Not Your Mother's Gynecologist: Why Adolescent Girls Should See Their Own Specialists
Jun 12, 2018
It wasn’t so long ago that a mother’s advice to her daughter regarding her menstrual cycle was, "Welcome to womanhood" or "I'm sorry, sweetie, every woman has painful cramps, you will get used to it. Take some medicine, use a heating pad and get some rest." As social media helps to increase mainstream conversations surrounding women’s health issues, young girls have become more comfortable speaking to their friends and parents about issues they experience related to puberty and menstruation. With this increased self-awareness comes the need for accurate, confidential and sensitive care from experienced health care providers.
Children are not little adults. Medical care for children is provided by physicians trained to understand how a child’s body works and how medications and procedures given to and performed on children have different effects. Without this specialized knowledge, children can inadvertently be exposed to preventable harm.
The American College of Obstetricians and Gynecologists (ACOG), which oversees gynecologic care in the U.S., recommends that young women have their first visit with a gynecologist between the ages of 13 and 15. This visit is an opportunity for the doctor to establish a relationship with the patient and parent or guardian, discuss normal and abnormal pubertal development, dispel myths and misconceptions surrounding weight, development and sexuality and help adolescent girls become comfortable with their changing bodies.
A physical exam to point out normal development and identify areas of concern is often performed to the patient’s comfort level. Although this will include a visual examination of the breast and genitalia an internal examination is not typically performed and the child and parent may decline an external visual examination if she feels uncomfortable. Invasive testing of the reproductive organs is also not recommended in this age group.
Pediatric and adolescent gynecologists undergo additional specialized training after residency to learn to care for medical and surgical gynecologic problems in girls and adolescents such as:
Developmental problems of the reproductive system
Abnormal uterine bleeding
Menstrual and pelvic pain
Contraceptive issues in medically complex patients
Vaginal problems in pre-school age children
Although adult gynecologists treat many of these conditions in older women, differences in the anatomy of children make the advanced training of a pediatric and adolescent gynecologist valuable in the care of girls and adolescents.
The journey from childhood to adulthood involves many changes in physical appearance, behaviors and belief systems. Partnering with a provider with the knowledge to help safely navigate these changes is important to optimizing the future reproductive health of girls and young women.
Kate McCracken, MD FACOG is a distinguished member of Nationwide Children’s Pediatric and Adolescent Gynecology team.
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