VIDEO INTERVIEW | Dr. Sima: The youngest mother is 14 years old, more and more babies are born after the age of 35

Dr. Aneta Sima / Photo: "Sloboden Pechat"

The month of May, the month of women's health. When is the time to visit a gynecologist for the first time, how often should regular check-ups be done, how to get through menopause more easily are just some of the questions discussed in the show Free Press We asked assistant professor Dr. Aneta Sima, specialist gynecologist, obstetrician from the Clinic for Gynecology and Obstetrics in Skopje for an answer.

The doctor says that girls usually ask for their help, that is, they go to a gynecologist for the first time when they get their first period.

– A gynecologist is rarely visited before that, only if there are some disorders. It usually happens around 10-12 years of age. If they are fine, there is usually no cause for concern. Even if the cycles are irregular during this period, in the first 5 so-called menstrual years, cycle oscillations and irregularities are allowed due to the immaturity of that hormonal axis that dictates that menstrual cycle, says Sima.

She explains that in the last ten years, the awareness among women about regular visits to a gynecologist has been increasing, which is to be welcomed.

- Apart from these changes with the cycle, other disorders that are more typical at this age, and until adolescence, is the so-called polycystic varicella syndrome, which most of the time they don't even know they have. However, it gives some changes such as increased hairiness, increased body weight, acne, which especially bothers girls during puberty - says Sima.

She explains that the cycle can be late and scanty, and this is even more of an alarm to visit a gynecologist immediately.

- Regular examinations in this period until adolescence are not particularly mandatory, unless there are some deviations. In this period, it is very important to remind you of the importance of information about contraception, because in this period until adolescence, most of the time, they start their sexual life. And a lot of attention should be paid here, mostly because the number of teenage pregnancies is increasing. It is a big serious problem that we are already working on. And the second reason, which is very clearly forgotten, is the need for protection against sexually transmitted diseases - says Sima.

Dr. Aneta Sima / Photo: "Sloboden Pechat"

According to our regulations, the Health Fund allows choosing a family gynecologist between the ages of 12 and 18. The doctor says that there are still environments in which the prevention of early pregnancy is not discussed.

– Depending on the environment they come from and where they are, there are still regions that are stigmatized in some way and we think that there is still a serious lack of education. We are making efforts in cooperation with the Ministry of Health to create a counseling center for contraception for young people. However, still, in my opinion, as a parent, it remains that the family is the basic unit from which education should start, the mothers, I emphasize them here for girls, says Sima.

Over the years she has been working, she has seen pregnancies at 13 and 14 years old, and as early as 15 years old, childbirth is common for some environments.

- We are so amazed, and they give birth in the most normal way, in the past 5-6 months we had 2 or 3. So, they come from such environments where it is normal, they accept it that way, they behave like that, not to mention they cooperate better and the birth is going most normally, unlike older women in labor - says Sima.

As for the reproductive period, it is one big period of a woman's life, when physiological changes also occur. Sima says that the trend in recent years is some awareness and a growing need for seeking help, for controls.

- The PAP test in itself is a cytological method whose task is to detect those early changes and act preventively on cancer, mostly on the throat and uterus. That's why it's done. Currently, the Pap test is done at three-year intervals. I'm talking about patients who don't have any problems. So-called screening with HPV typing is already being introduced in European countries, says Sima.

She says that regular gynecological check-ups are recommended as a preventive measure, at least once a year. This includes an examination under a speculum, a gynecological ultrasound, a Pap test, if we have a need and a problem. It is supplemented with HPV, typing, colposcopy, so there are monitoring methods. Regarding the late pregnancy, Sima says that the first baby is planned after 35 years.

- In our opinion, this is too late. The birth rate is falling, sterility is rising. After covid there was an epidemic of malignancy. Most of them occurred at a late stage when survival is low and there is still an epidemic of malignant diseases, somehow creeping through. The survival rate has not changed. As for sterility, I can say that it is enormous, especially male sterility. "Covid has afflicted us with a number of pathologies," says Sima.

Regarding HPV vaccination, he says that it is at a very low level. Menopause is the third period of every woman's life.

- It is a period in which every patient will literally get what she has not done for herself during her life. It will come back to her like a boomerang in these years, says Sima.

She explains that every patient should take care of herself, her health, should do preventive examinations, go for regular check-ups, take care to maintain a normal body weight, lead an active life, pay attention to her diet.

– That woman will grow old healthy and will be healthy in later years as well. And vice versa, any neglect will be reflected in further early onset of chronic diseases. The recommendation for every woman is to take care of herself, feel her body and listen to it, says Sima.

See the full interview below:

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