What are Teen Gynecologic Problems?
A teenager or teen is defined as children between 13 and 19 years old. Teen gynecologic problems refer to conditions that affect the normal functioning of teenage girls’ reproductive organs, such as the breasts and organs in the pelvic and abdominal region, namely the vagina, vulva, ovaries, fallopian tubes, and womb (uterus).
What are the Common Teen Gynecologic Problems?
The teenage years are a period of enormous physical and psychological changes in young girls, and gynecological problems are one of the most common reasons for teenage girls to visit a physician. Some of the common teenage gynecologic problems include:
Menstrual Irregularities: Abnormalities in the menstrual cycle of a woman is called menstrual irregularities. Various menstrual irregularities include:
- Amenorrhea – No menstrual periods until the age of 16 years or absence of menstrual periods for 3 consecutive months and is not pregnant.
- Dysmenorrhea – Painful menstruation periods
- Menorrhagia – Excessive bleeding which lasts for 8 to 10 days
- Oligomenorrhea – Irregular menstrual periods or getting periods frequently
Symptoms observed in patients with menstrual irregularities include burning while urinating, fever, painful bowel movements, vaginal discharge, painful cramps, and lower back pain. Menstrual irregularities should be diagnosed early to prevent complications such as infertility (inability to get pregnant), anemia, hemorrhage, and uterine cancer.
Treatment includes medications such as medroxyprogesterone for amenorrhea, ibuprofen, and naproxen to relieve pain for dysmenorrhea, iron supplements and anti-prostaglandin medications for menorrhagia, and injection of progesterone or the administration of 5-10 mg of medroxyprogesterone for oligomenorrhea.
Endometriosis: Endometriosis is a common gynecological problem affecting women of reproductive age. It occurs when tissue that generally lines the uterus grows outside of it. Symptoms of endometriosis include heavy periods, large clots, back or pelvic pain, pain when urinating, bowel problems, pain during sex, and/or the inability to get pregnant.
As there is no known treatment for endometriosis, a gynecologist will usually focus on mitigating the symptoms and reducing a teen’s risk for complications by utilizing hormonal therapy, pain medications, or fertility treatment. If non-surgical interventions fail, surgery will likely be recommended.
Vulvovaginitis: This condition refers to inflammation or infection of the vulva and the vaginal tissues caused by bacteria, fungi, parasites, and threadworms. The use of irritants such as perfumed soaps, bubble baths, and antiseptics also cause vulvovaginitis. Itching, burning sensation, vaginal discharge, and redness of the labia are some of the symptoms observed in young girls. Tight clothes will worsen the condition because of the moisture around the vulva which may promote the growth of pathogens.
Maintaining hygiene will help to prevent infections. Avoid the use of tight innerwear, teach children to wash hands before and after using the bathroom, avoid bubble baths, and use of antiseptics for baths. Topical applications of clotrimazole, Mycostatin, and soothing creams such as soft paraffin, and nappy rash creams may provide relief from rashes. Surgical treatment is rarely advised in children with vulvovaginitis.
Ovarian Cysts: Cysts are non-cancerous sacs filled with fluid that develop in women’s ovaries. Cysts are formed when the follicle that contains an egg fails to break and release the egg out of the ovary, resulting in the accumulation of fluid in the follicle. Some of the risk factors for cyst formation include heredity, early menstruation, irregular menstrual cycles, excessive upper body fat distribution, and hormonal imbalance. If there is more than one cyst present inside the ovary, the condition is called polycystic ovary syndrome (PCOS). Ovarian cysts usually do not cause any symptoms, but you must visit your doctor if you observe swelling or bloating of the abdomen, experience pain during bowel movements, pelvic pain, severe pain leading to nausea and vomiting, and pain in the pelvis region before or after the menstrual period begins.
Some cysts will disappear by themselves and some cysts that are large will require treatment. Treatment options include non-surgical and surgical treatment. The non-surgical treatment includes:
- Birth control pills help to decrease the formation of new cysts and prevent the formation of eggs that will become cysts.
- Non-steroidal anti-inflammatory drugs such as ibuprofen and acetaminophen help to relieve pain.
- Surgery will be recommended to remove the cyst or ovary if the medications do not help or if cysts are 5 to 10 cm in diameter. Different types of surgeries to remove the cysts include laparotomy and pelvic laparoscopy surgery.
Sexually Transmitted Infections (STIs): STIs are infectious diseases caused by bacteria or viruses that spread from one person to another by sexual contact. Teenagers who are sexually active may develop STIs because of lack of sex education and intense sexual experimentation. The most common STIs are chlamydia, genital herpes, AIDS, and gonorrhea. Some of the commonly occurring symptoms include vaginal discharge, pain in the lower abdomen, skin rash, ulcers, blisters around the genital area, and fever. If STIs are not treated, they may lead to problems such as infertility and cancer of the cervix.
Non-surgical treatment includes antibiotics such as penicillins, cefixime, tetracyclines, azithromycin, or erythromycin and antiviral medications such as acyclovir, famciclovir, and valacyclovir.
Teenage pregnancy: The United States has one of the highest rates of teenage pregnancy of all developed countries. Some of the causes include lack of sex education, unprotected sexual intercourse, sexual assault, or sexual experimentation. The common pregnancy symptoms include breast enlargement, fatigue, nausea and vomiting, fainting, missed periods, and abdominal distension. Teenage pregnancy can cause health problems such as chronic pelvic inflammatory disease, pregnancy-induced hypertension, sexually transmitted diseases, depression, premature delivery, anemia, and toxemia (toxins in the blood). Infants born to teen mothers may develop low birth weight because of inadequate growth of the fetus during pregnancy. Teenage pregnancy may result in the death of the mother or the infant, and other infant developmental problems.
Your doctor will discuss with the pregnant teen about abortion, adoption, and raising the child with family support. The doctor may also suggest various programs about self-care and the care of the baby. There are several preventive measures that can help teenagers to understand the risk of early pregnancy. Some of the education programs include:
- Birth control education programs – They help teens to resist sexual activity until marriage and prevent unintended pregnancies.
- Knowledge-based programs –They will provide information about the use of contraceptives and the prevention of sexually transmitted diseases.
- Other counseling programs - They will provide skills and information on the use of contraceptives.
