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Re: 19 yr old with vaginismus From: Douglas L. Madsen (dlmmd@fidalgo.net) Tue Aug 5 00:07:59 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Ealgail@aol.com: "Re: Why did you harm me?" Previous message: Ealgail@aol.com: "Re: 19 yr old with vaginismus" Maybe in reply to: douglas krell: "19 yr old with vaginismus" Next in thread: Deborah Wage: "Re: 19 yr old with vaginismus" I agree with Roger. The pts first visit is very often not for the reason advertised and most pts. will not bring abuse up esp. on the first visit unless specificallly asked. We have recently incorporated specific HX questions about current/past sexual/domestic abuse in our first OB intake taken by an RN at our office. I am shocked at the prevalance of positive responses. It may take several visits after the subject has been initially broached before the pt feels secure enough to admit this Hx. I now try to ask these open ended questions in all first pt visits, but sadly it has not become completely incorporated in my routine as of yet. Doug >Look carefully for a history of sexual abuse remembered or not. > >Roger Klam, M.D. > >> 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. >> > Doug Madsen, MD, FACOG Pvt. Practice Mount Vernon, WA Next message: Ealgail@aol.com: "Re: Why did you harm me?" Previous message: Ealgail@aol.com: "Re: 19 yr old with vaginismus" Maybe in reply to: douglas krell: "19 yr old with vaginismus" Next in thread: Deborah Wage: "Re: 19 yr old with vaginismus"

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