Other causes include an unsuitable, generally secondary lubrication to inappropriate or insufficient preliminaries; Forceful pressure on a sore urethra during sexual intercourse; Inappropriate penetration; Injury of the introit due to inflammatory alterations ( p ej., vestibulitis ); Infections ( p ej., abscesses of the Batholin’s glands or their conduits ); Gland inflammation sudoriparous labials; Secondary irritation to the use of bad-quality prophylactics or with unsuitable lubrication; Allergic reactions to the contents of foams and contraceptive gels and to the prophylactics; Anomalies of the genital feminine expanse of territory ( p ej., vaginal congenital partition, rigid hymen ) and dermatological diseases ( p ej., sclerosed lichen ). The psychological cause more frequent it is vaginism ( v later on ).

The acquired dyspareunia does not relate with the first sexual intercourse and frequently develops years after of the same. Their causes include: Menopausal involution drily and thinning of the vaginal mucosa, enlargement of the secondary introit to perineorrafia behind episiotomy or plastic reparation of the vagina, uterine marked retroflexion with ovarian prolapse to the caecum, endometriosis, vaginitis, sub-urethral diverticulum and inflammatory pelvic disease. The radiation therapy for the treatment of myxolipofibrosarcomas can be also cause of dyspareunia. The psychological factors and other ones related they are similar to the implicated in the orgasmic feminine upset ( v previously ). The sexual unsuitable stimulation or your psychological inhibition can cause a vaginal inappropriate lubrication and to coital pain.

DIAGNOSIS

The pain during or behind sexual intercourse it is the fundamental symptom.
The location and the nature of the pain can be useful for diagnosis; For example, the pain with the deep penetration can be indicative of an uterine injury and or of the broad ligament. Background general and sexual doctors and the physical and pelvic exploration generally reveal diagnosis. The local lesions of the introit and the uterine shift or other pelvic pathologies can detect themselves with the exploration, for the one that anesthesia can be necessary ( v. Vaginism, later on ).

PROPHYLAXIS And TREATMENT

The exploration of both sexual companions before marriage or the sexual activity, an obvious explanation of the sexual organs and players, their shows and the physiological and psychological factors related with sexual intercourse and the advice on sexual techniques can help the prevention of some problems. What’s most important is listening to the couple and answering to their questions.

Injuries or defects should correct themselves if possible. For example, a hymenal thickened ring can increase to the 1 % in the same previous consultation lidocaína’s application.
The treatment of the non-complicated injuries is simple. It is important to avoid sexual relations temporarily. An anesthetic sour cream should be applicable m externally ( p ej., cinchocaine to the 1 %, lidocaína to the 1 or 2 % ). Hip-baths can relieve the vulval bothers.

The use of a water-soluble lubricant immediately before sexual intercourse generally you avoid the pain and the myospasm. In some cases, the later penetration avoid the pressure in the urethra with enlarged sensibility and reduce the pain. For the treatment of vaginism, seeing later on. The local estrogen preparations or the substitutive treatment with estrogens, pray to them they are useful in women with postmenopausal vaginitis.

Cysts or abscesses should process themselves surgically; The inflamed lips should keep clean and dry. For the treatment of vulvovaginitis, seeing chapter 238. If inflammation and vulval pain exist, a humid compress with dilute aluminum subacetate solution can be applicable m locally. If the pain is severe an analgesic is indicated by v.o., P ej., codeine, 30 to 60 mg, with paracetamol, 500 mg, each 4 h. If the patient is beneficiary of an ill-disposed diaphragm that hurts the uterosacral ligaments, this should place back itself or being extracted from.

The talks with both sexual companions are commendable sexual. However, if the dyspareunia becomes of long evolution or if they cannot correct the psychological subjacent factors, the patient should be forwarded on to a psychiatrist.

Diagnosis and Treatment of Vulvodynia

The diagnosis of vulvar pain and/or irritation requires a careful history by a gynecologist familiar with vulvar problems.  The vulva is examined with the aid of a colposcope — an instrument similar to binoculars with an excellent light.  The vulva is gently touched with a Q-tip to see if there are specific areas of tenderness.  The muscles surrounding the vulva and vagina are checked for tenderness and tension.  Any vaginal discharge is checked under a microscope, and cultures may be taken.

