1. The Medical Component Dr. Asem Anwar Moussa MD Professor of OB/GYN Al-Azhar School of Medicine

2. The medical component n focused on: n 1- Clinical assessment of the current health status of women participated in the present study. n 2-reviewing their gynecologic history as well as past obstetric history. to evaluate the impact of marriage at an early age on the reproductive health. n 3-Laboratory investigations.

3. METHODLOGY: n A purposive sample of 31 women were chosen. Actually, 44 participants out of the 300 women wished to be examined vaginally. However, only 31 were able to attend the examination and the resting 13 couldn’t, because of social constraints and logistic problems.

4. HISTORY TAKING: n The researcher took it in a non judgmental, sensitive and a thorough manner. The complaints of the clients were classified into 7 categories.

5. : PHYSICAL EXAMINATION n The general appearance, vital signs and body mass index were recorded.. Breast examination, cardiac, chest and abdominal examination were done. Ultrasound examination was performed to rule out any pelvic swellings. Mental and sexual health were also considered to exclude mental health problems such as depression and sexual problems.

6. PELVIC EXAMINATION: n It was carried out at a private clinic where privacy was strictly ensured. Counseling, preparation of the patient, adequate lubrication and sensitivity to pain and discomfort were considered during the examination. The external genitalia were inspected for any abnormalities..

7. LABORATORY ASSESSMENT: n Some laboratory tests were requested for some patients as hormonal profile, complete blood picture,cervical smear and coloposcopy to rule out any cervical premalignant lesions. n Laparoscopy n

8. RESULTS

9. n Table E1: Age at Marriage

10. E2 Table : Main Complaints in Relation to Age at Marriage ِ Above 18Less than 18Complaint %No% 18.0340.06Menstrual disturbances 50.0826.74Inability to conceive 6.3126.74Urinary problems 25.0413.32Non gynecological problems 6.3 16.71More than one complaint 6.316.71Sexual problems ( dyspareunia) 6.316.71Antenatal Care 1615Total

11. table E3: : Body Mass Index in Relation to Age at Marriage

12. Table E4: Past Obstetric History in Relation to Age at Marriage

13. Table E5: Breast Examination in Relation to Age at marriage

14. Table E6: Vaginal Examination in Relation to Age at Marriage

15. Table E7: Type of Vaginal Discharge

16. Table E8: Provisional Diagnosis in Relation to Age at Marriage

17. Table E9: Treatment of cases in Relation to Age at Marriage

18. Table E10: Referred Cases in Relation to Age at Marriage

19. Table E11: Other Findings in Relation to Age at Marriage

20. Female pelvis

21. Conclusion n This a small sample sized qualitative study, further more studies on the implications and consequences of early marriage on reproductive health as well as sexual and mental health should be addressed.

22. The 4 “Ts” Recalled “THROMBIN”Check labs if suspicious.