Wednesday, February 25, 2015

Archives of the Vagina: Chapter One

by Margaret Aranda Ferrante, MD., Ph.,D.

different version found on

I have a daughter, and when I first started this book, I thought I would write something for her benefit and knowledge, as she was to soon become a teenager. The maiden enters puberty and eventually learns that she is growing up. There are several professional societies that recommend she be immunized against human papilloma virus, or HPV.  HPV can lead to cervical cancer, anal warts, and a variety of other maladies.
Possibly one day, our daughters will be a mother who is pregnant, and if she ever started bleeding, I wanted to review some basic concepts because they really do not change too much with time. The human body is the human body, so I included causes of vaginal bleeding during each trimester of pregnancy. With or without children, she would eventually go into menopause, and I thought it would be great to prepare her for that, not so much now, but definitely later. Especially if I wasn't alive by then. So Archives of the Vagina: A Journey through Time is for her.

I learned many things that were not taught to me in college or medical school, and I tried to portray girls and menstruation in different geographical areas, like Uganda, as well as provide a historical story of how women used to be treated since the time of Aristotle. I got a little caught up in what I was doing and ended up reviewing the literature on several subjects of importance for the baby boomers of today. I am shocked that I discovered that of women in the United States who are over 45 years of age, 40% of them have had their uterus taken out by a hysterectomy. Of these, about half had their perfectly normal ovaries removed. My desire is that this changes.

We know so much about how the ovaries protect against unhealthy aging by preventing heart disease bone decay, Alzheimer's disease, and a myriad of other factors important to women. So sit back and be prepared to learn many things that you just did not know. How could you know? You could not have known unless you went to medical school, internship, residency, Fellowship, and practiced medicine in Anesthesiology, Critical Care and Forensic Medicine.

I only know because I'm I'm a doctor, but I thought it important to pass along the information that's in my head. And since so much of medicine is evidence-based, I have used and listed references, many of them from the National Institutes of Health website, so that you can refer to them, too.

For any piece of information that a doctor states, there should be a research study or paper, cited within the medical literature, that is the reference. But just because a paper makes it into the literature that does not mean that it is the truth. I bring this fact home when discussing the Women's Health Initiative. That is why doctors go to Journal Club and professional meetings. We review the medical literature, critique the study design, analyze the study outcomes, and evaluate the recommendations. We can still make up our own minds, because sometimes, the study was done poorly and/or the conclusions don't apply to every woman. By the time you finish this book, I hope you understand this more fully.

If you are giving this book to your daughter to read before she inserts her first tampon, I have divided the anatomy of the female genitalia into discussions. This way, she doesn't need to learn about inserting the penis at the same time. I have also included instructions in the Appendix and hope that this "red book" serves as a reference for different times in your daughter's life.

And I hope you use it for your mother, your sisters, and your aunts, too, especially when they are undergoing menopause or considering hysterectomy. It's all about women helping women.

Should boys and girls undergo a series of three Gardasil (R) immunizations in six months, per recommendation, starting at eleven to twelve years of age to prevent Human Papilloma Virus (HPV)? It is a series of three immunizations that occurs over six months. She's old enough to have a measure of understanding about shots, and why would they be necessary? Do I just tell her that it will prevent some kinds of cancer (the PAP Smear does that, too)? She will understand that. Do I discuss the number of sexual partners with her? Certainly not, since she is too young. Sexual abstinence and avoiding multiple sexual partners will reduce her risk (as will as not smoking cigarettes), but the question remains. Should our girls and boys be immunized at eleven years old for HPV and prevention of cervical carcinoma? 

My opinion is a resounding NO. Too many complications, autoimmune disorders, magnesium in the vaccine, and over 900 girls died of the vaccine during their own clinical trials. Now Japan, France, & India (which has more children than any other country) have banned the vaccination. More recently, Spain has criminal charges against the release  of the vaccine. 

Let's educate ourselves. That's what the American Society of Obstetrics and Gynecologists wants us to do anyway. With some help from your male and female physicians who are willing to stick their necks out, we can get good at helping all women. I know we can. We can get good at this.

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