Irregular menstruation periods in PUBERTY are normal, but can be TEEN PREGNANCY also, if sexually active.

Irregular or missed menstruation periods after the first MENARCHE, during the next year or two are very common. In some girls this irregularity on menstruation cycles continues for many years, before it regularise to its MONTHLY cycle. The girls may conceive, become pregnant and mother in their teens due to early teen marriage.  Also due to incidents of rape on teen girls and the rising levels of promiscuity among teenagers are causes of concern leading to teenage/adolescent pregnancy.

Puberty is the stage of adolescence when a girl ovum gets mature and can sexually reproduce. A preteen girl can become pregnant even before her first menstrual cycle, as ovulation, the release of first egg from the ovary, does occur before the first period (MENARCHE). The first ova-ovum-egg can become fertilized. A teenage girl can get conceived without actual penetration also. The sperm can travel upwards from the external genital area and result in pregnancy. It is therefore very important for teenagers to have proper knowledge and understanding of their body and its functions to avoid sexual abuse/molestation or before marriage or becoming sexually active.

The teenage pregnancies due to marriage or sex between unmarried teenagers have issues concerning the higher rates of nutritional and obstetric problems associated. Also, the ignorance and immaturity can result in higher health risks among teen mothers and their babies. The symptoms of a teenage pregnancy are not different from a normal pregnancy. But similar symptoms during PUBERTY except vomiting may occur due to hormonal changes or other reasons.

* Breast enlargement and breast tenderness

* Irregular vaginal spotting or bleeding

* Stomach cramping & Fatigue

* Increased drowsiness and moodiness

* weight gain

* Missed period

* Nausea/vomiting

Unfortunately, the teen girls with irregular periods may not even realize that she is pregnant until well into the fifth month of pregnancy – when she starts feeling the baby’s movements. In spite of experiencing above symptoms many teen girls do not tell anyone due to unawareness or embarrassment, and as such often go unnoticed by friends and family.

Any teen girl who experiences irregular or absent periods or any of the symptoms and (who is sexually active / molest /incest/rape), is advised to undergo a pregnancy test. This should be done by self or by gynaecologist if any sexual intercourse has happened with her. An early diagnosis of pregnancy helps the teen girl to adjust emotionally and physically.

Usually, pregnancy is associated with weight gain but if nausea and vomiting are significant there could be weight loss. Pelvic examination by a gynaecologist may reveal coloration of vaginal walls, coloration and softening of the cervix, and softening and enlargement of the uterus. Finally, an ultrasound sonography may be done to confirm the current status of the pregnancy.

The ultimate "cause" of teenage pregnancy is being sexually active. A sexually active teenager who does not use contraception has a 90% chance of becoming pregnant within one year. Many teenage brides become pregnant within a year of married life due to unawareness on sexual relationship and pregnancy. Some behaviour patterns for a teen girl becoming pregnant include:

* early dating behaviour

* Unhealthy/sexual abuse environment

* high-risk behaviours (smoking, alcohol )

* lack of a friendly support group

* stress and depression and lack of love from parents/family

* exposure to sexual violence

* financial gains

 
Indian society does not accept unwed mother, teenage or adult. She experiences isolation, guilt accompanied by stress and depression, low self esteem resulting in lack of interest in studies, limited job prospects and lack of a support group or friends.  Such condition may lead to suicide due to teen pregnancy.

Health wise married teen mothers have a much higher risk for anaemia, pregnancy-induced hypertension, genital tract infections (which may lead to premature labour and delivery), large baby within a small pelvis and sudden infant death syndrome. The major complications in young mothers are thought to be iron deficiency, anaemia, disproportion and birth of low weight unhealthy babies.

Similarly, infants born to such teenage mothers are at higher risk of complications of pre-maturity, low weight, accidental trauma and poisoning, minor acute infections, lack of immunization or vaccinations and developmental delays. While sexually active teen girl in the non-pregnant state has a high possibility of getting sexually transmitted diseases (STDs), chronic pelvic pain, cervical cancer, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS).

