Menarche
Everything Dads &
Husbands Must Know About:
Feminine Hygiene, Gynecology & Menstruation
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Menarche:
When Your Daughter
Becomes A Young Woman!
By
the time your daughter reaches puberty, she should already be able to properly
care for her vulva, and her parents, have already taught her proper feminine
hygiene and vulva care.
Puberty in girls is the time when she changes from a girl into a young woman, who is able to become pregnant and become a mother. There are many changes that take place but the biggest change a girl will experience will be menstruation.
Special note to Dad's: Your daughter needs your love and
support now more than ever. Be involved!! Menstruation and growing up is a
normal part of YOUR daughter's life and not something to
shy away from. Talk with your daughter about these topics, let her know
that you know what she will be experiencing. And when she has her first period,
celebrate the day and make a big deal of it... take her out on a special
“daughter - daddy date" to her favorite restaurant, buy her flowers, take
her shopping.... let her know that you are thrilled about her
becoming a young lady!!
Some of the other changes a girl will notice will be that she changes from a
girl's body to a young woman's body. All girls develop and mature at their own
pace. In girls, puberty can start anywhere between age 9 and 14.
This
is what happens just before and during puberty:
ON
THE OUTSIDE
Her
whole body grows in height, weight and her waists expand and become contoured in
order to have the room in her pelvis for a baby.
Her breasts grow. Starting about 2 years before menarche or her first menstruation, the nipples on her breasts start to bud and her breasts begin growing.
Hair
grows in her pubic area, on the vulva, the labia majora, but not on the labia
minora - this area remains free from pubic hair. She also begins growing
hair on her underarms and legs. At this time, she may need some coaching from
her parents, dad and/or mom on hygiene issues, the need for deodorant, as well
as a course on feminine hygiene, and the different feminine hygiene products she
will be needing for the next 40 years or so!
Her
face will start producing extra amounts of oil, and even with proper washing,
pimples and/or acne may appear.
Her
genitals grow. This includes the vulva, the outer parts that can be visibly
seen. These parts include the labia majora, labia minora and clitoris. All of which begin to expand and grow. Before her first period, she may
begin noticing a discharge from the vagina that may be whitish in color. Immediately
prior to menarche - her first period or menstruation, the color of her vaginal
discharge may change to light brown. The labia
minora, or inner lips, begin to elongate and may protrude from the labia majora
or outer lips. The clitoral hood, which covers and protects her clitoris, becomes more pronounced.
Also,
her emotions will be changing as well. BE PREPARED!!
Parents need to be prepared for all of these changes and this starts with having
good communication skills with your daughter. Do not neglect this important time
in her life. Talk to her, encourage her and educate her. Make sure she can talk
to you about these changes, before these changes start!! If you are too
embarrassed to talk to her about sex, menstruation or what she will soon be
experiencing, buy a book on the subject, let her read it and make sure that she
asks you any questions she may have.
ON
THE INSIDE
The
genitals inside her body develop. They include the uterus and vagina.
Her
uterus grows.
Her
vagina gets longer and the vaginal walls get more elastic so they can stretch
wider, to allow for a baby to be delivered, someday!
As
girls go through puberty, they get taller, in a short time, they spurt in growth
and many become taller than boys of the same age.
When
do girls become young ladies, i.e. start to menstruate?
A girl becomes a young lady when she begins menstruating. Her first menstruation, or menstrual period, is called "menarche" which means the date she had her first period. A young lady's first period or menarche usually begins between the ages of 9 and 14, although sometimes as early as 8 and as late as 16. Her first period is also a sign that puberty has begun.
For
more information about your daughter's puberty, see Puberty: When Your Daughter
Becomes a Young Woman.
Special note to Dad's: Your daughter needs your love and support
now more than ever. Be involved!! Menstruation and growing up is a normal part
of YOUR daughter's life and not something to shy away from.
Talk with your daughter about these topics, let her know that you know what she
will be experiencing. And when she has her first period, celebrate the day and
make a big deal of it... take her out on a special daughter - daddy
"date" to her favorite restaurant, buy her flowers, take her
shopping.... let her know that you are thrilled about her becoming
a young lady!!
