Journal Of Pediatric And Adolescent Gynecology[JOURNAL]
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200 papers
Prevalence of Heavy Menstrual Bleeding in Adolescents with Mullerian Anomalies: A 10-Year Single-Center Retrospective Cohort Study.
Jean-Louis BS, Golden C, Jergel A … +2 more , Gooding HC, Sokkary N
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42069243 · Publisher ↗
BACKGROUND: Heavy menstrual bleeding (HMB) is a common complaint in young women in the general population and is associated with disruptions in physical, mental, and social well-being. This study aimed to describe the pr...
BACKGROUND: Heavy menstrual bleeding (HMB) is a common complaint in young women in the general population and is associated with disruptions in physical, mental, and social well-being. This study aimed to describe the prevalence of HMB among adolescents with Mullerian anomalies. METHODS: We conducted a retrospective cohort study of adolescents diagnosed with a Mullerian anomaly at a tertiary children's health system from 2014 to 2024. We queried the Electronic Health Record for the following diagnostic codes: Mullerian anomaly, uterine anomaly, bicornuate uterus, didelphic uterus, uterine septum, unicornuate uterus, and arcuate uterus. We defined HMB as provider diagnosis of HMB, menorrhagia, or prolonged menstrual bleeding. We collected data on patient race, age of menarche, age at time of diagnosis of Mullerian anomaly and HMB, subtype of Mullerian anomaly diagnosis, imaging modality used in diagnosis, presence or absence of a bleeding disorder evaluation, and treatment received for HMB. Only adolescents with a confirmed Mullerian anomaly and a documented menstrual history who had reached menarche were included in the analysis. RESULTS: Of the 140 adolescents included, 60 (43%) experienced HMB. HMB was most prevalent in those with bicornuate uterus (58%), uterine septum (55%), and arcuate uterus (50%). The most common treatment for HMB was combined hormonal contraception (44%). CONCLUSION: The prevalence of HMB in adolescents with Mullerian anomalies in this cohort was 43% but varied by subtype. Understanding the prevalence of HMB in patients with specific Mullerian anomalies will allow clinicians to provide improved anticipatory guidance for this patient population.
Identifying Suicidality Risk in Adolescent Gynecology: Implications of Combined PHQ-2 and ASQ Screening.
Nowlen MA, Williamson A, Temkit M
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42066984 · Publisher ↗
OBJECTIVE: To evaluate the association between depression and suicidal ideation (SI) screening results among patients in a pediatric and adolescent gynecology clinic and to determine whether associations differ between s...
OBJECTIVE: To evaluate the association between depression and suicidal ideation (SI) screening results among patients in a pediatric and adolescent gynecology clinic and to determine whether associations differ between school and summer periods. STUDY DESIGN: This retrospective cross-sectional study included patients aged ≥ 13 years who completed both the Patient Health Questionnaire-2 (PHQ-2) and Ask Suicide Screening Questions (ASQ) from June 2023 to April 2025. Depression was defined as a PHQ-2 score ≥ 3; SI was defined as any affirmative ASQ response. Simultaneous positive/negative combinations were evaluated, and associations were tested using chi-square or Fisher's exact tests. RESULTS: Among 1,481 patients, PHQ-2 and ASQ scores were significantly associated (p < 0.0001). Negative PHQ-2 screens corresponded to negative ASQ screens in 1,192 (92.5%) patients. However, 97 (7.5%) patients screened negative for depression but positive for SI, including one (0.1%) with severe SI. Positive ASQ screens were more frequently associated with positive PHQ-2 screens (40.6%) than negative PHQ-2 screens (7.5%). All severe ASQ scores occurred during the school year. CONCLUSIONS: Screening for depression alone is insufficient to identify all adolescents at risk for suicidality. Dual screening with PHQ-2 and ASQ enables more comprehensive identification of at-risk patients in pediatric and adolescent gynecology settings, thereby enabling practitioners to connect such patients with the necessary mental-health resources.
Clinician Evaluation of AI-Generated Responses to Girls' Puberty-Related Questions.
Chojnicki M, Bruś-Chojnicka A, Religioni U … +1 more , Kapczuk K
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42055390 · Publisher ↗
STUDY OBJECTIVE: Adolescents often look online for answers to sensitive questions about puberty and sexual health. As chat-based AI tools become more accessible, they may influence how young people interpret symptoms and...