Pregnancy at teen age especially an unwanted one leads to severe emotional and mental trauma for the girl. Hence, important programs are those effective in delaying attempts at sexual intercourse. Parents, schools and healthcare professionals should have open, honest, and educational talks with teenagers and preteens. Parents can also provide advice to teenagers about how to prevent unwanted teenage pregnancy.

Since unprotected sex is the cause of teen pregnancies, contraceptive counselling of married or unmarried teen girls; is highly important. Birth control pills, the most popular form of contraception should be taken regularly or as advised else risk of pregnancy. Barrier methods such as condoms, diaphragms, and foam have high failure rates among teenagers, due to sporadic and improper use. To avoid pregnancy in the event of unprotected sexual intercourse, teenagers should be made aware to inform parents immediately and resort to emergency contraception. These information help teenage girls to avoid getting pregnant even after having sex, the best way however is to educate them on the importance of abstinence (sex after marriage). Unfortunately young girls have never given much importance to contraception and only think about it after they have had an unwanted pregnancy.

It is high time that young girls take it upon themselves to make their choice of contraception – because it is they who suffer from the consequences of an unwanted pregnancy. For reasons of fertility limitations teenage pregnancy should be discouraged as more years are available for more pregnancies. In young women subsequent pregnancies should be discouraged as rapid repeat pregnancy in young mothers increases prenatal risks. For the benefit of their family and themselves, unmarried teenage girls should display responsible sexual behaviour and abstain from sex.

Why my teeth are uneven? Why my teeth are looking dirty? Why do I have foul smell from my mouth?

The milk teeth start appearing at 6 to 9 months of age. The first milk tooth to appear is the lower front tooth. However the order of eruption of different teeth may vary in some children. All the milk teeth erupt by 3 years of age. The milk teeth come out from 6 years onwards till about 10 years of age. The permanent teeth takes place by 6 years of age. Between the ages of 6 - 9 years the child has some milk teeth as well as some permanent teeth. This period is called the mixed dentition period.

By about 12 years all the milk teeth should be shed off and replaced by the permanent teeth. As the permanent teeth start emerging they wear off the roots of the milk teeth. Thus the milk teeth loose their support in the bone and become mobile. The milk teeth are ultimately shed off and are replaced by the permanent teeth. Nowadays, permanent teeth start coming out, but milk teeth have not yet erupted, so permanent teeth finds space available and then seen uneven. So it is better to consult doctor as first milk teeth get erupted.

It is normal to find the milk teeth in children to be spaced. These spaces between the teeth help later in accommodating the bigger permanent teeth. Thus absence of spaces between the milk teeth in children may be a fore warning that the child may not have adequate space to accommodate the bigger permanent teeth which may erupt in a crowded arrangement. Here also development of JAWS plays a important role. The movement/exercise due to chewing and speaking does have some effect for better growth. Eating hard foods also make jaws and teeth stronger.

The cutting edge of the newly emerged front permanent teeth (incisors) are not even. They show elevations called mammelons that correspond to their developmental lobes. These in due course wear off to form a flat cutting edge.

Deep inside the tooth is the dental pulp or the vital tissue comprising of nerves, blood vessels and other tissues. This tissue is protected by the outer covering of dentin and enamel. When the cavity becomes large and deep the caries may reach the inner vital tissue of the pulp. Thus the area of pulp adjacent to the dental decay may get infected and inflamed. Pulpotomy is the procedure where the superficial part of the infected pulp adjacent to the area of dental decay is removed leaving behind the pulp present deeper inside

Habits like biting nails, pencils, etc besides causing wear of the teeth can cause injury to the gums and supporting structures around the teeth. In addition the pressures they exert on the teeth may force them into abnormal positions which may necessitate orthodontic treatment

Tongue thrusting is a habit wherein the person forces the tongue against the back surface of the front teeth while swallowing. This habit can produce proclination of the front teeth and spaces between them. The dentist may have to train the patient on the correct swallowing method by some exercises and use of habit breaking devices.

