First gynecological examination: at what age it should be done, in which cases anticipate it
Accompanying a girl in the path of knowledge of her body and reproductive health is a crucial moment, which should be faced with common sense and correct information
There first gynecological visit It is an important moment in the life of a young woman: it serves not only to do preventionbut also to create awareness. And it must not be experienced as a traumatic or medicalizing moment, but as an opportunity. Often the girls show their need, other times it is mothers who bring their daughters with them by their gynecologist, perhaps against desire and without a real reason if not their anxiety. But then at what age Is it right to start? We asked Dr. Tiziana Casalena, gynecologist of Humanitas Medical Care of Varese, to clarify.
When to make the first visit
« In Italy, unlike what happens in the United States, where there are guidelines that indicate to start in the age group between 13 and 15 years old, there are no official indications -explains Casalena -. We must be guided by common sense. If the menarca It happened in an age included between 11 and 13 yearsThe cycle not And excessively abundantThe pain And manageable with simple painkillers and cycles they are enough regularalthough not always respecting 28 days, there is not generally reason for concern. It can be useful to perform an blood and iron to exclude a possible anemia from iron deficiency. In these cases – continues the gynecologist – the first visit can be postponed When the girl begins to have a partner or has recently taken sexual activity. The first meeting with the specialist will not be invasive, but will be based mainly on a counseling, which can include information on contraception, prevention of sexually transmitted diseases and correct lifestyles. Often the mothers ask for advice for teenage daughters ».
Symptoms not to be underestimated
Some symptoms must not be underestimated. «If the cycle And painful, very abundant And limits daily life of the girl, making her absence at school or precluding physical activity, is right go into detail – Casalena recommends -. Behind these symptoms could be hidden pathologies such as theadenomyosis or theendometriosiswhich affect about 10-15% of women of fertile age. Also a cycle very irregular, with intervals of 3-4 monthsaccompanied by acne severe or hair, it must be deepened, since it could indicate thepolycystic ovary. This syndrome, if not treated, can compromise future fertility and strongly affect the quality of the adolescent life. If the menarca And delayed, and 16 years old has not yet occurredbetter to undergo one visit – suggests the gynecologist -. The same goes for the presence of vaginal infections. Some, like the candidaare not necessarily sexually transmitted, but can have endogenous origin in girls who have never had sex, since they derive from intestinal microorganisms. Finally, the amenorrhea prolonged, or the absence of the cyclecan be linked to eating disorders ora drastic diets: in these cases a multidisciplinary approach is fundamental that involves not only the gynecologist, but also a psychologist and nutritionist ».
How the first visit takes place
The gynecological visit to adolescence does not necessarily involve a complete examination. “We always start from a Comparison with the girlrespecting his times and needs. In many cases, an observation of the external genitals is sufficient to verify normal anatomy and a pelvic ultrasound transdominal with full bladder, a non -invasive technique – explains Dr. Casalena -. Unfortunately, adequate sexual and emotional education is still missing in Italian schools. In this phase the gynecological examination it can become a precious moment to talk about prevention. It is important that girls know that, among the sexually transmitted infections, even less discussed pathologies such as the clamidia They may have important consequences on future fertility. For this reason, the use of barrier methods must always be encouraged. Among the fundamental themes, the vaccine against theHPVthe human virus papilloma, which is recommended starting from 11 years For males and females. Administered before the start of sexual intercourse, the vaccine guarantees a more effective immune response and prevents about 90% of the tumors of the uterine cervixin addition to benign injuries such as i Condilomas. Before the age of 15, two doses are enough, after three there are. Finally, the gynecological examination can be a precious opportunity to promote The self -evasion of the breastfundamental to learn about his body, « concludes the gynecologist.
