Re: 19 yr old with vaginismus
From: Ronald R Helm (rrhelm@juno.com)
Mon Aug 4 11:03:55 1997
Actually, even in the Pap crazy USA, a Pap smear is not indicated at age
19 unless the patient is sexually active. Ron
On Mon, 4 Aug 1997 09:29:49 -0500 Malcolm Griffiths
<malcolm@mgriff22.demon.co.uk> writes:
>In message <33E57F9B.37D8@club-internet.fr>, Bernard Cristalli
><bcrist@club-internet.fr> writes
>>douglas krell wrote:
>>>
>>> A older patient of mine brought her 19 yr old daughter in to see me
>last
>>> week for a PAP. Upon trying to insert a narrow pederson speculum,
>it
>>> was apparent that the patient suffered from vaginismus. The hymen
>was
>>> not intact.
>>>
>>> She complained of severe pain in the vaginal introitus for as long
>as
>>> she could remember. She had never used tampons nor has she had
>sexual
>>> intercourse. She never recalls even having touched her own vagina.
> Her
>>> 17 year old sister has already had a baby and the patient is now
>>> beginning to worry that she is not normal. She has a boyfriend who
>is
>>> beginning to suspect that there is a problem since the patient
>shows no
>>> interest in sexual activity of any kind.
>>>
>>--
>>
>>An exam under general anesthesia is not a bad idea. It would allow
>you
>>to affirm she's normal. Then refer her to a head shrinker or
>sexologist.
>>
>So far the only real problem is a 19 year old who's difficult to do a
>pap on. You didn't say she had a complaint. I think it's refreshing
>that
>she isn't repaeting the sisters mistake of teenage pregnancy. Not
>everyone wants to lose their virginity in their teens. If you think
>she
>is likely to be about to attempt to try sex with her boyfriend
>offering
>contracrtion would be an good idea.
>
>What do you want to do a pap on a 19 year old for ? Don't tell me
>because its the USA ! :-)
>Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt
>Obstetrician & Gynaecologist Luton & Dunstable Hosp., LU6 2DT, UK.
>Tel: 01582-497459 (office) Fax: 01582-497376
> 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk
>http://www.obgyn.net/board/griffith.htm
>"It is dangerous to be right on a subject on which the established
>authorities
>are wrong." (Voltaire) "But sometimes it's fun :-)" (Griffiths)
>
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