Got a Question
for the Doctor?
by Dr. Ann L. Engelland
(June 30, 2005) Breast lumps, tampons, and vaginal odor
are three topics my readers have asked me about in recent
emails. I cannot answer emails from this online newsletter
personally and privately but plan to do so periodically in
My ten-year-old daughter has a small lump on one of her
nipples. Is this normal development?
Breast development is usually asymmetric at first, so
it is not unusual that one of your daughter’s breasts
has a “lump.” The lump is the beginning of
development of breast tissue and it is usually right under
the areola (or nipple area). Often there can be as much
as a six-month lag time before the other side begins to
catch up. Ten years old, by the way, is the average age
for American girls to develop breast tissue. And this usually
means that if she stays healthy her period will come between
twelve and thirteen.
Is it safe for young gymnasts to use tampons when they
have their first menstruation?
It is safe for any girl or young woman to use tampons
as soon as she menstruates - providing she is knowledgeable
and comfortable with her own body. Proper insertion is
important for optimum comfort. In addition, she needs to
understand that tampons should be changed every 4 hours
or so to avoid serious bacterial infection. In my experience,
athletes are motivated to use tampons at a young age because
of the obvious advantages for an active person.
I was thinking of trying a deodorant suppository
that is inserted in my vagina. It says they are safe
to use everyday on the box. I now use a douche after
my period but thought the suppository would be better.
Also what do you think of feminine wipes? -- Thanks,
Let’s assume that Suzie is using these suppositories,
douches and wipes to manage vaginal odor. In general,
soap and lots of water is all that is needed to take care
of odors. They are caused by natural secretions that combine
with normally occurring bacteria that increase in number
and odor if hygiene is not maintained daily.
Absorbent, (usually cotton) ventilated underwear also
helps with odors. The popular thong underwear that create
a highway from the anus to the vagina can certainly contribute
to abnormal bacteria growth, irritation and odor.
believe that douching or cleansing acts as a contraceptive.
It absolutely does not. In
fact changing the acidity, bacteria and natural secretions
of the vagina may increase the risk of sexually transmitted
illness including pelvic inflammatory disease (PID),
a serious infection that can lead to infertility. So,
all in all, these products are not only unnecessary but
might pose some risks.
I would want to talk with Suzie, examine her for vaginal
infection, see what contributes to her perception of odor
and educate her about woman-centered personal hygiene.
Dr. Engelland has a practice in Mamaroneck devoted
to Adolescent Primary Care. She can be reached at
Have a teen health question? Use the form below
to send it to Dr. Engelland. Please
note: Dr Engelland cannot respond privately to
individual queries online. Comments are
welcome and anonymous questions may be answered
in future columns. Serious
medical problems should be referred to your own
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