Gynecological Care for Adolescents

Adolescent gynecology focuses on the reproductive health of young girls between 10 and 16 years of age. Adolescence is the time during which there are changes in the body which range from physical, mental, psychological, and emotional. Every parent can relate to this because they have a tough time understanding adolescent behavior.

Puberty mainly deals with bodily changes that are obvious. The age of onset and progression is influenced by genetic, environmental, and socioeconomic factors and is hormone-driven. The key events start with breast change followed by pubic hair, and an increase in height leading to menarche.

The ideal age to attain menarche (a woman’s first period) is between 12 and 13 years. Both situations wherein, if a girl attains menarche before 8 or 9 years or fails to attain menarche even by 15 or 16 years, need evaluation.

1) When should an adolescent first visit a gynecologist?

Every girl between 13 and 15 years old should consult a gynecologist for routine checks. Common issues that need evaluation are menstrual irregularities, painful periods, white discharge, breast lump, or urinary issues.

2) How to maintain menstrual hygiene?

• Track your cycles
• Carry a menstrual pouch
• Change pads every 3 to 4 hours and wash hands with soap and water after changing
• Learn to dispose of sanitary pads properly
• Menstrual cups are a better alternative for young girls as it is hassle-free, reusable, and can be reinserted every 4 to 6 hours

3) Is it normal to have menstrual cramps?

Period cramps start with periods or just before it. It is colicky in nature especially involving the lower tummy and it improves with age. Abnormal menstrual cramps usually start 2 to 3 days prior to the periods, especially in the lower tummy radiating to the legs and back, and worsen with age.

How to prevent menstrual cramps?

• Healthy diet
• Exercise
• Yoga
• Walking
• Cycling
• Swimming
• A good sleep routine
• Using hot bags
• Hot showers, and
• occasionally Painkillers

4) Is it normal to have white discharge during adolescence?

Mucoid vaginal discharge is normally seen in girls either premenstrual, post-menstrual, or during ovulation due to hormonal changes and it helps keep the vagina moist. Discharge is said to be unhealthy if it has a strong odour, is copious, itchy, and if there is associated soreness; in such cases, evaluation by the gynecologist is a must. Poor hygiene, allergy, and wearing tight-fitting clothes can cause white discharge. Infections can be prevented by remaining hydrated, eating nutritious food, including probiotics like curd, and wearing loose clothes and cotton undergarments. Understanding what is normal discharge will allay anxiety and encourage open conversations.

5) What is the cause of urinary infections in adolescence?

Urinary tract infections (UTIs) are common in adolescents and the most common symptoms are pain while peeing, burning sensation, lower tummy aches, and fever with chills. It is caused due to poor hygiene, inadequate fluid intake, and holding urine for prolonged periods in order to avoid peeing in school or public places. Seeking medical advice from your gynecologist and early treatment can reduce complications.

How to avoid urinary infections?

Behavioral modifications are the key to avoiding repeated UTIs.

• Staying hydrated
• Wearing breathable fabric
• Regular bathing, and rinsing the genital area with water with strokes from front to back and patting it dry

6) Is PCOS (Polycystic Ovary Syndrome) common in adolescents?

PCOS is a common hormonal disorder in adolescents.

Symptoms of PCOS:

• Menstrual irregularities
• Weight issues
• Acne
• Excessive hair growth, and
• Blackish discoloration around the neck and under the arms

PCOS needs evaluation. Lifestyle modifications, diet, exercise, adequate sleep, etc. can keep PCOS under check.

7) Should adolescents take the HPV (Human Papillomavirus) vaccine?

Yes, the HPV vaccine protects against the HPV virus which is the main cause of cervical cancer. The vaccine can be given by 9 years of age. Between 9 and 15 years, 2 doses are given 6 months apart, and > 15 years, 3 doses are required.

Investing in adolescent health is key to unlocking lifelong health!