Adolescent gynecology in the office setting

Abstract

As stated by the Committee on Adolescence of the AAP, All pediatricians who choose to see teenagers should be able to provide counseling about sexual behavior, education on contraceptive methods and prevention of sexually transmitted diseases, and assistance with access to family planning services, preferably in the office or, if necessary, by referral. Expansion of skills and office capabilities to provide routine reproductive health care for adolescents, including pelvic examinations, annual Pap tests, diagnoses of pregnancy, diagnoses and treatment of sexually transmitted diseases, and the prescription of contraceptives, is also encouraged. Pediatricians who have longstanding relationships with their patients, and who are admired and trusted are ideal for providing this care.

PIP: This paper discusses adolescent gynecologic experiences in health care provider clinics. Pediatricians in this study deal with problems that are not encountered by their predecessors. Traditional pediatric practice 20-30 years ago differ from that in the modern adolescent practice. Medical practitioners providing care to adolescents need to ensure that their practices are able to meet the demands of the patient. Incorporating general pediatric setting implies a change in one's practice to be more receptive to adolescents. This involves having appropriate staff, philosophy, decor, expertise, and equipment. They should be prepared to handle multiple issues related to pubertal development, sexuality, self-esteem, and body image. Office services must choose comprehensive scope of services and develop policies or guidelines acceptable to all providers in the practice. Practitioners and staff must be able to possess and understand the importance of confidentiality and its limitations. It is necessary to have complete, useful, and essential office equipment and supplies. Lastly, it is also the role of pediatricians to educate and counsel adolescents and parents regarding adolescents' gynecologic health. Among the common gynecologic problems encountered are the following: menstrual disorders; vaginitis and vulvar disorders; breast disorders; sexually transmitted diseases; and adolescent pregnancy and contraception.