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Transitional Care in Gynecology: When Should Your Child Switch to an Adult Provider?

Oct 17, 2018
image of a doctor talking to a young woman

It isn’t unusual for a young woman to be intimidated by the prospect of transitioning from a pediatric and adolescent gynecology (PAG) provider to an adult gynecology (GYN) practice. Patients develop a bond with their providers and it can be a daunting thought to have to re-establish the trust and comfort that takes years for many patients to develop with providers. 

Like many other important transitions in a young women’s life, such as a new job or going to college, young women should feel empowered to choose an adult practice that is the right fit for them. This should include an adult practice that emphasizes the needs of the patient and demonstrates willingness to listen to the patient’s concerns. A successful transition also requires engagement from the PAG provider to support the patient with any lingering concerns and communicate with the adult practice to ensure the patient has a smooth transition.   

When should I transition to adult GYN care?

By the age of 27, patients should find an adult gynecology practice to assume patient care, however there is no bright line age at which PAG teams will insist that you see an adult provider.  A variety of factors go into determining the appropriate time for a patient to transition care, including if a woman can appropriately advocate for herself and effectively communicate her health concerns.

Another factor for providers to consider is a patient’s cognitive and physical status. Women with special needs or developmental delays are often best suited to continue to see providers at a facility that specializes in treating children. These women frequently have multiple pediatric specialists involved in their care and having care centralized at one facility provides much needed stability for these patients who are dealing with chronic disabilities. These patients also benefit from staying with providers who understand their cognitive and physical abilities.

If a woman has difficulty finding an adult GYN practice, the PAG practice will continue to see her and assist her in finding an appropriate adult provider. 

What is the difference between pediatric and adolescent GYN and adult GYN?

PAG providers focus on providing care to females from birth to reproductive age and they treat medical or surgical gynecologic needs that might arise during this time. The American College of Obstetricians and Gynecologists (ACOG) recommends that women have their first visit with a GYN provider between the ages of 13 and 15, and then annually once they turn 21 years old.

A woman’s first visit to an adult GYN practice is a great opportunity for her to take further ownership of her gynecologic health as she transitions to another stage in her life. An adult GYN provider treats women’s breast and pelvic health issues and associated surgical needs, hormonal issues, pregnancy and postnatal care.

Is there an overlap in care provided by PAG and adult GYN practitioners?

Yes, a visit to either practice involves screening for additional health issues and social concerns and determining if any referrals are needed. Some patients treat their GYN provider as their primary care provider which provides an opportunity to discuss risk factors, immunization status and routine lab tests. It is paramount to provide education and counseling to patients as they anticipate new experiences or transitions in their lives.

Will my records transfer to a new provider?

Yes, offices will fax your records to the new provider once you sign a release authorizing the transfer. If offices are using the same electronic medical records system then most records are accessible to the new provider.

For more information about Nationwide Children’s Hospital’s Pediatric and Adolescent Gynecology Services, click here.

Featured Expert

Dana Lenobel, FNP
Pediatric and Adolescent Gynecology

Dana Lenobel, FNP, is a board-certified family nurse practitioner. She is a member of the Section of Pediatric and Adolescent Gynecology at Nationwide Children’s Hospital. Dana received her Master’s Degree at the University of Cincinnati and she attended The Ohio State University for her undergraduate studies where she received her Bachelors of Science in Nursing. She previously worked at the Cleveland Clinic as a nurse practitioner in their Department of Obstetrics and Gynecology. Her clinical interests include gynecological care for patients with special needs and developmental delays, menstrual disorders (dysmenorrhea, heavy menstrual bleeding, irregular menses, PMDD), endometriosis, pelvic pain, polycystic ovarian syndrome, vulvovaginitis, and contraception management.

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