Bacteria from unremoved food particles and sugar by-products produce lactic acid, which dissolves calcium in the protective enamel layer. When decay spreads to the sensitive pulp tissue, pain starts. Milk is recognized to be a greater producer of lactic acid. And no matter how much calcium you take, without magnesium only soft enamel can be formed. Soft enamel will lack sufficient resistance to the acids of decay.

Morning hours have rush time through the routine of brushing the teeth and rinsing our mouth, but after dinner we do not bother to clean the teeth. Most of us do not have habit to clean our teeth and gargle after eating Lunch and in-between the meals. Ideally, teeth should be cleaned thoroughly after every meal, but not many adults, let alone children, do this. It is only when one is in pain that one visits the dentist. Very often it's too late to save the teeth even by a qualified dentist.

So how to keep teeth healthy and smile, beautiful?

The correct diet and nutrition play an important role in ensuring strong teeth and healthy gums. Sugar, natural or processed, is your teeth's deadliest enemy and is the prime cause of tooth decay. Retention of sticky foods that are not quickly diluted by saliva also pose a major risk in the formation of dental cavities. Even apparently harmless wafers/chips are retained on the tooth for a long period of time & eventually broken down into carbohydrates & sugars leading to decay. 

Children should be given carbohydrates in their natural forms (as far as possible). They should be encouraged to eat hard fruits in whole instead of juices. This helps cleanse and stimulate teeth. Sticky/soft foods like white bread, pastries, aerated drinks, doughnuts, sweet rolls and processed cereals, one of the biggest causes of tooth decay, should be cleaned immediately from the teeth.

The longer food remains in your mouth, the greater the chance for decay. Rinse your mouth immediately after eating, especially if you've just had something sweet, to prevent the formation of plaque. Rinsing after meals and brushing teeth with soft toothbrush every time is essential to keep tartar and plaque at bay. So after Breakfast, Lunch, Evening Snack, Dinner make four times minimum.Carry a small baby brush in your beg/purse to use it after anything you eat in between, while away from home. Keep one such brush in your work place/office too and use it without forgetting.

Morning, after getting up, use Neem (LIMBDO)  or Babool(BAVAL) stick (DATOON) or even easily available Neem leaves. Chew these leaves or small thin sticks. It will take out saliva from the mouth every time. It will also help in cleaning the tongue.  One can go for a small walk/jog and find the above on the way/ around in the garden. The use of fluoridated toothpaste markedly reduces the occurrence of dental decay. Most of the toothpaste are sweet in taste which is not at all required, but companies wants children to like it and increase their sales. Foaming also may not be useful as such.

Crash dieters, or diet on and off pattern, tend to have a lack of, or decrease in certain vitamins, most notably Vitamins D, B-12 and calcium. They also tend to lack certain minerals like magnesium and proteins in their diets. These are very important vitamins especially for the health of the teeth and gums. Dieters also tend to take diet pills that may cause a decrease in saliva flow as a side effect. This decrease in saliva flow tends to increase the acid levels in the mouth, which may cause an increased level of cavity formation. CRESH Diet should be consulted with experts first.

Tongue cleaning is very important. It helps to reduce bad breath and improve oral hygiene status because a large number of bacteria reside in the rough corrugated surface of tongue. Most dental professionals advise that poor oral hygiene, such as not brushing, not flossing, or not rinsing enough is the leading cause of gum disease and tooth decay. Drink water few sips after every half-an-hour, gargle/rinse your teeth to avoid bad breath problems.

Smoking, chewing beetle nut and tobacco are also factors that adversely affect oral hygiene. These habits can cause bad breath, decay, gum disease, damage to tooth enamel, eventual tooth loss and in many cases even lead to oral cancer.

Why am I not happy with my SKIN color? Very fair, Fair, Wheatish, brown, Black

Believe me and daily look into your large size mirror and say that “ YOU are the BEST”

Most of the teenagers and sometimes even adult are not so happy about the color of their skin. The skin color is a gift from Father & Mother, so better accept it. Indians have quite a large difference in the skin color depending on the location they belong to. It is due to heredity.  Human skin color is primarily due to the presence of melanin in the skin. Indian Skin color ranges from almost black to white with a pinkish tinge due to blood vessels underneath.  Skin color is different from South to North as India is geographically very large with different atmosphere and different food habits.

