My dearest daughter,
I am writing this letter to you to give you advice and guidance on a topic that is difficult for me to discuss with you, your sexual health. As an African woman, growing up in Zimbabwe, there were so many things that I wanted to know about my sexual health and things I was inquisitive about, pertaining to my own body. For some reason, it was one of the subjects that I couldn’t talk about nor did I have any source I could use to find out information. A lot of work was done to promote safe sex due to the HIV/AIDS epidemic so that I knew. Nevertheless, I found myself oblivious to anything else and never knowing any warning signs to watch out for or knowing what to expect. All I knew was that it was a taboo subject and the advice I got from family was about my menstruation and to abstain from sex till marriage. It was all no, no, no, but I never got the reasons why not. Once I got married, I was given advice on using contraception. As close as I am to my mum, this was one area that we could not converse. Personally, for me, I felt like it must be inappropriate to talk about the subject because of how it was always made to be hush hush. Sometimes, I would just stumble onto information, and in the end, I had to learn about my sexual health myself. Even the health professionals were evasive and it felt like all their focus was on doing their job but they didn’t need to explain anything to me or tell me about what to expect with my own health. I remember as a young woman in Zimbabwe, I had heavy menstrual periods and abdominal pain and I had been diagnosed with endometriosis but I did not have much understanding of what it all meant. It was only years later that I realised and got to understand the diagnosis.
Now fast forward to us emigrating to the United Kingdom, it was such a culture shock to realise the vast wealth of information that was at my disposal. The health professionals would give me all the necessary information and guidance that I needed. To top it off, I also had access to google to search for anything I didn’t feel comfortable to ask the GP. So, I know that now as a young woman, you probably might have a lot of questions. As you have access to the internet, you will be able to search online and also read things on the social media. However, as a nurse working in a Specialist Gynaecology unit, I just wanted to give you some advice based on the experience that I have attained and the things I had observed. As a young woman, there might be issues that you feel that you cannot ask me or talk to me about but I can assure you that you are not alone. Through my line of work, I have met some young women making hard decisions on their own, sometimes with their boyfriends. Both of whom are young and mostly ill-informed. Even when the parents ask us, the health professionals, for more information or clarity about their daughter’s condition; we are not at liberty to discuss anything without the patient’s consent due to confidentiality laws. I always pray not to be in that position of ignorance, where I am there for you but I am not fully there because I do not know what you are actually going through. Hence, I wouldn’t know what to say, how to advise you or how to fully support you.
Therefore, I am going to give you a few vital details that I feel you can use to empower you to make the right decisions and to also illustrate the important issues that you should not ignore.
Firstly, I know that you young women are internet savvy but I would say be wary of the stuff that you read because not every article is from a reliable source and neither are some articles accurate. Sometimes, women refuse to try certain treatment recommendations due to what they have read on someone else’s experience. I highly recommend that you use the National Health Service (NHS) websites as guidance to finding out about your health and any symptoms you might have. With everything, there is always risks and benefits and people’s reactions are different. What will work for you, might not work for another woman, and vice versa. Do not be frightened to try the different treatment methods because of someone else’s opinion or experience.
Personally, as a Christian, I would strongly advise you to abstain from any sexual intercourse until you are married. However, in the world we live in, it is difficult for me to be your bodyguard and to scrutinise all your moves. My only prayer, is for your protection and guidance and like we have spoken before and I will reiterate; do not lose who you are and do not conform to someone else’s ideals about how you should live your life. As an adult, you can easily access contraceptives without my knowledge or input but I would say to you, be aware of them. As much as they all have their advantages and disadvantages, some can cause life-threatening conditions. For example, there are some women who have developed blood clots because of taking the oral contraceptive pill. Additionally, sexual intercourse can cause you to contract Sexually Transmitted Infections (STIs). Statistics show that STIs are more prevalent in young people because they have multiple sexual partners without using protection. Some of the STIs are silent in terms of symptoms, so women can go for years without knowing that they have an infection. For example, one of the STIs, chlamydia will show later on in life and it can affect fertility, it can cause pelvic pain, offensive vaginal discharge and vaginal bleeding with sex. So, some of the choices that women make when they are young, can affect their sexual health when they least expect it and moreover they will have an impact on starting a family. Therefore, it is important for you to be safe now as a young woman and to make better choices. Do not act ignorant and act without a care in the world, as if you are immune.