How
old will I be when I stop menstruation?
Women
normally menstruate until they are 45 to 55 years old, when menopause begins.
Menopause is when a female stops menstruation. An operation called a
hysterectomy, which removes some or all of the female reproductive organs, also
stops menstruation.
What
happens during menstruation?
Girls
have thousands of tiny eggs in their ovaries. Each month, or approximately every
21 - 42 days, on average, one of the eggs leaves an ovary and travels through a
fallopian tube. When the egg leaves the ovary, this is called ovulation.
Normally, the ovaries alternate each month, releasing an egg from the left ovary
one month and then releasing an egg from the right ovary the next month.
As
the egg travels in the fallopian tube, a soft spongy lining forms in the uterus.
This lining is mostly made of tiny blood vessels and is called the endometrium.
The lining gives nourishment in case an egg and sperm meet to form an embryo, or
baby, that begins to grow in the uterus.
If
the egg is not joined by a sperm, the endometrium or lining of the uterus is not
needed. It flows out of the vagina. This bleeding is called a period. This whole
cycle is called menstruation.
Menstruation is just one part of the menstrual cycle, in which a
woman's body prepares for pregnancy each month. A cycle is counted from the
first day of one period to the first day of the next. An average cycle is 28
days, but anywhere from 23 to 35 days is normal.
Estrogen and progesterone levels are very low at the beginning of
the cycle. During menstruation, levels of estrogen, made by the ovaries, start
to rise and make the lining of the uterus grow and thicken. In the meantime, an
egg (ovum) in one of the ovaries starts to mature. It is encased in a sac called
the Graafian follicle, which continues to produce estrogen as the egg grows.
At about day 14 of a typical 28-day cycle, the sac bursts and the
egg leaves the ovary, traveling through one of the fallopian tubes to the
uterus. The release of the egg from the ovary is called ovulation. Some women
know when they're ovulating, because at mid-cycle they have some pain--typically
a dull ache on either side of the lower abdomen lasting a few hours. The medical
word for this is mittelschmerz, from the German, meaning middle pain. Some women
also have very light bleeding, or spotting, during ovulation.
After the egg is expelled, the sac--now called a corpus luteum--remains
in the ovary, where it starts producing mainly progesterone. The rising levels
of both estrogen and progesterone help build up the uterine lining to prepare
for pregnancy.
The few days before, during and after ovulation are a woman's
"fertile period"-the time when she can become pregnant.
Because the length of menstrual cycles varies from one person to another,
many woman ovulate earlier or later than day 14.
It's even possible for a woman to ovulate while she still has her period
if that month's cycle is very short. Oftentimes, stress can play a role in this
occurring.
If a woman has sex with a man during this time and conception
occurs (his sperm fertilizes the egg), she becomes pregnant.
The fertilized egg attaches to the uterus, and the corpus luteum
makes all the progesterone needed to keep it implanted and growing until a
placenta (an organ connecting the fetus to the mother) develops. The placenta
then makes hormones and provides nourishment from the mother to the baby.
If an egg is not fertilized that month and the woman doesn't get
pregnant, the corpus luteum stops making hormones and gets reabsorbed in the
ovary. Hormone levels drop again, the lining of the uterus breaks down,
menstruation begins, and the cycle repeats.
In the illustration below, an egg has left an ovary after ovulation and is on its way through a fallopian tube to the uterus.
Most menstrual periods last from three to five days, but anywhere from two to seven days is normal. The amount of blood flow varies, too, but for most women, bleeding starts out light at first, followed by heavier flow for a day or two and then another light day or two. Sanitary pads or tampons, which are made of cotton or another absorbent material, are worn to absorb the blood flow.
Sanitary pads are placed inside the panties; tampons are inserted
into the vagina.
The amount of bleeding varies from woman to woman because
everybody's body has a different way of building up the lining of the uterus.
A lighter flow or heavier flow doesn't mean you can't get pregnant as easily or
you're never going to get pregnant, or that your periods will always stay the
same way. But if you're bleeding excessively-soaking one or more tampons or pads
an hour-you should see a doctor to see if there's a problem."