Treatment can be simple or complex.  One of the most common causes of irritation is frequent washing of the area with soap.  As a general rule, do not use anything on the vulva that you wouldn’t put in your eye!  Even soaps and products claiming to be gentle and non-allergenic can be irritating.  Rinse with plain water, blot dry, and then blow dry with a hair dryer on low heat.  An over the counter mild cortisone cream can be applied for a few days, but if the irritation persists a gynecologist should be consulted.

Chronic vulvar pain or burning may respond to cortisone creams or ointments.  One specific type of pain is caused by inflammation of the vestibular glands (vestibulitis).  This can be difficult to treat, and occasionally requires surgery to remove the inflamed glands.

Vaginal Pain

Vaginal pain is most commonly caused by infection.  Sometimes scar tissue can occur after childbirth, surgery or trauma.  In endometriosis tissue that normally lines the uterus can grow in the vagina and be painful.  Muscle tension or spasm is a common cause of vaginal pain, and may respond to physical therapy and psychotherapy.  Inflammation of the bladder from infection orinterstitial cystitis (a sterile inflammation of the bladder) can also cause vaginal pain.

Why a Multidisciplinary Approach…

The treatment of vulvodynia and other conditions requires great patience both on the part of the doctor and of the patient.  Most often symptoms will improve, but it can take months of treatment.  It is not surprising that vulvar pain can interfere with relationships, and cause a great deal of emotional distress.  In addition, tenderness in that area can lead to spasm of the pelvic muscles, which in turn can aggravate the pain.

Many times there are simple medical treatments that relieve these symptoms.  But when long term treatment is necessary, a psychotherapist specializing in sex therapy and sexual pain management can help minimize the impact the pain has on a woman’s life. When muscle tension or spasm appears to be a factor, a physical therapist, through gentle massage, biofeedback, or other techniques can help restore normal muscle balance.  For many women a multidisciplinary approach is clearly more effective than any single treatment.

Susi, 18: so that so much is valued the feminine virginity and not therefore the masculine one?

The valuation of the feminine virginity and the obligation to arrive as so at the marriage have been consequence of the masculine domination and the restoration of patriarcales systems. In order to certify the paternity, the man, it forced to the woman the forced fidelity, to the premarried abstention and the prescription of the virginity until the law of the marriage qualified it, erogando for himself the possibility of everything what it prohibited the woman him. F. Engels supposes that, like consequence, they appear the figures of prostitution and the adultery. The feminine virginity assured in the male, that her woman, had not been had and, like its utensils, its own house, its animals, its inheritance, also the female happened to be object of its property.

At the moment, to a great extent, there is lost the sense of the dominion and the control of the man on the woman; as much small as boys, in general, they decide with greater freedom the moment for having relations that it has to do more with the desire to do the one that with moral, legal or religious rules.
With regard to the men, in another article, we have developed the thematic one of the virgin man even with interesting testimonies.

DEBUT AND PAIN

Pablo, 18: Pain the first time? I have understood that a relation between frenillo exists and its rupture in the debut.
Cynthia, 19: The first sexual relation of a woman always is painful?

A penetration could have been painful for both if for of abrupt way and without previous a vaginal lubrication. This is one more a reason more valid than the rupture of the hymen, even often are neither pain nor no sanguineous losses or, if there are them, it is in minimum amount. In another article we have developed with greater extension the subject of the myth of the hymen. In the man it does not have so that to hurt nor frenillo is cut (a man can be all his life without he is cut to him, in other cases is necessary to arrive at the surgical act), since the vagina is the sufficiently elastic thing like allowing the penetration.

VIRGINITY AND BELIEFS

Omar, 25: Although it never seems strange I had sexual relations and I aspire to arrive at the marriage without them to have had, I consider this like a correct attitude. How take You?
Carmen, 53: Is advisable to arrive virgin at the marriage?
Alberto, 29: I have been leaving with a girl for two years. She is catholic medical instructor and she does not want to have relations before marrying. I want to know if the religion inhibits the sexual feelings.

