A woman's he alth is closely related to the secretion of sex hormones. They decide about the psyche, the appearance of the skin, and the way in which adipose tissue is deposited. Estrogens rule, but for our femininity it is also very important how we look after our body. - And from an early age - emphasizes prof. dr hab. n. med. Violetta Skrzypulec-Plinta.
Owomen's he althI asked prof. dr hab. n. med. Violetta Skrzypulec-Plinta, gynecologist and sexologist.
- Should care for a woman's he alth start already in the cradle?
Prof. Violetta Skrzypulec-Plinta : Of course. After all, even in a newborn girl, disturbing symptoms may appear in the form of spotting or vaginal bleeding, which are related to the estrogenization of the mother's pregnancy. In the early childhood period, when a girl begins to develop, the labia may stick together (clumping). This requires the rapid implementation of hormone treatment (estrogens) or surgery to separate the labia. Before the first menstruation, inflammatory changes occur most often in the area of the external genitalia. Usually the cause is, for example, allergic dermatitis. After the first menstruation, the changes affect the internal genitalia and are usually associated with urinary tract infections. These infections may have a bacterial, trichomonal, fungal, viral background.
- What is the most common infection in little girls?
V. S.-P. : Infections in little girls often result from their inability to maintain hygiene. The role of parents is to educate children about their sexuality from an early age, where the most important component is personal hygiene. The difficulty begins when the infection returns several times a year. It is then important to check that your child is free from parasites (e.g. pinworms). In the case of frequent infections, one thing is very important to keep in mind - sexual harassment, which is not uncommon at all. Last week, I had two forensic examinations of a girl who was molested by someone in the family. And here is another missing element of educationsexual. Out of misconceived shame, we don't talk to our children about good and bad touch. We do not warn that even someone close to us can hurt us.
- Who is most at risk of sexual harassment?
V. S.-P. : They are usually moderately mentally retarded, slightly obese girls. But whether a girl is intellectually fit or not, it is important to talk to her about puberty. About the fact that her figure will begin to change, that her breasts will grow, hair will appear, she will menstruate and what that means. Education is irreplaceable. It should be remembered that intellectually disabled girls grow up physically in the same way as non-disabled ones. It is a big mistake to pretend that this does not apply to them. If we do not prepare her for menstruation, it will treat it like a dirty thing, it will hide the fact of menstruation, and this will create more emotional problems.
V. S.-P. : At the age of 8-9, the first hair growth appears, the breasts begin to grow, and finally it's time for the first period. Here again, the role of mothers cannot be overestimated, and they should teach the girl not only proper hygiene during menstruation, but also introduce the habit of recording the dates of subsequent periods. For girls who come to me after their first menstruation, I teach breast self-examination. I repeat to mothers that it is worth taking a look at their daughter's diet, encourage them to eat vegetables and fruits, to play sports, because all this will bear fruit later.
V. S.-P. : It's natural, because hormones come to the fore. Girls aged 15-16 years have more sexual initiation than boys of this age. This tendency is observed all over the world. However, in Poland, the problem is the attitude of adolescents to sex. They learn about it mainly from the Internet. Unfortunately, no one tells young women about the effects of spontaneous sex. If we only show the bad consequences of early and "spontaneous" sex life, we can expect the right attitudes in this regard. Scaring with pregnancy won't do anything, because that's not all it is about.
V. S.-P. : You have to emphasize the value of the relationship. Now the lack of feeling, commitment, almost mechanical approach to sex and, finally, a low level of knowledge about it is common. Last year, oral sex was the most popular, including -anal sex. And young people often think that this is not sex at all because it does not make children. For many, sex is only when it comes to vaginal penetration. And let no one think that this is a distinguishing feature of youth from the margins or from "broken" cities. The same thing happens in the villages, only the circumstances of nature are different. Risky sexual behavior is everywhere. I'm not a puritan, but it's hard to consider it appropriate to undress in front of the camera and upload videos to the web.
V. S.-P. : Various. A lot also depends on the parents. Polish law allows the use of hormonal contraception at the age of 16-18, but only with the consent of the caregivers. More and more often, mothers come to the office with their teenage daughters and give their consent to use contraception. It's cool because you can protect girls against unplanned pregnancy. But the pill alone is not enough: it protects against pregnancy, but not against sexually transmitted diseases. The method most recommended by WHO for young women is hormonal contraception (tablet, patch, ring, IUD, implant) and a condom. Our daughters' first loves are usually great, spontaneous, and our role is to make them go through them wisely. This is another element of sex education.