Teenagers often are concerned if they expel blood clots during
their periods. This is very normal and not dangerous. The menstrual clots are
clumps of pooled blood in the vagina. Sometimes, instead of flowing freely,
blood drains from the uterus and stays in the vagina until there's a change in
position--say, from sitting to standing.
Young
women experiencing their first periods often wonder, "will my periods ever
become “regular?”
When
a girl starts to menstruate, her period may not come on a regular schedule for
several years. Her periods may come three weeks apart, or even months apart.
Why
you need to keep track of my periods.
A
girl should keep a record so she'll know if her period is late. A late period
may be sign of pregnancy or one or medical problems that you should immediately
inform/visit your doctor. Also, your doctor can provide you with better care if
he/she knows about your periods.
How
do I keep track of my periods?
The
first day of your period is called Day 1.
The
period or bleeding usually lasts 3 to 5 days but 7 days is not uncommon.
Ovulation
(when the egg is released) happens 12 to 16 days before your next period starts.
Ovulation, and the days before and after, is the time when you are most likely
to get pregnant.
If
the female does not get pregnant, her period comes and the whole cycle begins
again, with Day 1 starting over again when the next period starts. The
whole cycle usually takes 21 to 36 days, but even 42 days is not unusual for a
cycle.
Will
I get cramps and how bad are they?
Cramps
are a common complaint.
More than half of menstruating women have cramp-like pain during their periods.
The medical term for menstrual pain is dysmenorrhea. Cramps are usually felt in
the pelvic area and lower abdomen, but can radiate to the lower back or down the
legs.
Many girls have cramps severe enough to keep them home from
school. In fact, according to Danforth's Obstetrics and Gynecology,
dysmenorrhea is the most frequent cause of absenteeism from school among younger
women. Women seem to go through phases when cramps are severe, then get better
for several years, and then maybe worsen again. Most women find they have less
menstrual pain after having children.
Cramps are like labor pains. Just as the uterus contracts to open
up the cervix (neck of the uterus) and push out a baby, it contracts to expel
menstrual blood. Often, after several years of menstruating or after childbirth,
the cervical opening enlarges. The uterus doesn't have to contract as much to
discharge the menstrual flow, so there is less cramping.
Menstrual pain may also come from the bleeding process itself.
When the uterine lining separates from the wall, it releases chemicals called
prostaglandins. Prostaglandins cause blood vessels to narrow, impeding the
supply of oxygen to the uterus. Just as the pain of a heart attack comes from
insufficient blood to the muscles of the heart, too little blood to the uterine
muscle might cause the pain of menstrual cramps.
Menstrual pain can have other causes, although these are rare
among teenagers. They include tumors, fallopian tube infection, and
endometriosis, a condition in which fragments of the lining of the uterus become
embedded elsewhere in the body
Cramps
are the actual uterus' contractions. The uterus, which is like a pear-shaped
muscle, helps get rid of the endometrium, or lining of the uterus, since
no baby will be growing inside. These contractions, that sometimes feel
like cramps, are the body's way of shedding, or getting rid the lining of the
uterus, through the vagina, and out of the body, as the lining is no longer
needed that cycle.
What about cramps?
Some girls have cramps during their periods. For most they are mild and can be helped by exercise, a heating pad or aspirin. If there is a lot of pain, very long a heavy periods. or very irregular periods or very irregular periods you should get a checkup.
What
can I do to help with cramps?
Cramps
are usually mild. They can be helped by exercise, warm bath, use of a heating
pad or pain relievers such as aspirin.
If there is a lot of pain, long or "heavy" periods (heavy meaning more
bleeding than normal), which means saturating a tampon or pad in less than 2-3
hours, or if you have irregular periods, you should inform your parents and ask
them to take you to your doctor for a checkup.
Can
I take a bath or shower during my period? What about exercising?
Menstruation
is a very normal part of every girl's life. During your period, you can do
everything you normally do, including daily baths or showers, exercising,
dancing and playing sports are all fine. In fact, you will feel better by
continuing your normal routine, and find that warm baths are a great way to help
with any cramping you may have.
