The first gynecological exam is a modern rite of passage for American women, and physicians should take the time to understand the potential emotional trauma it can cause.
In "Health and the Female Adolescent," editor Sharon Golub has pulled together a weighty collection of such insights and facts from eight physicians and social scientists who have studied topics critical to providing comprehensive health care for teen-agers.
The book's chapters include discussions on the effects of poor nutrition, pregnancy, smoking and drugs on the physical and psychological development of young women.
Dr. Karen Hein's chapter on the first gynecological exam provides a detailed "how-to" guide for new (and experienced) practitioners, including the kind of questions to ask about menstrual and sexual history -- and how to ask them -- before the actual exam. She also discusses patient confidentiality about birth control and pregnancy counseling and the treatment for sexually transmitted diseases.
Another chapter focuses on scoliosis, or curvature of the spine, its diagnosis and present treatment methods. This deformity of the spine affects females five times as often as males; with early detection it can often be treated successfully without surgery.
By the age of 12 almost one third of all youths eat only one meal a day at home with their families, according to the chapter on nutrition by Brian L.G. Morgan. Morgan details caloric and nutritional needs of typical female adolescents and compares them with those of athletes.
Fad diets, anorexia nervosa and the treatment of the obese young woman are also outlined in a section on common eating problems. Morgan opposes the use of amphetamines to reduce or maintain weight. Besides the potential for addiction that comes with ever-increasing doses, he says, long-term use of amphetamines can injure the brain and can cause an eight- to 10-point drop in IQ.
A final chapter deals with destructive, risk-taking behavior and the complex factors that lead young women to abuse drugs, run away from home or try to take their own lives.
Because this book is a collection of scholarly papers with copious references on topics pertinent to adolescent development, it is more of a refresher course for medical professionals and counselors than a readable guide for parents or even adolescents themselves.
But the book deserves to be in every school and can serve as an informative early warning system for anyone -- physician, teacher or layperson -- who deals with the roller coaster ride called female adolescence.