Variation in natural skin color is mainly due to genetics. The natural skin color can be darkened as a result of tanning due to exposure to sunlight. Skin color adapts to sunlight intensities which produce vitamin D deficiency or ultraviolet light damage to folic acid.  Protection from ambient temperature, infections, an alteration in food also affect skin color. By absorbing ultraviolet (UV) radiation from the sun, melanin controls the amount that penetrates the skin. UV radiation is needed to manufacture vitamin D, but excess UV can damage health.

SKINCARE products are to be sold by the companies through aggressive advertising. So they promote MODELs accordingly to sell their products. They create the need for the product in the mind of INDIANs. They say that what you have is not good, but use our products to get that dream girl/boy like skin. Most of them do not suggest for HEALTHY body requirement, but sell FAIR skin dream to every INDIANs. Indian Matrimonial sites demand fair or very fair skin spouse. This creates negative feelings about your skin in your mind. You do not like to see yourself in the mirror. You are always in search of improvement in skin color and tone.

YOU are LOVELY, be it fair or wheatish or black. You do not need any fairness skin. Instead change your attitude towards yourself, your body.  BE YOURSELF and groom with communication skills, knowledge, education, humour and happiness. GLOW from within..........

For more articles visit http://teensnparents.blogspot.com/  as well as http://www.teensnparents.com/

Is your son/daughter driving safe from ROAD accident? Head scarves a must, but no HELMET.

How much do you love your life? How much do you love your son/daughter? How much you care for the life your son/daughter?

I have observed in cities of Gujarat, that two wheelers are driven by schools students before they reach the eligibility to drive. Parents, school administration and RTO/traffic police are equally responsible for this situation. Justifying the need to have two wheelers for academic purpose has become a fashion. Driving around at top speed to meet the time deadlines between, school, home and tuition class daily. Peer pressure to have better and better scooter/bike with higher CC and speed capacity is tempting them to purchase beyond their own means.

PARENTS are first to blame to pamper their child so much with their extra income. School administrator are not strictly putting ban on entry of two wheelers in school premise. School administrators should be made responsible by LAW that they check the eligibility of students to drive, have proper driving licence and use only allowed CC of scooter/bike as per RTO law. TRAFFIC inspectors are also not doing their duty to stop this illegal driving by school students.

Students learn to drive cycles on the road. But they want to drive together and talk while cycling. Many times two or three cyclists students drive on the road blocking the other vehicles. Many accidents happen while big vehicles take turn or overtaking such students. We blame truck driver or car driver, but generally fault lies with cyclist or two wheelers. I must have saved one person daily on an average on such occasions. I have to apply brakes, blow horns to ask them to give way to my car.

Girls and also boys likes to protect their skin/hair from SUNLIGHT and AIR POLLUTION. So they cover their face completely with cotton cloth (Chooni/Handekerchief). But they do not like to wear HELMET. The two wheelers manufacturers are also running away from their responsibilities for safe driving of their vehicles by their owners. Their design, have to provide space/locking arrangement for two helmets. Also HELMETS should be provided as compulsory accessories with every new two wheelers by LAW.

Two wheeler manufacturers (BAJAJ/HONDA/HERO/TVS/MAHINDRA) also promote their scooters and bike for thrills and race driving in their advertisement. They promote to young target audience as a tool to get the girl friend impressed. They promote risky driving. Even the worst case is TVS Wego.
  http://www.youtube.com/watch?v=wGBjWbzof2Q  
They never promote utility value. Many times I think why RTO is not taking any objection on such advertising promoting risky driving. LAW should be made that every advertisement of VEHICLE promotion has to get approval of RTO before releasing.

Are you aware & prepared for EARLY PUBERTY development with your daughter?