Should
I choose sanitary napkins or tampons for my feminine hygiene choice?
Feminine
hygiene products come in all sorts of types, sizes, shapes, absorbencies, smells
(vulva and vaginal “deodorant” protection – which we recommend NOT using)
and materials.
Sanitary napkins or pads, absorb the blood from your period on the outside of your vagina. Most sanitary napkins are made with adhesive strips that you simply peel off the backing and then they will stick or adhere to your panties or pantyhose.
Can
I still take a bath during my period, or should I take showers instead?
Menstruation is a very normal part of every girl's life. When you get your period, you can continue doing everything you normally do. This includes continuing to take baths or showers. However, some girls may prefer to take showers during the days of their period that bleeding is heavier.
What are sanitary napkins and how do they work?
Sanitary napkins come in different shapes, styles, absorbencies, deodorant, non-deodorant, as well as thin pantiliners for light days and pads, for heavy days of menstrual bleeding. All sanitary napkins, pads and pantiliners are made with removable strips of paper that reveal adhesive tape that is made to stick to your panties. Other pads and pantiliners have wrap-around "wings" that wrap under your panties to keep it from moving or "bunching."
Some young ladies don't like the feeling of sitting on a pad and may choose a tampon and pantiliner on their heavy days.
What are tampons and how do I use them?
Like pads and pantiliners, tampons come in many different brands, sizes, styles, absorbencies and deodorant, perfumed and non-deodorant choices. Also like pads and pantiliners, tampons absorb the menstrual blood, except tampons absorb the menstrual blood inside of the vagina, instead of on the outside.
Tampons come in different sizes and thicknesses. They come in applicator and non-applicator styles. There are "slim" or "slender" tampons for young ladies who have never had intercourse, or given birth via vaginal delivery. Tampons can be used whether or not a girl has had intercourse. Tampons cannot get lost inside a girl's body.
Inserting a tampon the first time takes a little practice. It gets easier with each new period. You may want to go to the bathroom or close your bedroom door as you will want some privacy. To insert a tampon, remove your panties, remove the wrapper of the tampon, and get into a comfortable position. Using a mirror may help you find your vagina, and insert the tampon the first few times. The best positions are those that help expand the vaginal walls inside your vagina, to help ease the tampon into place. Some women like a squatting position, others are comfortable sitting on the toilet. In any case, you will want to spread your legs apart, and then using one hand, spread the labia minora, so that you can see or feel the entrance to your vagina. Keeping your legs apart, while keeping your labia minora separated, slowly insert the tampon toward the small of your back. You may need to use a little vaginal lubricant spread on the outside of the tampon for easier insertion. Insert the tampon until the ridges of the tampon applicator come in contact with the entrance to your vagina. Then, slowly insert or press down on the plunger, that pushes the tampon into the correct position inside your vagina. Once a tampon is properly inserted, you shouldn't be able to feel it. If you can feel the tampon, you are using the wrong size tampon, or may not have inserted the tampon far enough into your vagina. After pushing down on the plunger, and inserting the tampon, remove and discard the applicator, BUT NOT IN THE TOILET!
Make sure the string on the end of the tampon remains outside of your vagina.
Using the restroom with a tampon in your vagina is easy, simply move the tampon string to one side before urinating, so that you don't get urine on the tampon removal string. Going to the restroom may also be a great time to see if your tampon needs to be changed. One way of determining whether your tampon needs to be changed is by tugging slightly on the string. If your tampon seems to not want to come out, it's probably not time to change your tampon. If, however, your tampon seems to slide easily, this is an indicator that your tampon is saturated, or has absorbed as much blood as it can hold. Another indicator that it's time to change your tampon is that your vagina is leaking menstrual blood onto your panties.
Removing your tampon is also very easy. When you believe your tampon has absorbed as much menstrual blood as it can hold, it's time to change your tampon. Simply pull on the string of the tampon in your vagina. This will remove the saturated tampon. Then discard the used tampon in the trash - NOT IN THE TOILET! And insert a new tampon.
