A survey by the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) pointed out that the average age of women in the first consultation with a gynecologist is 20 years. However, according to the Federation’s own guidelines and Dr. Karine Gavioli, gynecologist of the São Cristóvão Saúde Group, the ideal is that the girl starts earlier. “The ideal time to start medical monitoring is when the girl enters puberty and her body begins to transform, culminating in her first menstruation”, she explains.
At this stage, it is common for the girl to be afraid, ashamed or embarrassed, so the first consultation works more like a conversation, in which the professional will give guidance on everything that involves intimate health. Therefore, the specialist recommends that the patient take advantage of this moment to clear all her doubts.
To help at this time, Dr. Karine answered the seven most common questions girls can ask in the office:
- If I’ve never had sex, do I need to see a gynecologist?
The ideal is to start doing the gynecological accompaniment before having the first sexual relation, because in this way the professional will give all the necessary orientation so that she can start more safely.
The doctor recalls that lack of guidance can expose a woman to risks of STIs, unwanted pregnancy and other complications, which is why the conversation is so important.
- Does Pap smear hurt?
In order to detect altered cells in the cervix that may develop into a cancer, this examination is done at the doctor’s office. Despite the fears involving Pap smear, it is a painless and quick procedure. “Some girls feel a slight discomfort when scraping their cervix, but as they manage to relax, this sensation diminishes a lot,” says the gynecologist of Grupo São Cristóvão Saúde.
The Ministry of Health recommends that this examination be carried out from 25 years after a woman begins to have sexual intercourse, and after two normal examinations with an interval of one year between them, this examination can be done every 3 years. However, the gynecologist will examine the patient annually and individualize each case.
- Which contraceptive method is best for me?
There are several methods, according to the needs and profile of each patient. For example, injectable methods, IUD, implant or adhesive are indicated for people who do not want to take the pill every day or have difficulty remembering to take it. There are also different types of oral contraceptives according to each patient’s needs. “It is important that this choice is made together with the doctor, because he will help the patient to assess what are the advantages and disadvantages of each method, thus defining the ideal for her,” explains Dr. Karine.
- I have a history of breast cancer in my family. Do I need a mammogram?
There is no consensus on the age at which to start the screening that helps identify breast cancer. Following the orientation of Febrasgo and the Brazilian Society of Mastology (SBM), it is recommended either from the age of 40. However, each case is unique.
The gynecologist says that the history of breast cancer in the family is a factor to be considered yes, but other elements will be used by the doctor during the consultation to identify the need to do the examination before 40. It is important to stress that, although a little uncomfortable, this examination is quite simple and extremely important.
- What kind of diseases can I get if I don’t use a condom?
Regardless of the contraceptive method chosen, it is important to remember that the condom is always necessary as it protects against Sexually Transmitted Diseases (STDs). Besides being the only form of protection against HIV, the condom should also be used to avoid problems such as syphilis, herpes, gonorrhoea, chlamydia and others.
- Irregular cycle and secretions, when should I worry?
Every woman has vaginal secretions and this is normal when her colour is light and the texture, fluid or thick, produces a light smell. The gynecologist of São Critóvão Health Group explains that the secretion needs to be investigated in case of changes in any of these characteristics.
“When the woman smells a strong smell, changes in the colour of the secretion (greenish, greyish) or feels important vaginal itching, it may be a sign of infection,” she explains.
In the case of the menstrual cycle, it usually has an average of 28 days, with menstruation occurring for three to seven days. According to the doctor, in the first two years after the first menstruation, it is common to have changes in time and monthly flow. If the cycle remains irregular, it is necessary to look for a gynecologist, who will verify possible complications.
- I feel pain during penetration, is that normal?
According to Dr. Karine, some women may feel pain during intercourse, especially with penetration. This is the kind of doubt that usually generates embarrassment and, because of that, unnecessary suffering. The doctor explains that by sharing this issue with the gynecologist, he can help discover the origin of the problem, which can often be simple.
“If the pain is deep, the cause may be endometriosis, the presence of polyps or STIs; if it is superficial, it may be an allergy or stress, investigate the cause and appropriate guidance may minimize this discomfort,” he comments.
And to make the first visit to the gynaecologist even more relaxed, the specialist gives a tip. “The girl can go to her first appointment with her mother, for example, which helps to reduce anxiety and embarrassment before the doctor. Or, if she prefers, she can also talk to the doctor alone, whatever feels more comfortable”, she suggests.
In addition, it is worth noting that consultations always take place under secrecy. The patient can trust her doubts to the specialist without fear of having her life exposed to other people. “The office should be a place where the patient feels at ease to clarify her doubts and does not feel embarrassed or judged when exposing her personal life,” says the gynecologist. She comments that only cases of suspected abuse, serious illness or risk of life are shared with parents or guardians.
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