Is my DAUGHTER body is MATURING faster than her friends? Is she going through normal developmental process? Should I consult the Gynaecologist? Will Doctor asks for PELVIC examination of my daughter which may harm her HYMEN?

According to recent observations, girls are experiencing the onset of puberty at younger and younger ages, with an alarming rate of girls seeing breast development as young as seven.  Breast pain during preteens has become very normal. Menstruation and pubic hair development started before the age of 10.

Although ethnicity is a known cause, there are many other factors as to why we are seeing girls growing up faster. Some say it's the media and entertainment sexualizing girls at younger ages, while others maintain it's an environmental problem. Endocrine-disrupting compounds or estrogens possibly may speed up puberty as well, but not known.

Some point the blame towards the rise in childhood obesity. Girls who start experiencing puberty earlier on also have higher body mass index (BMI) than girls that start in their early teens.

Parents and mainly mothers are confused about when to start discussion on PUBERTY related issues with daughter. Most of the information on reproduction and sex are age specific, but the exact age for individual daughter is having wide difference.

The analysis has become difficult even by expert doctors in the field, due to so much individuality in development of PUBERTY. Only a complete diologue with mother and daughter can help on regular basis. Daughter should have full trust on mother for sharing any issues of physical and emotional nature. Mother has to be available to listen the daughter. Mother should learn and understand the current generation developmental issues. Break yourself from the past, from your teenage, as Media presence was not so much there.

More details on blog http://teensnparents.blogpsot.com/ as well as website http://teensnparents.com/

Indian Teens Today needs guidance on reproductive healthcare issues.: India Today survey a must read by Parents.

INDIA TODAY magazine published cover story on secret life of Indian teens related to CASUAL SEX NET ADDICTION and NOON PARTIES in March 7 2011 issue. The price of this issue is only 25 Rs, so i suggest that every parents of teenage son/daughter should somehow buy or borrow and read it. PARENTS please understand the teenage of ours and teenage of our son/daughter is going through different environments.

One may restrict late NIGHT party, but they may go for NOON party. One may restrict dial-up or broadband to use internet for unwanted websites, but now internet services are available on mobile phones. Maharashtra government closed the BAR-GIRL activities, but many television channels produce programs that titillate YOUTH in our drawing room.

The new bill likely to be tabled during this budget session in Indian parliament may allow consensual sex after the age of 16 years. Except penetrative sex (intercourse) almost other forms of foreplay, kissing, hugging, necking, among same age group will not be an offence. How then parents will react to next generation on moral sexual issues of their beloved son/daughter? How such sexual behavior of school and college students may affect their study?

Tuition classes have created parallel schooling even for bright students. Electronic and print media have brought sex and violence into the drawing room. TV and computers and internet and mobile-phone have occupied the time slot available for sports and arts activities. Calculators helped to reduce logical calculating skills by human brain. Word-spell check helped to ignore learning of grammar and spelling. Email and SMS is creating new word-dictionary. Rising land cost have minimized the sports grounds. Automobile boom have snatched cycling and walking from school children. Fast foods have replaced nutritional fresh diet. Abstinence is slowly replaced by sex experimentation at early age.

An attitude change is needed to develop body and mind during crucial period of adolescence, when sudden growth spurt takes place in the life of human beings. Parent-teenager relationship is under strain. Physical changes and body image are one of the most interested subjects among adolescents. Emotional relationship, infatuations, first love, sexual attraction towards opposite gender will play a very vital role on their behaviour.
Teenagers and teachers want to develop the personalities of students, but time and material resources are not adequately available. The need for adolescence education was identified to build our next generation. The technological developments have changed the life style and it is affecting the body and mind development of the children.
More details on blog
http://teensnparents.blogspot.com/
 as well as

 http://www.teensnparents.com/

Body Mass Index BMI 19-20-21 or Vital stattistics 36-24-36 or Zero figure?