NEVER SLEEP OVERNIGHT WITH A TAMPON IN YOUR VAGINA AS THIS MAY CAUSE TOXIC SHOCK SYNDROME.
Most tampons come with a plastic or cardboard applicator to make it easier to put them in. Only the tampon remains inside the body.
For women who have had a vaginal birth, they wouldn't use the slender tampons because their vaginas have been enlarged due to vaginal childbirth. If they did use a slender tampon during their period, the slender tampon would not absorb all of the menstrual blood, and she would have leakage of menstrual blood from her vagina.
Adult women who have delivered vaginally, will choose the wider, thicker tampons that are larger than the slender tampons, due to the enlargement of their vaginas.
Tampons are shaped so that they can be inserted into your vagina and absorb the menstrual blood before the blood comes out onto the pad the monthly period. Many women refer to use a tampon to avoid any possible smells that are associated with menstruation, as the menstrual blood that is absorbed by pads and pantiliners, are exposed to the air, and not changing a pad or pantiliner frequently enough, may produce a menstrual smell that some find objectionable.
HOW OFTEN SHOULD TAMPONS OR NAPKINS BE CHANGED?
They should be changed often enough so that there is no unpleasant odor or the girl's clothes do not get stained. Changing tampons and napkins often can help prevent infections.
Tampons also absorb the blood from your period like a pad or sanitary napkin, but they do so internally. You place the tampon inside your vagina. Tampons can be used whether or not a girl has had intercourse and tampons cannot get lost inside your body.
Depending
on how heavy or light your menstrual flow is - which varies during each day of
your period, from light bleeding, to heavy, almost “gushing” bleeding, back
to light bleeding again, heavy – will determine the type(s) of feminine
hygiene product you may use. Some
women start out by using a pantyliner only. While the menstrual flow increases,
they may switch to a pad, and many women find they need to use a pad and a
tampon simultaneously for the best feminine hygiene results.
It
is very common for women to use a pad as "back-up" to a tampon, as a
tampon will leak if it is not changed when it is saturated.
Healthcare Marketing Services believes that it is
very important that you choose a tampon that is made from organic cotton or use another form of
feminine hygiene protection such as a menstrual cup or natural sea sponge
tampons.
Most
tampons come with a plastic or cardboard applicator to make it easier to put
them inside your vagina. Only the tampon remains inside the body, the
applicator, if you use this type, is dis-carded in the trash can after you
insert it.
NEVER FLUSH A TAMPON DOWN THE TOILET AS THIS
Tampons
have a string at one end that stays outside the body. To remove the tampon,
gently pull on the string, removing the tampon, and throw it in the trash can.
NEVER FLUSH A TAMPON DOWN THE TOILET AS THIS
How
often should I change my pad, tampon or alternative menstrual form of feminine
hygiene product?
Pads
or tampons (or other alternative menstrual form of feminine hygiene product)
should be changed often enough so that there is no unpleasant odor or your
clothes do not get stained.
IMPORTANT!
NEVER LEAVE A
TAMPON IN YOUR VAGINA FOR MORE
IMPORTANT!
NEVER USE OR APPLY
TALCUM POWDER
Changing
tampons and napkins often can help prevent infections.
What
is Toxic Shock Syndrome?
Toxic
shock syndrome is a rare infection that can happen during a woman's period. The
symptoms include a sudden fever of over 101 degrees or more, diarrhea (the
runs), vomiting (throwing up), muscle aches and a sunburn-like rash. If you have
these symptoms during you period, see a doctor right away.
To
help prevent toxic shock syndrome, you should follow these guidelines:
1.
Wash your hands before unwrapping and placing a new tampon in your vagina.
2.
Never use super-absorbent or deodorant tampons.
3.
Change your tampon at least every 4-6 hours (read the tampon manufacturers
information inside the box).
4.
Do not use tampons all the time and switch to a pad for part of each day.
5.
Do not use a birth control sponge or diaphragm during your period. During your
period it is preferable to use other methods such as condoms and/or foam.