ImportantWho is avoiding the gynecologist?
The most educationally neglected group of women are women 40+ and 50+. This translates into their he alth. They are the least frequently examined and often do not have their own gynecologist. And they often develop endometrial or cervical cancer - cancers that should not happen at all, because by systematic control they can be detected early and cured. In addition, some cancers that were once diagnosed in women in their 80s are now affecting 50-year-olds (e.g. vulvar cancer). Young women are more educated because they can navigate the Internet and gain knowledge on their own.
You mentioned genital tract infections in young women. Are there really so many of them?
V. S.-P. : A lot. Mycosis, bacterial infections, mixed infections that are difficult to heal are the daily life of a gynecological office. There are many reasons for frequent infections: from inadequate diet to risky sexual behavior, such as frequent changes of partners.
With time, however, the girls want to settle down and start a family.
V. S.-P. : That's true. Women who do not want to pursue a career decide to have a child fairly quickly. However, it often happensso that women aged 40+ become mothers. Regardless of age, all women should know that they should take folic acid before pregnancy to protect their baby from birth defects. But they don't. Anyway, what can we say about folic acid supplementation, since 3/4 of pregnancies in Poland are not planned.
And what should mature women deal with in terms of their he alth?
V. S.-P. : In the period of 35-45 years, women expect effective contraception so that they can develop, work and not think about pregnancy mishaps. But they forget that from the age of 43 the time of perimenopause begins. There are significant changes in the functioning of the body, irregular menstruation. One day we wake up in sweat, the world is strange, the husband is less handsome, the son-in-law is terrible, all because our hormonal profile has changed. We go to the gynecologist and it turns out that it's already menopause. However, in my opinion, it may be the most fun time in a woman's life if we prepare well for it. This is not the end of an attractive life - if we have a developed habit of going to a gynecologist, doing cytology, mammography, and self-examination of the breasts. Naturally, during this period, there may be distressing he alth problems. Often, female patients complain that they do not want sex. However, when you ask them delicately, it turns out that they do not want close-ups, because they are painful for them. After all, medicine is great at dealing with atrophy, that is, vaginal dryness. Sometimes therapy with hyaluronic acid is enough, and after the problem! The joy of life and the desire for sex come back. This is, of course, an option for women who want to be sexually active.
Women are still reluctant to do preventive examinations, although it is known that thanks to them it is possible to detect many diseases early.
V. S.-P. : Reluctance to be regularly tested is a serious problem. More than once I hear: “Why should I test myself, they will find something else for me. I have so much on my mind, it's better not to know what's wrong with me. " No, it's not better. If I know, I can do something, I can save myself. There are tests for women in certain age groups that allow you to control your he alth. Many of the simple and painless tests can be lifesaving. You have to do cytology, ultrasound or mammography. But just as important is self-examination of the breasts. When I hear from a 30-year-old woman that I am the first doctor to examine her breasts, I am sorry and ashamed of my colleagues. A woman should demand tests and a reliable assessment of her he alth. And if she doesn't get it, she should change the doctor. In the gynecological office, you need to require disposable equipment, a bandage covering the hips, breast examination,perform a cytology and submit the test result.
In older ladies, many problems arise from the cessation of ovarian function.
V. S.-P. : Yes, but most of them can be remedied. The doctor should gently ask about urinary incontinence, painful intercourse. It is best to have such a conversation at a desk, not when the woman is lying on the gynecological chair. According to research, 40 percent. women then do not understand what is said to them. They are tied up, and it's no wonder. If a woman suffers from urinary incontinence, there are treatments that will greatly improve bladder control. It happens that a woman in perimenopause suffers from itching of the reproductive organs. It is an unpleasant ailment, but very good results are obtained, for example, by laser therapy, vaginal hydration, and hyaluronic acid globules. Aesthetic gynecology offers many good ladies of all ages. If a mature woman has enlarged labia and therefore cannot sit, ride a bike or have sex because it hurts her - you can help her. There is advice for everything, but the basic condition must be met: the woman must come to the appointment, she must tell the doctor about her problem.
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