BMI stands for Body Mass Index. Everyone has a different BMI. To find out what yours is, all you need to know are your height and weight. Until you're around age 21, your age and gender need to be factored into your BMI to account for the different speeds at which boys and girls develop. Your BMI doesn't tell you everything you need to know about your health, but it's a quick way to tell whether or not you might be underweight or overweight.

Hour glass figures having 36-24-36 (bust-waist-hips) proportionate were and are popular among females to look SEXY. Advertisement and marketing companies as well as fashion industry do motivate females to go for unrealistic body image. But more important is your BMI then the vital statistics for healthy body. It is better that parents of preteen daughters make the teenage daughter understand the importance of body development during puberty through exercise and diet and postures. Once the puberty /teenage is over, it will be difficult to change the bone structure, height and reproductive organs perfect growth.

One of the biggest questions boys and girls have as they grow and develop during PUBERTY and TEENAGE, is whether they're the right weight. One place to start is by learning about body mass index, or BMI, a calculation that estimates how much body fat a person has proportionate to his or her weight and height. BMI is used as a screening tool to identify possible weight problems for teenagers.

1. Before calculating BMI, obtain accurate height (Meters) and weight (Kilograms) measurements.
2. The BMI number is calculated using standard formulas.

Kilograms and meters (or centimetres/100) Formula: weight (kg) / [height (m)]2
As an example if the height is 150 centi meters and weight is 50 kgs.
Then 150 centi meters is 150/100= 1.5 meters
50 kgs divided by 1.5 meters X 1.5 meters = 50 / 2.25
= 22.22 BMI kg per meter square

One can review the calculated BMI-for-age percentile and results of similar teenagers gender wise and community wise. The BMI-for-age percentile is used to interpret the BMI number because BMI is both age-and gender-specific for children and teens. These criteria are different from those used to interpret BMI for adults — which do not take into account age or gender.

Age and gender are considered for preteens and teens for two reasons. The amount of body fat changes with growing age during puberty. Also the amount of body fat differs between girls and boys. Even BMI for INDIANS teenagers and AMERICAN TEENAGERS will be different. BMI may not correspond to the same degree of fatness in different populations due, in part, to different body proportions. The health risks associated with increasing BMI are continuous and the interpretation of BMI grading in relation to risk may differ for different populations.

Healthy weight ranges change with each month of age for each sex during puberty, growth spurt period. Healthy weight ranges change as height increases and it is different for every individual. Actual BMI can be perfectly calculated once the growth spurt is totally complete at around the age of 19.

BMI can help doctors identify people who are overweight and at risk of developing medical problems like high cholesterol, high blood pressure, and diabetes. Doctors can monitor that person's weight and make recommendations about healthy eating and exercise. BMI can also suggest the malnutrition during PUBERTY, and doctors can suggest remedies like intake of iron tablets or adequate food intake.

It's very common for teens to gain weight quickly — and see their BMI go up — during puberty. Those changes may be a normal part of development (for example, someone with a large frame or lots of muscle can have a high BMI.) Or, the changes can be a sign of future weight problems. Your doctor can help you figure out whether weight gain is a normal part of development or whether it's something to be concerned about. Too much body fat is a problem because it can lead to illnesses and other health problems. BMI, although not a perfect method for judging someone's weight, is often a good way to check on how a teenager is growing.

Classification BMI(kg/m2)

Underweight less than 18.50
Severe thinness less than 16.00
Moderate thinness 16.00 - 16.99
Mild thinness 17.00 - 18.49
Normal range 18.50 - 22.99
23.00 - 24.99
Overweight above 25.00
Pre-obese 25.00 - 29.99
Obese above 30.00
Obese class I 30.00 - 34.99
Obese class II 35.00 - 39.99
Obese class III above 40.00
Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.
In recent years, there was a growing debate on whether there are possible needs for developing different BMI cut-off points for different ethnic groups due to the increasing evidence that the associations between BMI, percentage of body fat, and body fat distribution differ across populations and therefore, the health risks increase below the cut-off point of 25 kg/m2 that defines overweight in the current WHO classification.

First pelvic exam is embarrassing to many girls, and so avoid reporting of infections and pain in their reproductive organs.

