University Of Alabama At Birmingham Answers Questions On Adolescent Puberty And Gynecologist Visits

Puberty brings on many unanswered and embarrassing questions for an adolescent. For a parent of an adolescent girl, it is important to teach proper health care practices, including gynecological and reproductive care upon puberty.

“Having an open conversation with your daughter about her overall health is important at any age,” said Janeen Arbuckle, M.D., Ph.D., a pediatric and adolescent gynecologist in the University of Alabama at Birmingham Department of Obstetrics and Gynecology. “This includes initial reproductive health visits that serve primarily as an opportunity for the adolescent to review her reproductive health and address any concerns she may have regarding her development.”

Gynecological care
The American College of Obstetricians Gynecologists recommends that adolescents have a reproductive health visit between the ages of 13 and 15. This visit provides a platform to talk about what adolescent girls can expect from their menstrual cycle, including cycle frequency, duration, flow and associated symptoms. It also is a time for the patient to address concerns regarding their changing bodies.

Depending on the patient’s needs, the initial reproductive health visit may be conducted with the patient’s pediatrician, an adolescent medicine specialist, or a pediatric and adolescent gynecologist. A pediatrician provides more complete health care maintenance, while pediatric and adolescent gynecologists specialize in reproductive health care with a focus on the pubertal transition and the initiation of therapies in patients with additional health concerns.

An important part of gynecological health is having a yearly Pap test. This is not typically necessary until age 21. However, an adolescent could see a pediatric and adolescent gynecologist to address issues she may not be comfortable discussing with her parents or pediatrician, ensuring that her overall health is intact, including periods, sexuality and relationships, pregnancy, and sexual transmitted diseases. Patients experiencing abnormal menstrual cycles or with concerns regarding their reproductive anatomy may also be referred to a pediatric and adolescent gynecologist for additional evaluation and management.

Reproductive care
As adolescents age, their friendships and relationships also change. According to the National Survey of Family Growth, 42 percent of female adolescents ages 15-19 had ever had sex. Evidence-based and age-appropriate sex education is critical to allow for adolescents to establish healthy relationships and to protect themselves from unintended pregnancy and sexually transmitted infections.

1204506363198113.IWjMFiJ5Xh8FFdjsLi6X height640Adolescents should be informed when it comes to pregnancy — from conversations on why the adolescent may want to be on birth control to planning ahead to future, healthy pregnancies.

“It is important that adolescents know how to prevent pregnancy, but also how to handle it if they do become pregnant,” Arbuckle said. “We have expertise in contraception and can help adolescents choose the right birth control for themselves. We also focus on informed, shared decision-making with our patients.”

Additional concerns in the sexually active adolescent are the potential exposure to STIs. Educating patients on barrier contraceptives is central to the reduction of STIs. In addition, vaccination against human papillomavirus, or HPV, during adolescence can protect patients from having abnormal Pap smears in the future. HPV vaccination is ideally administered between the ages of 11 and 13, regardless of whether the adolescent is sexually active at that time.

“Our job as pediatric and adolescent gynecologists is to provide resources for adolescents to make informed decisions regarding their reproductive health,” Arbuckle said. “We offer age-appropriate and confidential care to adolescents as they navigate this vulnerable time in their lives.”

Patients may be referred to a pediatric and adolescent gynecologist by their pediatrician, or they may make an appointment for themselves. It is helpful but not required for the patient’s medical records to be available for review at the time of her first visit. These can either be brought with the patient at the time of the visit or faxed to the office by the referring physician.