In relation to the question of Alberto on the possible inhibiting effect of the religion on the sexual feelings we must say that some religions in special of derived from the common trunk judeo-Christian, have condemned and repressed the placenteros aspects of the sexuality, subordinating them its merely reproductive facet.

To maintain or relations sexual is not a decision that will have to be ruined to the intimate election of each person. It is based on the own ideals and beliefs, but these are always influenced by systems of values, familiar or religious pressures. Nevertheless there is nothing criticable or no censurable in the decision to remain virgin, but in the same way the will will have to be respected of those who wishes to begin sexually outside the law of the marriage.

THE FEARS

Noemí, 16: I am much scared to lose the virginity and that later the men do not accept to me.
Marta, 18: I have been of fiancèe for two years, we are wanted. My fiancè began to request to me that we make the love, nevertheless I am scared of which if acceptance and this relation do not continue other they consider less me not being virgin.
Esteban, 21: My fiancèe, who is not virgin, wants to have relations. She gives fear me that she of account of my inexperience. How I must act?
Louis, 22: Which are the fears most common in the young people who have not begun in sex?

Let us think that the young people of our days no longer consider like a supreme good to the virginity. The fears related to the possible loss of the love or the respect of a man to have acceded to maintain sexual relations with him, seem to have more to do with folletines of the years 40 that with the present reality. Although still prohibitions and fears persist in certain social sectors and orthodox religious groups in which it is continued valuing the feminine virginity like a supreme good, thing that we think that it is related to the scorn by the woman and the submission that this one must suffer. In addition if un/a compañero/a, novio/a, rejects to its pair by the mere fact of being virgin is not being confused the part with the whole and it is let value to the other like person.

They do not exist technical certain and precise appropriate for the debut, yes are minimum conditions based on the love, the confidence and the mutual security.

The most frequent fears in the girls are:

To the pain
To being damaged
The social consequences
To that one notices to them
To the pregnancy
To being “a easy girl”
To the object that is going to penetrate in its near space
To being put under
To being left later
To the rejection
To being discovered by its family
To I infect of some disease

In the men they are:

To penetrate
To the blood
Not to have erection
To fail
To not knowing how what to do
Not to find where
To the ridiculous situation
To the hymen
To eyacular before penetrating or “to go away fast”
To make damage
To embarrass
(Adapted of an investigation of Kornhauser- Rosenzvaig, 1985)

Which would be the best conditions for the sexual initiation of the adolescents?

Some of these conditions already were commented but it is worth the trouble to reiterate some requirements necessary to assure a good sexual initiation:

A free and responsible education
Trustworthy information
A suitable and safe place
Time available
Contraceptive and surely reliable, suitable and proven method with previous medical advising
Use of the Profhylactic
To obtain privacy
Knowledge that more express and is not synonymous much of better
To have tolerance, compression and patience towards the other and one same one
Mutual affection and care

The best sexual fantasies, those that offer more pleasure, are centered in ideal situations, those that cannot practically be obtained in the real life, and that, unlike this one, yes can ignite or

to extinguish itself to our will, or to accelerate or to check the sexual activity. Habitual sexual fantasies can be:

- To maintain relations sexual in group.
- To make the love with a person who is not their pair then.
- To maintain relations with a person of he himself sex.
- To make the love in an unusual place.
- To be forced to make the love.
- To make the love in public.
- Etc…

THE MASCULINE SEXUAL FANTASY

The sexual fantasy is a species of ensoñación that allows the individual to escape briefly of the reality, imagining sexual situations that it is never going to live or that it would like to carry out at some time of its life.

The fantasies can appear voluntarily in the mind of the person, or of involuntary form, without the intervention of no specific sexual stimulus. Although many people perfectly control the moment and place in which they wish to imagine his fantasies sexual, others cannot do it, and it can seriously affect its conduct.

But many men and women have fantasies, and in most of the cases they provide beneficial effects to them: for example, when imagining an adolescent which would be its conduct during the first sexual contact, makes a species of test of which not yet she has experimented; also usually one resorts to the fantasies to before increase to the excitation or during the masturbation or the sex.