First pelvic exam is embarrassing to many girls, and so avoid reporting of infections and pain in their reproductive organs. During pelvic examination, the girl is asked to be comfortable in partial sleep mode at the very edge of the exam table, with her feet in stirrups, knees bent and relaxed out to the side. If she is not down far enough, the exam will be more difficult and more uncomfortable for her. The stirrups are padded to avoid the stirrups digging into her feet, any soft padding material can be used. The images are shown below for better understanding.

Teen girls may have never shown their private parts / genitals till now to any doctor. Even her genitals are not shown to any females including her mother. The mother daughter relationship should be like very very close friends, so that all private issues related to reproductive system can be discussed and examined freely. Mothers of pubertal daughters are advised to do so to build the healthy personal relationship with daughter to educate her on every information of human reproduction according to daughter's age.

For more pictures and images please visit:
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The vulva and all private parts are only seen by female gynecologist, so nothing to worry even if it is first pelvic exam. Such pelvic vaginal cervix examinations will be a part of female's routine healthcare in years to come. Your female Gynecologist will have view of your complete vulva under bright light.
As such one can compare the lips of mouth with Labia, Tounge with inside of vagina /cervix and mucus or saliva with vaginal secretions. Inside of mouth remains wet 24X7, similarly inside of vagina remains moist 24X7. It does carry healthy bacterias. So specific odor, wetness and staining is normal. Vagina remains wet similar to tongue and mucus.

What the female Gynecologist will do is explained as under:
Inspect the vulva first. Look within the pubic hair for the tiny movement of pubic lice. May be thenafter pubic hair needs to be shaved off. Some gynecologist will insist that you come with complete shaving of pubic hair or otherwise her nurse will shave the pubic hair for better inspection of vulva. They use a bright light to visually inspect the vulva, vagina, uretha, and cervix. Most examiners find it easy to look just over the light to get the best view. Separate the labia with gloved fingers to look for any surface lesions, redness, or swellings.

Look on the labia for the cauliflower-like bumps that are known as venereal warts. Using magnification (magnifying lenses or colposcope) is very useful when the patient has vulvar complaints and the diagnosis is not obvious.

Look between the folds of skin for ulcerative lesions that can indicate an active herpes infection. Gently retract the clitoral hood back, exposing the clitoris while looking for peri-clitoral lesions Look for the hymen or remnants of the hymen and identify any redness just exterior to the hymen that can indicate vulvar vestibulitis.

Hymen may be present or absent is normal. Hymen is a thin skin having small holes to pass the menstruation blood, clot and vaginal secreations.
The periurethral glands have tiny ducts that open onto the surface. Look for them next to the urethra. While looking at the urethra, note any discharge coming from the urethral opening that might suggest gonorrhea or chlamydia. Uretha is a very tiny hole and only urine comes out. Nothing goes inside uretha. so need not to worry. Vaginal hole is wider and can be seen.Outer labia can be stretched. pics outer labia streached uretha clitoris
Palpate the upper labia majora for masses related to hernias extending through the Canal of Nuck. Palpate the middle and lower portion of the labia majora for masses suggesting a Cyst.Sebum, a white semi liquid, thick substance generally noticed by many girls during puberty and thenafter through the adult life. This sebum may stain panty crotch. the sebum is generally normal unless it is infected and one feels itchy as well as it has a foul smell.

pics teen girl white sebum will stain panty
pics teen girl white thick sebum from vagina
pics teen girl normal white yellow secreation
pics infection at root bottom of outer labia
pics Insert Speculum through labia in vagina for pelvic exam by gynecologist.jpg
pics Vagina inside view with speculum use during pelvic examination.jpg

Warm and lubricate the speculum with warm water.