Importance of Proper
Feminine Hygiene
and Vulva Care
Importance
of proper feminine hygiene and vulva care
Baby girls
are born with special glands that are located on the inner surfaces of the
clitoral hood. These glands produce an oily substance called sebum that
lubricates the glans of the clitoris. The glans of the clitoris is the end or
the tip of the clitoris that is sometimes exposed or can be exposed when you
retract the clitoral "hood." The clitoral hood is that portion
of the vulva where the labia minora come together above the vagina and urethra
and looks like an inverted "v" ^ . The clitoral hood
protects the clitoris and in particular, the glans of the clitoris which is very
sensitive.
The sebum that comes from the glands that surround the clitoris produces a shiny
appearance on the glans of the clitoris. When the sebum or oily substances are
not regulary cleaned or bathed away, it accumulates, and then it is called
smegma. Smegma has a white cheesy appearance, that becomes sticky and
begins to adhere to the skin surrounding the vulva with greater, the longer it
is not cleaned or washed away.
Without proper care and hygiene, the smegma will collect under the hood that
covers the clitoris and the glans of the clitoris, which can result in pain,
irritation and/or inability to experience orgasm. When the smegma is not
properly cleansed from the vulva, and in particular, the areas surrounding and
under the clitoral hood, the clitoral hood will adhere to the glans of the
clitoris, which is referred to as a "clitoral adhesion."
When the clitoral hood adheres to the clitoris, either partially or entirely,
this prevents the hood from properly protecting and caressing the glans, making
orgasm difficult or impossible.
It is very important for the glans of the clitoris to have adequate lubrication.
This permits the the clitoral hood to slide over the glans of the clitoris
easily and without undue sensitivity or discomfort. The clitoris, and
especially the glans of the clitoris, is usually most sensitive to frictional
stimulation, versus direct pressure. Womens masturbation methods almost always
involve sliding the clitoral hood in various back and forth or circular motions
across and over the glans of the clitoris. Without proper lubrication from
the glands next to the clitoris, pain will result in the stimulation of the
clitoris and when there is movement of the clitoral hood.
Importance
of washing and cleaning the vulva
The smegma
accumulations of the vulva, specifically in the area of the clitoris, needs to
be cleaned on a regular basis. Otherwise, the smegma can accumulate and
dry out, causing the smegma to harden beneath the clitoral hood, which causes
resulting irritation leading to significant pain. This can result in pain
during masturbation, vaginal intercourse, and perhaps when walking, or wearing
tight pants. In addition, using sanitary napkins may be painful.
This
accumulation of smegma also occurs in infants and preadolescent girls. Parents
should check their daughter's vulva for these accumulations of smegma at every
diaper change and bath by gently separating the vulva and looking for the
cheesy-white accumulations and gently wiping/cleaning away. Always be sure
to wipe her from the top of the vulva toward the bottom or rectum to prevent
germs and bacteria from entering her vagina. In mild cases the dried
smegma may only slightly irritate the clitoris, resulting in your daughter's
need to rub or scratch it. This can result in infants and young girls
masturbating frequently. The resulting redness, irritation, caused by the
frequent masturbation may conceal the primary problem. Adult women may also be
distracted by this mild irritation, feeling a need to masturbate or engage in
sex frequently. This sensation should not be confused with that of having an
erect clitoris. When the irritation is severe though, while the desire to touch
the area is there, the inflammation makes any contact extremely painful. So
accumulated smegma can either increase the desire for sexual contact, or make it
impossible.
Proper bathing and care of the vulva prevents clitoral adhesions
Preventing clitoral hood adhesions means that you need to retract the clitoral
hood each time you bathe or shower, and wash out the secretions from this area.
Most women need to be aware that simply wiping their vulva with a washcloth or
their hand may not be enough to keep it clean. The spaces between the
labia minora, labia majora and the area under the clitoral hood can retain the
sebum from the glands around the clitoris, as well as other accumulations such
as sweat, vaginal lubrication, toilet paper, menstrual fluid, urine, bacteria
and feminine hygiene products. The normal body fluids don't expose a woman to
any harm as long as they are removed before bacteria that are normally present
are able to reproduce, resulting in infection and odor.