In the case of the man, the most frequent arguments of their sexual fantasies are the following ones:

- to imagine to have sexual relations with a woman different from the habitual companion
- to imagine simultaneously making the sexual act with several women
- to think about homosexual activities with other men
- to remember previous sexual contacts
- sadomasochistic fantasies, in which it is considered that the violence has attractive a special one, because the pain is united to the sexual pleasure; the man plays dominating or dominated the role of before a submissive or authoritarian woman.

Whereas some men and women use always he himself argument in their fantasies, also there are them prefer one different every time.

Some people worry about the content about their fantasies, since feel like guilty to imagine certain things, or because they think that those thoughts indicate that perhaps they would behave of that other way in the real life.
And since often the argument turns around prohibited conducts or outside the system of values imposed by the society, they consider that they have a psychological problem or an alteration of the personality, but has demonstrated that in the great majority of the cases it is not thus.
Generally, the sexual fantasies are solely a search of pleasing carried out by means of the imagination of eróticas ensoñaciones that excite sexually to who thinks about them.

The fantasies would be negative if they made difficult the sexual operation, for example, in case to the person it were to him essential to resort to them to be excited sexually with his pair or in any other situation of the real life. Also those fantasies have injurious effects that interfere in the capacity of the people to be related.

THE SEXUAL FANTASY IN THE WOMAN

The sexual fantasy is a erótica ensoñación that provides sexual excitation to the person who imagines it.

The sexual conduct of the man presents/displays a greater tendency than the one of the woman to the use of these imaginary stimuli during the masturbation or the sex.
Nevertheless, the women are many who have sexual fantasies, and their arguments agree in their majority with those of the men.

Most frequent they are:

- to imagine to have sexual relations with a man different from the husband or habitual companion
- to imagine to be object of a violation, carried out by one or several men
- to think about homosexual activities with another woman
- to evoke previous sexual contacts
- violent fantasies, in which a sadistic or masoquista relation settles down; the woman plays the role of dominating before a submissive man who is to please it, or is she the one that must satisfy all desires with an authoritarian man.

Other subjects that appear in the sexual fantasies of men and women are the sexual incesto, prostitution, relations with very young people or of other races, etc.

Most of the fantasies it turns around situations or sexual activities that the individual never has experimented, and that generally does not have the intention to carry out in the reality. One is mere ensoñaciones that are positive and inoffensive, unless they interfere in the habitual conduct of the individual or that they are its only source of sexual stimulation. -

Definition, etiology, causes, examinations, therapies.
¿As it walks your erectil health? , it answers the test and you know

The SEXUALITY, phenomenon complex in that biological influences intercross, psychological and sociocultural, constitutes one of the fundamental expressions of the human being. Until recently time it was known very little of the physiology of human the sexual answer: plenty of taboos and reluctance, constituted a field of little accessible study for the scientific investigator.

In these last decades, the deep changes that have experimented the sexual customs in the western world and the new value of the sexuality have impelled the study of the physiological foundations of the human sexuality.

On the other hand. this new cultural attitude has given rise to that every day more men and women go to their attending physician or the specialist to consult a sexual upheaval to him.

The disfunción of the erection, defined more current as impotence, is a situation in which, even being present the libido, the sexual stimulus does not lead to an increase of the vasocongestión of the penis, with the consequent absence or instability of the erection.

Many men undergo difficulties in the erection sometimes and live this experience on very negative form; the own “impotent” term sounds like an insult, reason for which in the scientific scope it is to replace it by the term “erection deficit”.

THE UPHEAVALS OF THE ERECTION

The term impotence designates very diverse pictures.

The total absence of erection. Either spontaneous, or in the presence of sexual pair.

The insufficient erection. For comfort reasons, the intensity of the erection that the individual note and observes can be classified from 0 to 10. In order to be able to surpass the vaginal orifice and to carry out the penetration an erection of 50% is necessary. Below this percentage the consistency of the penis is too soft for the penetration. It often happens that the patient who suffers insufficient erection and from him his sexual pair refers that he notices the cold penis.

The unstable erection. During the erótico encounter, the penis presents/displays in this case “bumps”. A good erection during the preludes can vanish when the penetration is tried. On the contrary, a 50% erection can be completed once the penetration has taken place.

