TSR Med Students' Society Part V

I guess what I'm asking is, clearly, we should all be prepared for apparently "common" situations like this by the end of medical school, but how do others (particularly males - females seem to be slightly more comfortable with these conversations from what I have witnessed, though I could be VERY, VERY wrong) feel about taking sexual/obstetric/gynecological histories from young teenage females (as above) who are more often than not, sexually active? I struggled this morning. A lot. But hey, that's what these sessions are for right?

It's not exclusive to being male. I've been a teenage girl and still struggle with those conversations. On paeds day case ward I had to ask all the female patients if they were sexually active and it was the most awkward thing ever. They either look horrified that you even ask or are wayyyy more chilled about it than they should be at 14.

When I ask young girls if there is a possibility of them being pregnant (consenting for orthopaedic stuff that needs on-table xray)

I just preface it with 'this is just a routine question I need to ask everybody'.

Im not a guy, but as a girl who has had to speak to male doctors as a teen and I taught Sex Ed in secondary school so I might be able to weight in a bit...

Get comfortable about periods etc... Talk to a female friend and just get used to it, so many guys look like they are about to die inside when they say the word period!

I'd say you need to air on the side of caution as often teenage girls (having been one) often hate talking about sex to adults and if you are sounding like their dad it just makes it awkward for both parties. When I was teaching sex ed I was answering all sorts of questions and having to keep a straight face and be honest ("Do you taste poo when rimming" a personal fav of mine), so it's just being natural about it and also asking her what she understands about safe sex etc instead of just talking at her how unprotected sex is bad etc etc- often they 'think' they know some things, but infact its an urban myth etc...

Again I think it's just something you end up getting used too, the first few times I was teaching sex ed it was horrific and when I just made it into a more casual affair the students really opened up and were not afraid to ask so called "silly questions".
Is that of any help?

It just comes with practice. You'll soon develop a matter-of-fact way of asking these questions. When I ask young girls if there is a possibility of them being pregnant (consenting for orthopaedic stuff that needs on-table xray) I just preface it with 'this is just a routine question I need to ask everybody'. Parents and the girls are usually okay with that.

Right, so I was being a complete nerd and writing up a voluntary reflection after our comm skills session this morning. Yeah, I know. Not cool. Our session was on "Difficult Conversations about Women's Health"

Anyway, just thought I would ask on here - how do males feel about asking young females questions about really sensitive issues about monthly cycles, regularity or lack of, painful menses, IMB, PCB, dyspareunia etc.? Now, don't get me wrong, I'm pretty comfortable talking about this sort of stuff (and indeed my sexual histories have been described as "rather thorough" ), and I'm fine taking this sort of history from pre/post menopausal female adults (20's+), but today, I had to take a hx from an actor playing a 15yr old girl who had come in (mum was waiting in the waiting room) with painful, heavy, but regular periods (LMP was 10 days ago), in a fully consensual sexual relationship with a guy from school (think he was 16/17) who she regularly had unprotected sex with, missing school because of severe period pains, stressed about upcoming GCSEs, mum wasn't aware about the sexual nature of her relationship with her bf, and on top of all of this, had what sounded like vulvovaginal candidiasis... Yeah. Easy. You can see why I decided to reflect on it!

Now, I just about got through that consultation and decided on a haphazard management plan (there was just so much to cover in a 10 min consultation), but It was really strange. I got rather paternalistic and phrased things much like an awkward dad would if he had to have "the talk" with his daughter. I actually realised this earlier on in the consultation, but I couldn't think of how else to phrase things so just carried on. This was reflected in the feedback I received from the actor who thought I was "overly professional".

I guess what I'm asking is, clearly, we should all be prepared for apparently "common" situations like this by the end of medical school, but how do others (particularly males - females seem to be slightly more comfortable with these conversations from what I have witnessed, though I could be VERY, VERY wrong) feel about taking sexual/obstetric/gynecological histories from young teenage females (as above) who are more often than not, sexually active? I struggled this morning. A lot. But hey, that's what these sessions are for right?

Personally I found actually doing my Gynae rotation solved that, you just get used to it and it becomes more natural over time. STI placement also helped. Baptism of fire that one was...
People have sex at impressively young ages, learnt not to get surprised about it but just to check the situation is not an unsafe one.

edit: living in an otherwise al girl flat has somewhat helped too, if slightly distressing.

Heard about a case of a 9-10 year old girl undergoing appendectomy because nobody thought to do a pregnancy test, was an ectopic...

Not sure where it was, I'm sure I read it on here

On the subject, does anyone have any tips for asking about consanguinity? The language barrier normally makes this particularly difficult =\

Are you both from the same area? How do you know each other?

Make it friendly, like your their bro who isn't there to be judging.

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On the subject, does anyone have any tips for asking about consanguinity? The language barrier normally makes this particularly difficult =\

Obvious squint in 10 month old and the only treatment available is a patch. Useful or not?

All the websites I can find are just like 'treatments can include...'. Ok great but what do I actually DO???