Gynecological Assistance: The Three Basic Areas
Dr. Nelson Soucasaux , Brazilian gynecologist
As I have explained in my book "Novas Perspectivas em Ginecologia"
("New Perspectives in Gynecology"), the ideal gynecologic assistance
must include, in an integrated way, three fundamental areas:
1st) The basic clinical routine of gynecology - Here, use must
be made of the habitual medical technical-scientific methodology, and of
all of its propaedeutic and therapeutic means at our disposal. A careful
anamnesis [history] must be done, paying attention to both somatic and psychological
aspects, followed by a complete, meticulous gynecological examination.The
necessary complementary examinations and tests must also be performed and,
if indicated, medicinal and/or hormonal therapy adequate to the case must
be prescribed. These items include the practice of the entire clinical part
of gynecology. Special emphasis on the preventive aspects of the speciality
is fundamental, and we must orient the patients about the importance of
periodic examinations, which must be done every six or even three months,
according to each case. Such examinations must be done even in the absence
of any symptom.
2nd) Orientation concerning the basic aspects of the female physiology
- This also includes an analysis of those situations in which we have
to interfere in the woman's physiology, as in the use of hormonal contraceptives.
We must provide the patients with information concerning aspects related
to puberty, the menstrual cycle, the main effects of the ovarian hormones,
the occurrence or not of ovulation, sexuality, contraceptive methods, pregnancy,
menopause, etc. The basic anatomy of the female genital apparatus must also
be presented. These topics can be talked about as the opportunities arise.
Consultations must always be utilized for orientation about the need for
the use of reliable contraceptive methods, and the basic information concerning
the various contraceptives available must be given.
3rd) Orientation concerning the main aspects of the woman's psychophysical
constitution This also refers to all of the problems related to
the features of female nature which directly apply to the mind-body interaction.
In this manner, the patients will become more conscious about their psychophysical
constitution, as well as gaining a basic notion concerning the somatopsychic
and psychosomatic processes in women. This is essential to help them understand
some of the basis of their emotional problems, and how they are projected
into the body. It is here that the methodology of the psychological sciences
becomes integrated with gynecology and makes us, as gynecologists, also
able to provide some psychological assistance to women. The psychosomatic
approach in gynecology begins from this point on. It is obvious that the
introduction of these subjects to the patients must be adequate in each
case, and be done at the most appropriate moments.
Here are some examples of the aforementioned aspects of the woman's
mind-body relationship and psycho-physical constitution: 1) the very special
and intense ways through which women experience their own bodies; 2) the
fundamentally corporal and even "self-erotic" feature of female
nature; 3) the effects of the hormonal oscillations of the ovarian cycle
and of the phenomena that characterize the menstrual cycle upon the woman's
somatopsychic wholeness; 4) the very particular features of female sexuality,
both at the psychological and physiological levels; 5) the especially complex
and problematic implications which the possibility of getting pregnant have
in women's nature and lives; 6) the woman's constitutional "split"
between their aphrodisiac and maternal sides; 7) the several paradoxical
and even ambiguous situations that characterize both the female physiology
and psychology. For a detailed study of these aspects, see my already mentioned
book "Novas Perspectivas em Ginecologia" ("New Perspectives
For more information on "Novas Perspectivas em Ginecologia",
see page http://www.nelsonginecologia.med.br/novas.htm
, from my website www.nelsonginecologia.med.br
Copyright Nelson Soucasaux 1990, 2001
Nelson Soucasaux is a gynecologist especially dedicated to clinical,
preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade
de Medicina da Universidade Federal do Rio de Janeiro, Brazil, he is the
author of several articles published in medical journals and of the books
"Novas Perspectivas em Ginecologia" ("New Perspectives in
Gynecology") and "Os Órgãos Sexuais Femininos: Forma,
Função, Símbolo e Arquétipo" ("The
Female Sexual Organs: Shape, Function, Symbol and Archetype"), published
by Imago Editora, Rio de Janeiro, 1990, 1993.
Web site (Portuguese-English)
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