The capricious erection. The patient presents/displays erections in solitaire, as much spontaneous as during the masturbation. In the presence of a sexual pair the patient cannot predict if she will have or not a valid erection: everything will depend on the individual or environmental circumstances, the sexual pair, et cetera.

The painful erection. It is pronounced generally in a promotional pathological context (infections, neuritis), although in the long term can cause a capricious although painless erection.



In this way, it is possible to “read” tissueconditions that relate to the “whole” person being viewed.
We areseeing the “whole” body at once.The chart developed by Dr. Bernard Jensen is the fruit of 50 years ofresearch and intense study. Spending many years as a student of pastmasters of iridology, he has brought forward and incorporated thoseaspects and details proven to be accurate by verification in clinicalpractice.

Each organ is identified and those of major importance are outlinedso that they are easily located, The chart represents the arrangement ofthe iris into its corresponding locations as found in a normallyorganized body.
You may find exceptions, realizing that there areindividual differences.Basically, the chart represents the placement of organs and tissuesas would a map.
There are signs and features in the iris that areinexplainable and unknown at this time.
Utilizing a transparent overlay of the chart with the wordingremoved, it is possible ‘to project an image of the iris onto a rearprojection screen. In this way, the two are superimposed on each other.

This procedure makes possible individual iris analysis, which is veryaccurate. By noting the major landmarks, boldly outlined on the chart, itis possible to orient the grid to correspond to individual differences.

ANOMALIES OF THE MENSTRUATION

The maturation processes that not always follow menarche they develop without upheavals, but that sometimes are accompanied by irregular menstruations.
It is possible to emphasize that in many cases it is arrived at a spontaneous normalization of the cycle.

Frequency.

The upheavals of the menstrual cycle are as frequent as the inflammations in the infantile gynecological pathology.
A correct menstrual calendar serves as departure point for any diagnosis. In the most complicated cases the registry of the curve of the basal temperature is from utility, that clarifies if it is normal cycles, two-phase (ovulatoris) or single-phase (anovulatoris) and identifies the phase that possibly is extended or shortened.
As the Basal temperature is moderate? immediately after waking up, with a thermometer normal to measure the fever (it is not necessary to use one of the special thermometers for basal temperature), the temperature in a cavity is taken from the body (vagina, rectum or oral cavity) and next in the armpit.
In any case the oral measurement is simplest. The results in a diagram are reflected to newspaper.
It is important to measure the temperature in the morning nothing else to awake, before undertaking any physical activity, like for example moving, speaking or to have breakfast. Anomalies of the menstrual rate and the intensity.
The too short or too long menstruations must in general to anovulatoris cycles.
These upheavals indicate a maturation incomplete of the endocrine system and disappear in general of spontaneous form without treatment some.
If menarche has happened behind schedule and the cycle is absolutely irregular (irregular menstrual intervals, resistant dysfunctional hemorrhages to the treatment and recidivants, repeated periods of amenorrhea), it will be necessary to think about a deficit of the hypothalamic function.
The anomalies of the menstrual rate of the adolescents usually are also due to anovulatorios cycles. If the cycle is inferior to the 25 days, polimenorrhea speech: in this case the menstruation also usually is prolonged.

If the cycle lasts more than 31 days, oligomenorrhea speech.
Also in this case the menstruation usually is longer of the normal thing and can even become a hemorrhage by dripping long play.
The anomalies of the rate are very frequent: they are registered in a 25% of the girls who suffer menstrual upheavals. The prognosis is nevertheless good, since approximately in half of the cases a spontaneous regulation of the cycle takes place.
If the upheaval of the cycle of origin anovulatorio lasts more than two years from menarche, will be essential to undertake a treatment with object to stabilize the cycle.

Dysfunctional youthful Metrorragy.

