfortunately, it is. If you have severe arthritis or other disabilities that prevent you from getting your feet 20 ᮣ you and your gynecologist into the stirrups, the oﬃce nurses can hold up your legs for you. It is possible to do pelvic exams on women with hip problems and even spinal cord injuries, though achieving the correct position is a little more diﬃcult. Once you have your feet in the stirrups, you should just let your knees ﬂop apart and relax like a rag doll.
I usually suggest that girl and mother talk to their pediatrician (most girls this age still go to a pediatrician for their general care). If their pediatrician is not well versed in these matters, he or she can always consult with a gynecologist or an endocrinologist. There are a couple of anatomical causes for primary amenorrhea, but they are quite rare. One is an imperforate hymen, which means that the hymen is completely closed, leaving no way for the menstrual ﬂow to exit the body. Tracey was sent to me by her pediatrician when she was 14 years old, because she had cramps every month but no menstrual ﬂow.