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 this column.

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, Suzie.

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.

Some girls 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 698-5544.

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 physician.

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