The irregular, acyclic, prolonged and intense menstruations are relatively frequent (2 5% of the girls). Good part of the menstrual upheavals of the puberty belongs to this category. The pathological picture pronounces in general months after menarquía and soon, with the passage of the years, it appears spontaneously alternating with normal cycles.
The cause of metrorragis dysfunctional youthful still has not been clarified; one is an upheaval of the regulation mechanisms of the hormonal system. If a therapy does not settle down, these situations can cause excessive losses of blood and one serious post-hemorrhagic anemia. In case of very serious and resistant hemorrhages to the first attempts of treatment, it is recommended to consult an expert gynecologist in endocrinology or to send to the patient to a specialized clinic. Reduced intervals and prolonged menstruations constitute youthful functional the typical manifestations of metrorragys.
The diagnosis can settle down to start off simply of the analysis of the menstrual calendar, so that it is possible to prescribe a treatment immediately. Obvious it is necessary to exclude other organic origins from menstrual upheavals, like: – pathology – inflammations (strange bodies); – malignant tumors; – extragenital hemorrhages (vejiga, intestine); – diseases of the blood (upheavals of the coagulation, aplasic anemia).
In case of metrorragy youthful dysfunctional can be resigned almost always to hormonal doses. Once established the diagnosis, he is not either indispensable to measure the basal temperature, since in general they are observed only curved single-phase, corresponding to a cycle to anovular.
In the treatment of metrorragy youthful dysfunctional the objective must be: to block the intense hemorrhage; – to restore a cycle that if possible is anovulatorio.
In general a series of preservative measures is advised and very not very often the possibility of one more a more radical intervention considers.
The treatment depends on the gravity of the pathological problem.

The term menstrual disorders refers to any of a number of conditions that are related to the menstrual cycle. Menstruation is the shedding of the lining of the uterus (the endometrium) each month, also referred to as the menstrual period. Menstrual periods usually last for five to seven days.

The adolescents usually undergo of diverse pathological upheavals in the puberty and adolescence -
In case of menstruation slightly prolonged, reduced intervals and sporadically increased menstruations, that nevertheless do not repel of important form on the values of hemoglobin, usually it is enough with clarifying to the patient or to the mother of in question patient only of a transitory upheaval that usually sends spontaneously.

It is advised to wait for about three months before applying to treatment some, and in this time interval they are possible to be adopted reconstitute measures (iron) and to be advised to the patient who follows a diet appropriate (rich foods in proteins and vitamins).

- If the menstruations very are prolonged and frequent, the values of hemoglobin fall, so that the general measures of character unspecific are insufficient.
The election treatment is the hormonal one.
The therapeutic principle consists of causing, by means of the administration during about 10 days of hormonal preparing, the halting of the hemorrhage.
This treatment must take place during several months, since otherwise relapses can take place.
Inasmuch as it concerns to the inhibitor use of the ovulation (that are to administer from 5º day of the cycle as if it was a contraceptive treatment, in the girls in pubertal age it is necessary to have much well-taken care of.
In effect, in a phase of the development in which is to be a balance between hípofísaria and ovarian activity, this treatment can alter this so sensible process through the artificial suppression of the ovulation.
If the hormonal treatment fails, is probable that it is not true dysfunctional metrorrhagia, but of the first signs of a disease of the blood. In case of metrorrhagia profuse and prolonged, with very short intervals in which the values of hemoglobin descend below the 9 g %, the hospitalization necessity prevails.

Amenorrhea

Adolescents frequently experience irregular menstrual bleeding patterns, which can include several consecutive months of amenorrhea. Amenorrhea-except that occurring before puberty, during pregnancy or early lactation, and after menopause-is pathologic. Amenorrhea may be caused by anatomic abnormalities; hypothalamic, pituitary, or other endocrine dysfunction; ovarian failure; or genetic defects

Secondary amenorrhea.

With the term of secondary amenorrhea the menstruation absence is defined during a more or less long period (more than 6 months).
This form of amenorrhea can as much be physiological as pathological. – Physiological Amenorrhea.
In case of long amenorrheics periods, in the following year to the one of menarche, it is possible to be hoped, without preoccupations and following treatment some, to that the menstruation reappears of spontaneous form. Generally, in the first 6 months or even later, the spontaneous regulation of the cycle takes place. Anyway, before a girl who suffers secondary amenorrhea is necessary to always exclude the possibility from a gestation. -

Pathological Amenorrhea.