Special "feminine" soaps and washes are not necessary to clean your
vulva. All one needs to use to clean the vulva is plain water. In fact,
the use of soap and feminine hygiene products can irritate the delicate genital
tissues. And douching is rarely, if ever needed, to cleanse your vagina.
Douches, vaginal deodorants or vulva deodorants, and chemical additives pose
unnecessary risks when applied to the vulva and vagina. These products have been
linked to increased cases of vulvo vaginitis and yeast infections.
Clitoral adhesions
Clitoral adhesions or labial adhesions limits or prevents the clitoral hood to
slide across the glans of the clitoris. If you have adhesions, when you
pull on your clitoral hood, the glans of the clitoris moves with it instead of
the hood retracting by itself, i.e., the glans of the clitoris moves with your
pulling the clitoral hood. This can be very painful.
You may not
be able to pull the hood back far enough to expose the entire glans if you have
clitoral adhesions. This could make cleaning the clitoral area difficult
if not impossible.
Minor
clitoral adhesions may be remedied by without the need for a doctor's
intervention. The clitoral adhesions may be released through pressure on the
clitoral hood. Things like bathing, masturbation, bicycle riding, and horseback
riding. If you do not properly wash your vulva in a manner that places
traction on her hood, or masturbate in a manner that causes you to pull back the
clitoral hood, you may not separate any clitoral adhesions that form, or prevent
the formation of adhesions in the future.
If you believe you have clitoral or labial adhesions, you may be able to
eliminate them by repeatedly pulling on your clitoral hood, in 360 degree
directions (up, down, left, right, rotating in circles as well), or by taking a
hot bath.
Clitoral
adhesions will not disappear immediately as it took some time for the clitoral
adhesions to form.
Women who
experience pain can ask their partner or doctor to examine their vulva, and
separating the labia, attempt to locate the source of the pain or by using a
mirror and seeking the source of the pain themselves. If you experience a
clitoral adhesion, either you or your partner can moisten a q-tip with baby oil
or vitamin E to clean and loosen the secretions. Remember, the clitoral hood
needs to "glide" easily over the clitoris. To lubricate the clitoral
hood and loosen the secretions underneath, you or your partner may want to
massage the area with a topical cream or baby oil. This may require you
and/or your partner to do this for several days or for several weeks. Due
to the sensitive nature of the clitoris and clitoral glans, it may be painful
during the cleaning or massage due to the adhesions.
In the event
you are unable to treat the symptoms of clitoral adhesions, and you or your
partner cannot determine the reason for the pain, a doctor may need to be
consulted. If your clitoral hood extends well past the glans, or if your
clitoral hood is thick or closed, the adhesions may be totally concealed, with
no visible indications. You should be very explicit in your office visit with
the physician regarding your pain and show him the exact location of the any
pain, even retracting your clitoral hood, if necessary for his viewing.
The clitoral adhesions caused by the accumulated smegma is caused by the two
tissues surfaces growing together, due to failure to wash away these
accumulations. As a result, the body tries to heal and eliminate the source of
the irritation, thus causing the tissues to fuse as adhesions. These clitoral
adhesions, or labial adhesions in the event the labia minora fuse together, may
also form as a result of the hood laying in constant contact with the glans of
the clitoris.
Additionally, either you or your partner may want to massage baby oil, vitamin
E, or a petroleum based lubricant or antibacterial ointment up under your
clitoral hood and on the glans of the clitoris.
Properly
cleaning of the vulva
Naturally,
one of the best ways to keep from having clitoral adhesions is through proper
washing of the vulva and to wash away the secretions before they turn into
smegma. Proper care of your vulva or your daughter’s vulva means to wash away
these secretions at every bath or shower. When you wash your vulva, it is
important for you to retract the clitoral hood and wash this area. Also, be sure
to wash the inner and outer portions and folds of the labia minora.
