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Adolescent Gynecology


Gynecologic Care: An Adolescent-Young Adult Medicine Approach

Parents of adolescent girls are often unsure when, how, and with whom their daughters should begin their gynecologic care. Adolescent girls themselves are often unclear about what constitutes this most basic aspect of their health care.

A young woman's first routine pelvic (internal) exam is generally done between the ages of 18 and 21. Pelvic examination may be done prior to age 18 to evaluate certain concerns, for example, severe menstrual cramps, irregular bleeding, or abnormal vaginal discharge.

We recognize, however, that a girl's gynecologic care begins long before her first pelvic exam. That care really begins in her preteen years with discussions of vulvar hygiene, puberty, and menstruation. It continues after her periods begin with routine check-ups of her growth and development and assessment of any menstrual problems. Throughout her adolescence, this care continues with age and developmentally appropriate discussions of sexual health. Any problems which arise – such as pelvic pain, vaginal discharge, irregular periods - are evaluated in a thoughtful, careful, and sensitive manner.

Many types of doctors provide gynecologic care to pre-teen and adolescent girls including pediatricians, adolescent medicine specialists, gynecologists, and family physicians. An Adolescent Medicine Specialist is trained to provide highly individualized gynecologic care that is integrated into a young woman's overall health care and that recognizes her own level of maturity and development. We believe that an adolescent girl can benefit tremendously from this type of comprehensive care.

While we are not gynecologists, we are expert in the diagnosis and management of common gynecologic disorders of adolescent girls, especially those occurring during the pre-teen and early adolescent years. We will, of course, facilitate a referral to a gynecologist if a complex or unusual situation arises or if our patients prefer to obtain this aspect of their care elsewhere.

The most common gynecologic concerns we see are those related to periods - too long, too frequent, too infrequent, too heavy, too light, or too painful.

Dr. Trager is an active member of the North American Society for Pediatric and Adolescent Gynecology, an organization which provides a forum for education, research and communication among health professionals who provide gynecologic care to children and adolescents.

Dr. Trager provides a broad range of gynecologic care which is tailored to the specific needs and concerns of our female patients:

Assessment of pubertal development and concerns

Evaluation and treatment of
   - Menstrual problems
   - Vaginal discharge, irritation, itching
   - Vulvar skin problems
   - Pelvic pain

Pelvic examination
   - Routine exam
   - Expert first pelvic exam with pre-exam counseling
   - A female chaperone is always in the examination room during a pelvic exam and breast exam

Pap test – a screening test for abnormal cervical cells

Discussion of
   - Abstinence
   - Sexuality concerns
   - Pregnancy prevention

   - Birth control pills
   - Contraceptive patch
   - Contraceptive ring
   - Emergency contraception ("morning-after pill")

Pregnancy testing
   - Office-based urine pregnancy test
   - Blood test

Diagnosis and treatment of sexually transmitted diseases

Breast health

Breast examination
   - Evaluation of common breast problems
   - Breast self-exam teaching

Please feel free ask about any gynecologic concerns you may have. Good communication about this particular aspect of care will help us provide our female patients with the highest quality, comprehensive health care possible.