It is necessary to clarify the diagnosis whenever the secondary amenorrhea attends accompanied of one of the following conditions. Virílización: it is necessary to think about the existence of ovarian tumors, syndrome of Stein Leventhal or tumors of the suprarrenal crust.

Galactorrhea (raised of milk): before anything it is necessary to exclude a possible pregnancy and next to make a x-ray of the Turkish chair (skull) and a valuation of the prolactose to exclude a tumor hipofísarío. In addition, it is necessary to verify if the patient used contraceptives, psícotropos fenotíacins or other drugs.
In case of amenorrhoea of neurógen or psychogenic origin the psycotherapy prevails, with which in numerous cases a spontaneous reappearance of the menstruations is obtained. -

Premenstrual Tension.

The premenstrual syndrome does not have much importance in the girls. The symptoms begin immediately after the ovulation and increase of intensity until the appearance of the menstrual flow, the girls refer the suffering of hemicranias, nervousness, increase of weight due to the water retention and pain breasts. In most of the cases it is enough with a good control, not being due to overvalue the symptoms.

Algomenorrhea.

The regular menstruations that appear of painful form during the adolescence (dismenorrhea of the adolescent) are dismenorrheas primary, dysfunctional almost always, that does not respond to no organic cause. 2 or 3 years happen after menarche in girls with a already two-phase cycle. The concomitantes dismenorrheas to the first menstruation are very little frequent.
The origin of the primary dismenorrhea is not very clear. They often talk about like main the neurovegetativos factors, that do not have any determining meaning nevertheless.
A hormonal component cannot be excluded, since these girls always present/display two-phase cycles.
The dismenorrhea can even consider a sign of which the ovulation has taken place. It is very possible that one is angiospasms of the uterine musculature, that cause painful contractions ísquemícs. Anomalies of position of the immature and still hipoplasic uterus can cause painful contractures upheavals of the uterine irrigation and.
Although 25% of these girls do not require treatment some, this one can be problematic in more from a case.
As preventive measure in any case is indicated the explanation about the physiology and the function of the menstruation.

Oligomenorrhea

Oligomenorrhea is the term used to describe infrequent or light menstrual menstruation in a woman with previously normal periods cycles; are known as oligomenorrhea. It is very common in early postmencharchal period and not usually worrisome. But any woman with regularly established periods can develop oligomenorrhea.
When girls first menstruate they often do not have regular cycles for a few years. In some women periods may occur every three weeks and in others, every five weeks.
Flow also varies and can be heavy or light. Women should be concerned when periods come less than 21 days or more than 2 to 3 months apart, or if they last more than eight to ten days. Such events may indicate ovulation problems.

Dysmenorrhea

It is the cyclic menstruation pain in the lower abdomen usually associated with other gastrointestinal and neurological symptoms. It may be associated with pathology (secondary dysmenorrhea) or may be idiopathic in origin (primary dysmenorrhea-more prevalent). Dysmenorrhea is a common disorder that affects approximately 50% of menstruating women 10 .The pain is thought to result from uterine contractions and ischemia, probably mediated by prostaglandins produced in secretory endometrium; therefore, primary dysmenorrhea is almost always associated with ovulatory cycles and usually appears within 1-2 years of menarche, when ovulatory cycles are established. This common disorder usually starts during adolescence and tends to decrease with age and after pregnancy. Some women experience mild to moderate lower abdominal pain during mid-cycle (the 13th – 15th day of the cycle), some times there is blood spotting also. This is because of the release of the ovum into peritoneal cavity and no treatment is required for this Mittelschmerz syndrome

Adolescent has to prepare to for presentation of first menstruation, because she must to know that she is a physiological process, that will normally condition all its life while the sexual maturity lasts, without special upheavals and pain.
Although in some cases he attends himself spontaneous remission, is not due for that reason to neglect the treatment in the puberty, because otherwise the picture is considered irremediable and been left form in psique of the patient.
Only in serious, resistant cases to the mentioned treatment, one resorts to a hormonal therapy. In case of secondary dismenorrhea, the treatment will have to fight the base disease, being the gynecologist the one in charge to establish it.
In the young people operations like the expansion of the neck of the uterus under narcosis or the resección of likeable, the so habitual ones in other times are almost never indicated.