Adolscent Clinic

Anaemia in Adolescent

Adolescent Health An Overview Dr Jyoti Agarwal

Female Foeticide

ADOLESCENT

ADOLESCENT

All girls and their mothers

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“Adolescent girl” THEY ARE DIFFERENT

• Anemia, Abortion, Abuse
• Developing, Depressed
• Obese, Overindulging
• Lack of information
• Experimenting
• Social, Sexual,
• Courageous
• Emotional
• Never say no to peers
• Temperamental, Teenage pregnancy

Gynaecologist require

• Specific knowledge & expertise
• No treatment is also an option
• Gynaecological problems are common
• Serious pathology is rare
• S/T congenital disorders present 1st time
• Vaginal examination only if sexually active or very necessary

MENSTRUAL DYSFUNCTION

• Common – immature HPO axis for 2 years
• May disguise other worries- contraception, bullying, abuse, STD, pregnancy
• Privacy during counceling

MENORRHAGIA (Heavy Period )Clots, Prolonged Days

• Menstrual diary, 3-7/21-45, explanation, reassurance is required.
• Anti-Fibrinolytics – Tranexamic acid.
• Anti-Prostaglandin- Mefenamic acid.
• Cyclic Progesteron for 21days.
• COC

Intractable Menorrhagia (Very Heavy Period)

• 10-20% bleeding disorders.
• USG, coagulation profile, EUA, Hysteroscopy.
• Admission & Blood transfusions.
• High doses of Estrogen, Factor Vll a
• DMPA, MIRENA ( mentally retarted)

DYSMENORRHOEA (Painful period)

• Mild - Anti-Prostaglandin / COC
• Refractory - USG, MRI, Laparoscopy to rule out Obstruction of lower genital tract Endometriosis

ENDOMETRIOMA-USG

50% of adolescent girls with severe gysmenorrhea
opelvic pain are found to have endometriosis

ENDOMETRIOMA

Bilateral endometriosis cyst
Seen at laparoscopy
“Reccurrence High”

DISORDERS OF PUBERTY

PRECOCIOUS PUBERTY

• Precocious puberty-8yrs age
• Idiopathic 75%- treatment by GnRh agonist
• Others- Hypothalamic lesion
1. Functioning gonadal tumor
2. Exogenous Estrogen
3. McCune-Albright syndrome

DELAYED PUBERTY

• >14 years- No secondary sex character
• Causes- Idiopathic, Chronic medical illness, Gonadal failure, Gonadotropin deficiency, Anatomical anomalies
• Estrogen- for breast development & bone protection

AMENORRHOEA (No Periods)

• Primary
1. 14yrs - without sec. sex characters
2. 16yrs - With sec. sex characters
• Secondary
1. no menses > 6mths

AMENORRHOEA (Causes)

• Pregnancy
• Uterus / Vagina- Obstruction, Adhesions, Agenesis
• Ovarian- PCOD, Premature ovarian failure, Agenesis, Iatrogenic

AMENORRHOEA (No Periods)(Diagnosis)

• Hypothalamic- Excessive exercise, Idiopathic, Head injury
• Pituitary- hyper. / hypopituitarism, hyperprolactinemia

IMPERFORATED HYMEN

One of the causes of No periods

AMENORRHOEA

• BMI, Pubertal staging, Hirsutism, Signs of Turners syndrome
• Investigations- pregnancy test, FSH/LH/PRL, TFT, Androgen levels, SHBG, Karyotyping
• Imaging- USG, MRI, BMD
• Treatment is according to cause

OVARIAN MASS

• Rare- 6% of all Ovarian Tumors
• 36%- Physiological
• 64%- Neoplastic
1. Benign- Epithelial cell & Teratoma
2. Malignant- Germ cell 58%
1. Epithelial cell 19%
2. Stromal cell 18%
• Early diagnosis of torsion-to save the ovary

PRACTICE POINT

• Gynecological symptoms can mask other pressures eg bullying or abus
• Endometriosis is a common cause of severe dysmenorrhoea

Do you know a child or teen who may benefit from seeing a gynaecologist?

For young ladies, visiting the gynaecologist can be a very frightening experience.

Understanding their needs, our team of doctors and nurses take on an active approach to reach out, and provide effective solutions and sound advice to our young patients.

Reasons to seek gynaecologic care for young ladies include:

• Menstrual periods that are very heavy or painful, causing decrease in normal activities or school absence.
• Itching, persistent irritation or rashes in genital area
• Concerns regarding anatomy or puberty
• Abdnominal or pelvic pain that persists
• Human Papillomavirus Vaccine (HPV)
• Contraception
• Safe sex practices
• Sexually transmitted disease testing

Vaccination for Cervical cancer

Vaccination is recommended for all young women and your doctor will be able to help decide which vaccine is right for you. Ideally, the vaccine should be given before first sexual contact. This will activate a healthy young woman's immune system and protect her against HPV.

Vaccination for Cervical cancer

Vaccination is recommended for all young women and your doctor will be able to help decide which vaccine is right for you. Ideally, the vaccine should be given before first sexual contact. This will activate a healthy young woman's immune system and protect her against HPV.

Please click here to read more about vaccine in related to India

Please click here to read more about vaccine in related to India Please contact the Life care Centre at 01122414049, 42401339 for more information or to make an appointment, or email us at, E mail :- sharda.lifecare@gmail.com.