What every girl should know. Jan van Elfen

to put up with acute dysmenorrhoea. If you really suffer during your period you should consult a doctor. There may be some cause that can be treated, or the doctor might prescribe stronger painkillers.

      If you are one of those people who are scared of the doctor, get nervous in the waiting room and feel petrified on entering the consulting room, you must try to get over your fears. If you’re scared of an injection or embarrassed about a medical examination, remember that many girls feel just like you. Be brave. Doctors don’t inject their patients without good reason, and in these enlightened times there is no need for exaggerated shyness when your health is on the line.

      A doctor is aware of a young patient’s fears and keeps them in mind. If you suffer from unmanageable ailments or problems and your mother cannot help, you should not hesitate to consult a doctor. Visit your doctor if your menstruation bothers you because it is very painful or lasts too long, especially if you really worry about it. You can also, of course, in many cases opt to see a female doctor. Doctors are not only there to cure illnesses, but also to give information about health matters. The doctor will listen sympathetically and examine you carefully, without making you remove clothing unnecessarily. You could take your mother along for support the first time. Later you should go on your own, so that you can explain the problem yourself and gradually build up a good relationship with the doctor of your choice. Once the ice has been broken you should make it a habit to visit her regularly, about once a year, whether there is something wrong with you or not.

      You already know that you need not avoid soap and water when you menstruate. Another important aspect of personal hygiene you should keep in mind is that it’s not only your sexual glands that start working during puberty. Your other glands, especially your sweat glands, also start to work overtime. Stale sweat in the armpits and groin smells very unpleasant, so you should wash these areas regularly and thoroughly. Be sure to wash your armpits and genitals after exercise and on hot days, to ensure that you smell fresh.

      After that you could use an underarm deodorant to help you stay fresh. Try to avoid the kind known as antiperspirants, unless you sweat a lot. The ingredients in an antiperspirant could cause an allergic reaction in someone with a sensitive skin. When you wash your genitals, use only soap and water. Do not use disinfectants or deodorants, as the strong chemicals in them could damage the sensitive mucous membrane that lines the vagina.

      Protecting your clothes during menstruation has become easier due to the absorbent qualities of synthetic materials. No girl need fear that she will embarrass herself. There are different kinds of protection available to absorb the flow – worn externally or internally, and which are disposable.

      The first kind is a sanitary towel worn between the legs. It has a strip of glue on the underside so that you can stick it to your panties. Sanitary towels are available in various sizes and thicknesses and are therefore equally suitable for young girls and mature women and during days with a heavy flow or when the flow has eased.

      There are advantages and disadvantages to sanitary towels. The main advantages are that they are easy to replace and that two can be worn at once when the flow of blood is particularly heavy. A disadvantage is that the gauze layer, which feels soft against the skin when the towel is first put on, could chafe the groin when damp. If the towel is worn for too long because there is no chance to replace it, it could give off a slight smell.

      The other kind of protection, a tampon, is worn internally (inside the vagina). One type of tampon comes enclosed in two thin cardboard tubes. A string is attached to the tampon and hangs out of the smaller tube. Both tubes are placed in the vagina, the tampon is pushed in with the smaller tube and the cardboard tubes are then removed. The string now hanging out of the vagina is used to pull out the tampon when it becomes saturated. The other type of tampon is not enclosed in cardboard tubes, but is inserted by hand into the vagina, with the string at the bottom.

      There is no scientific opposition to the use of tampons by young girls, as long as they replace them regularly, insert them correctly and ensure that they fit properly. If a tampon is inserted correctly you will hardly be aware that you’re wearing one. Tampons have other advantages too: they are small enough to carry unobtrusively in a handbag during sporting or social events, they can be worn invisibly (a great advantage in activities such as swimming, athletics and dancing), and they are easier to wear than sanitary towels.

      There are many girls, however, who do not manage to insert a tampon. The most common reason for this is that the opening in the hymen is too small (see page 38). Other possible reasons are fear or nervousness, incorrect technique or an infection at the mouth of the vagina.

      If a girl wants to use tampons but finds she can’t because of the narrowness of the hymen opening, she could ask a doctor to stretch the opening. This is a simple procedure involving little or no discomfort.

      If you are uncertain about how to insert a tampon, you should either read the instructions on the packet carefully or else ask your mother’s advice. You also need to know about the female anatomy.

      Study your genitals using a small mirror and experiment with a lubricated index finger. Remember that the vagina runs diagonally towards your back. Crouching with your legs wide apart is the most comfortable position to be in when inserting a tampon.

      If it hurts when you insert a tampon and the hymen is not to blame, you might have an infection of the internal or external sex organs. It’s not uncommon to have an inflammation of the labia majora or of the mucous membrane at the opening to the vagina. This can develop as easily and innocently as a boil or bout of tonsillitis.

      Another type of infection that nearly every woman will experience at some stage of her life is vaginitis – inflammation of the vagina. The same germs that could, for example, cause a bladder or skin infection, also cause vaginitis, as could a fungus.

      It usually develops quite innocently, but it could be an indication of poor personal hygiene or sexual contact with an infected person (see page 105). Signs which could indicate vaginitis are an itchiness of the genitals and an excessive white or yellow discharge from the vagina (leucorrhoea).

      The vagina is of course always moist, but excessive moisture, especially if it occurs in conjunction with an irritation or leucorrhoea, should be regarded as a warning sign. Since vaginitis is often contracted for reasons unrelated to sexual activity and is easy to cure, it is foolish to keep quiet about it out of shyness. It is especially stupid to play doctor and try to heal yourself by applying home remedies. And to come back to the use of tampons – it is best to avoid wearing them until a vaginal irritation and/or infection has cleared up.