Parents can
teach their daughters how to properly wash their vulva and help prevent them
from experiencing the pain of clitoral or labial adhesions. Parents need to
educate their young daughters about the various parts of their vulva so that
they know they have more than "just a vagina," which they can't see,
but a clitoris, clitoral hood, labia minora and labia majora, that they can see.
Proper
cleaning of your daughter's vulva includes the following;
1. Gently spread the inner and outer labia and wash between them.
2. Place upward traction on the clitoral hood (in the direction of her
bellybutton) while washing the exposed surfaces.
3. The glans of the clitoris may not be exposed when you do this. If there are
adhesions, don't forcibly try to remove them.
4. Do not use any soap or other harsh ointments while cleaning away the, sebum,
secretions or smegma.
5. You may need to use a q-tip or cotton ball moistened with baby oil or vitamin
E to help loosen any stubborn smegma collections. If doing this, use another
q-tip or cotton ball that is moistened with water to remove the baby oil or
vitamin E.
6. Make sure that you are very gentle and use only light pressure when cleaning
your daughter's vulva due to the sensitivity.
7. When your daughter is old enough to understand how to wash her vulva, may
also be the right time to teach her the correct parts of her vulva, as well as
explaining that her vulva is "private," and that she should be the one
that cares for it. Also, when she is old enough, ask her permission to wash her
vulva at bath-time, or ask her if she wants to wash her own vulva, following
your directions to make sure that she removes the accumulated secretions or
smegma.
SPECIAL NOTE:
Talcum powder has been linked to numerous cancers, including vulva, vaginal,
cervical, uterine and ovarian.
NEVER USE TALCUM POWDER NEAR YOUR
DAUGHTER'S VULVA.
Instead of using talcum powder, you may want to consider the use of corn starch in this area, making
sure that the corn starch is used externally and never placed in or near her
vagina.
The
doctor says that our daughter has labial adhesions. What are labial adhesions?
Young girls, and even adult women may get “labial adhesions.” Labial
adhesions occur when the labia minora (sometimes the labia majora) or the
“lips” of the vulva surrounding the vagina — have become stuck together.
This happens to about 5% to 10% percent of all young girls.
Young girls and women with labia that are stuck or fused together should
immediately be seen by a pediatrician or gynecologist as the urine flow (and
menstrual flow in adult women) can become blocked and a serious infection or
infections are very likely to occur if she is not seen by a doctor.
What causes labial adhesions?
This probably happened because your daughter has little to no estrogen. Baby
girls get a large dose of estrogen while they're still in the uterus.
About one to two months after her birth, the maternal estrogen level drops off,
and this hormonal change can affect many parts of a baby's body, including the
lining of a girl's labia. Her labia may even stick together. This
"adhesion" of her labia can continue or come and go throughout
childhood, according to many pediatricians.
What can be done to treat labial adhesions?
First of all, parents should NOT try to pull or separate your daughter's labia
apart, since that might hurt. Unless the adhesion is causing any problems, it's
best to leave it alone. The idea of your daughter having labial adhesion
probably worries you more than it bothers her. However, if the adhesion
extends to cover the opening of the urethra and is trapping urine in the genital
area, then you'll definitely want to see your child's doctor about treatment.
Trapped urine can cause irritation and possibly infection. You'll know if your
daughter's labial adhesions are covering the urethral opening if you find less
urine in her diaper (for a young child) or she's having trouble peeing, or if
her genital area looks irritated, she's irritable and crying, and she has a
fever (due to infection).
Normally doctors prescribe a topical estrogen cream to treat the problem. Your
doctor will tell you to apply this cream directly to the affected tissue, and in
about two weeks it should unseal the labia. You'll probably start by applying
the cream two or three times a day, then two times a day, then just once a day.
It's important to reduce the amount of estrogen cream you use gradually. If you
just stop the treatment suddenly, the labia will close up again.
Will our daughter always have labial adhesions?
Your daughter may continue to have adhesion off and on throughout childhood, but
the labia tend to unstick when a girl approaches puberty and her body starts
producing higher levels of estrogen. Until then, though, there's no reason to
worry about the adhesion if it's not causing any problems. Many little girls
never even know they have it.
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