In a few years, you will be offered an appointment for cervical screening, which is the smear test taken from your cervix to check for any abnormalities and it also checks for any pre-cancerous cells. This screening is very important for your sexual health, so you should not ignore it. When it comes to health matters, there is lots of evidence-based research that demonstrates the significance of screening or testing for various conditions. As a result, do not take it for granted and ignore getting screened. Sexual health is very private and it involves examination of your genital organs or by means of looking through them. This experience can be daunting and sometimes the thought of having the vaginal examination is enough to put off young women from accessing medical care for their symptoms. Please, do not dwell on this, but just put all your energy and focus on receiving help and getting treatment. Always ask to go with someone for support, if not me then choose someone you feel comfortable with. Above all, prevention is better than cure. Research supports that notion as well because the chances of getting cured are higher when conditions are diagnosed early. Henceforth, do not take your health for granted, trust your gut instinct and do not ignore persistent symptoms. It is not normal to bleed in between your periods, to bleed after intercourse, to have a smelly yellowish or greenish vaginal discharge, unexplained bloatedness and abdominal pain. Women do not have to suffer from heavy menstrual periods because there are a lot of treatment methods that can be used. Heavy menstruation can be as a result of various factors like fibroids and endometriosis. They can be debilitating enough to affect people’s day to day routines and their social life. Additionally, they can cause other conditions like Anaemia, which can affect one’s daily activities with fatigue, dizziness, shortness of breath and general weakness.
Know your own body, that way you will be able to ascertain any abnormalities. Every so often, as women, we check for any abnormal lumps and bumps. You do so by just slowly running your fingers over your neck on both sides, especially under your ears all the way down onto your collarbone; under your armpits; over your breasts; over your groin. Sometimes, if you are unwell with a cold or flu, you might feel a lump on your neck but that will soon disappear. It’s the ones that are persistent and also increase in size, that you should get checked by your GP.
On another note, I just want you to deeply understand that there is nothing that you can do, nor is there any decision that you can make, that will ever diminish my responsibility and love for you as your mother. As a nurse, I have encountered young girls who have gone through some challenging circumstances on their own and have found themselves making tough decisions on their own. For example, if a girl gets pregnant and doesn’t know what to do about that predicament. The impact of the situation is worsened by the fact that she has no one to approach for support, or she feels scared to tell her parents, or feels ashamed to hurt their feelings, or she feels she has let her family or religion down. Sometimes, young women then make ill-informed decisions without thinking things through rationally, and moreover, they can decide to put their boyfriend as their next of kin because they do not want their family to know what is happening. Now and then, you meet such cases and it is sad because you just feel like, here are 2 young people and the one who is being classified as the next of kin, doesn’t seem to understand what it means, the gravity of the responsibility and would they even know what to say if ever they were called in an emergency. All I am trying to illustrate is that there is nothing that you can do that will stop me from giving you all my love, my support, my guidance, my shoulder to lean on, my hug to comfort you and prayers to sustain you. Even if you then have a committed relationship and you decide to add your boyfriend as your next of kin, I will be there to support you both and help in any way possible for the benefit of you and your health.
As I conclude my letter, I would want you to know that I am here for you when you need me. You should never find anything too difficult to talk to me about it. Whatever it may be, I am here for you, to help you make the easy and the hard decisions, to give you guidance, to face any situation with you and weather any storm with you. Should you ever feel, you don’t want to talk to me about something, I know you are level-headed enough to seek appropriate guidance elsewhere. Knowledge is power. Use the information and guidance at your disposal correctly and for your benefit.
Written with love and care,
Words by Sinini Chikwiri