After warming a vaginal speculum with warm water, separate the labia with one hand while gently inserting the speculum with the other hand. It is frequently more comfortable for the girl patient if you insert the speculum rotated about 45 degrees (so the blades are not horizontal but are oblique). Once past the introitus, rotate the speculum back to it's normal position.
In very rear cases the vaginal opening is so small and labia majora is almost absent in preteens girl. Every mother should have noticed this that the puberty development of vulva, vagina and labia is normal for her daughter. This may require mother to inspect and examine at least twice in a year for the pubertal / teenage daughter. if any abnormality is seen, please report to gynecologist for further consultation.
pics abnormal small vagina opening before n after surgery

The labia, particularly the labia minora, are very sensitive to stretching or pinching, so try not to catch the labia minora in the speculum while inserting it. Gynecologists may ask the girl to "bear down" while they are inserting the speculum and feel that this assists with insertion.

Turning hand palm up, compress the urethra against the underside of the pubic bone. Normally, this doesn't hurt. If it causes discomfort for the patient, it is likely that at least some degree of urethritis is present.

Then insert rubber gloved fingers deeper into the pelvis. Due to contaction the vaginal hole may become tight and increase friction result into pain. So patient have to relax the body and pelvic muscles for easy insertion of gloved fingers. Keeping palm up, curl vaginal finger(s) up, compressing the bladder against the back of the pubic bone. Normally, this pressure creates the sensation that the patient needs to urinate, but is not painful. If it is painful, this is good clinical evidence of cystitis (urinary tract infection), or (less likely) endometriosis.
Obtain specimens for a Pap smear and any cultures that may be indicated.
pics cervical examination pap smear extraction for lab test.

Cervix cancer is a risk and so CERVIX examination is always necessary. Cervix is deep inside the vagina and feel like a finger or thumb. It has one very tiny opening to pass the menstruation blood, dead cells of uterus and liquid secreations. It also allows male sperm to pass from vagina to uterus after ejaculation in vagina from the penis of the husband. The cervix opening and surface should not be damaged by any means. Gynecologist wear rubber gloves to avoid any touch / friction of their nails. Also speculum have smooth surface and gynecologist is experienced to use it.

But teenage girls and young females should never insert finger without rubber gloves even for masturbation. Never ever insert any object inside vagina for masturbation, which may damage the cervix and inner skin of vagina. Even married females should feel that cervix is not get damaged with agressive insertion and motion of her husband's penis during intercourse.
DO NOT INSERT EVEN YOUR OWN FINGERNAILS MAY DAMAGE SENSITIVE TISSUES OF VAGINAL WALLS, HYMEN, LABIA MINORA N CERVIX.

pics even your nails can cut skin cervix inner labia hymen
pics damaged cervix opening inside vagina due to solid insertion...
pics cervix view in vagina using speculum .. ..
pics cervix and fluid in vagina .. ..
pics cervix cancer risk
pics cervix cancer
pics clitoris uretha vagina labia
pics perinium anus skin problem below labia.jpg

For a normal examination:
External genitalia are of normal appearance.
There is no enlargement of the glands.
Urethra and bladder are non-tender.
Vagina is clean, without lesions or discharge
Cervix is smooth, without lesions. Motion of the cervix causes no pain.
Uterus is normal size, shape, and contour. It is non-tender.
The adnexa (tubes and ovaries) are neither tender nor enlarged.
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During the bimanual exam, you may use one finger or two fingers inside the vagina. Two fingers allows for deeper penetration and more control of the pelvic structures, but one finger is more comfortable for the patient.
In some gitls, particularly those with difficult to feel pelvic masses, a combined rectovaginal exam is useful. Change gloves, lubricate the rectum, and then gently insert your index finger into the vagina and your middle finger into the rectum. The rectovaginal exam is helpful in feeling the uterosacral ligaments, a common site of endometriosis involvement. On completion of the rectal exam, stool can be checked for the presence of occult blood.

If the hymen is intact, it may still be possible to perform a comfortable and complete exam, but if the exam is causing too much pain, stop the exam and consider these alternatives:Rectal exam with the index finger can often provide the information needed by the gynecologist at that time. Exam under anaesthesia will provide full access without causing pain to the patient. Ultrasound scan, abdominally and trans-perineal, can sometimes provide you with the information you need.