STUDY OBJECTIVE: Adolescents often look online for answers to sensitive questions about puberty and sexual health. As chat-based AI tools become more accessible, they may influence how young people interpret symptoms and decide whether to consult a doctor. We examined whether GPT-4o responses to common puberty-related questions from girls aged 8-17 years were judged by clinicians to be acceptable and appropriate for the user's age. METHODS: Ten common puberty-related queries from a Polish search context were identified using Google Autocomplete in May 2024 and converted into standardized first-person prompts beginning with "I am X years old and…". GPT-4o generated one response to each prompt in separate new chat sessions without manual editing. Eighteen clinicians (11 pediatric and adolescent gynecologists and 7 pediatricians) rated each response for content quality, adequacy of recommendations, empathy, and age appropriateness on 5-point scales. The main outcome was the proportion of ratings considered acceptable (scores of 4 or 5). RESULTS: Overall, 79.2% of ratings (570/720; 95% CI 76.0-82.1) were in the acceptable range, exceeding the predefined threshold. Across domains, acceptability ranged from 72.2% to 84.4%. Internal consistency was high for empathy and age appropriateness. Agreement between individual raters was low but improved to a moderate level when scores were averaged. Greater concern about adolescents placing too much trust in AI was strongly associated with the expectation that its use could reduce contact with physicians (Spearman's ρ = 0.86; p < 0.001; n = 18). CONCLUSIONS: Most GPT-4o responses to common puberty-related questions were judged acceptable by clinicians. At the same time, concerns persisted that young users might rely too heavily on AI and delay seeking medical advice. Any use of such tools by adolescents should therefore include clear advice on when in-person medical assessment is needed.
The Impact of Patient Navigation on Health Care Utilization in Pediatric and Adolescent Gynecology: A Retrospective Cohort Study.
Appel ZT, Vargo SG, French AV … +1 more , Berger-Chen SW
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42055389 · Publisher ↗
STUDY OBJECTIVE: Pediatric and adolescent patients face barriers to accessing comprehensive reproductive health care. These barriers are intensified by limited infrastructure and confidentiality regulations that make sch...
STUDY OBJECTIVE: Pediatric and adolescent patients face barriers to accessing comprehensive reproductive health care. These barriers are intensified by limited infrastructure and confidentiality regulations that make scheduling, follow-up, and communication more challenging. A patient navigator (PN) position was implemented within a newly established Pediatric and Adolescent Gynecology (PAG) clinic in a large urban medical center to improve access and support confidential care. This study evaluated the impact of the PN on PAG health care utilization and investigated the effects across racial and ethnic groups and insurance types. METHODS: A retrospective cohort study was conducted using electronic medical record data from Epic SlicerDicer. Health care utilization metrics were compared for 1 year before (March 3, 2023-March 3, 2024) and 1 year after (March 4, 2024-March 4, 2025) the implementation of the PN position. RESULTS: After PN implementation, total appointments increased by 39% (P < .001), completed follow-up visits increased by 65% (P < .001), and the missed appointment rate decreased by 44% (P < .001). Patients who self-identified as Asian experienced a 66% decline in missed appointment rates (P = .031), those who selected "Other" had a 49% decrease (P = .003), and the "Unknown/Declined" racial group saw a 57% decrease (P = .041). Additionally, patients with public insurance saw a 49% (P < .001) decrease. CONCLUSION: Establishing a PN in a PAG clinic improves utilization of care, continuity, and appointment adherence. We observed significant reductions in the missed appointment rate among several racial and ethnic groups and in the underrepresented group of patients with public insurance.
Leave the Uterus Alone: Uterine Torsion in Children.
Schneider G, Faraj S, Rossignol G … +6 more , Goulin J, Enache T, Demede D, Bidault V, Mure PY, Kassir R
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42034155 · Publisher ↗
BACKGROUND: Uterine torsion is an extremely rare condition in pediatric patients and is most often associated with an ovarian mass. When acute symptoms occur, uterine blood supply may be compromised, occasionally leading...
BACKGROUND: Uterine torsion is an extremely rare condition in pediatric patients and is most often associated with an ovarian mass. When acute symptoms occur, uterine blood supply may be compromised, occasionally leading to ischemia or necrosis. Because of its rarity and nonspecific presentation, pediatric uterine torsion may be misdiagnosed, and no clear recommendations currently exist regarding its management. CASE: We report the case of a 21-month-old girl who presented with acute abdominal pain and vomiting caused by torsion of a large ovarian mature teratoma. Surgical exploration revealed a 270°-360° uterine torsion with signs of severe ischemia and a necrotic appearance of the uterus. A right salpingo-oophorectomy was performed, but a conservative approach was chosen for the uterus despite the absence of immediate macroscopic recovery after detorsion. The postoperative course was uneventful. Mid-term follow-up of 5.5 years demonstrated normal uterine morphology and vascularization on imaging, with the patient remaining asymptomatic. SIGNIFICANCE: This case highlights uterine torsion as a rare but possible complication of ovarian masses in children and a potential cause of acute abdominal pain. Our experience, supported by a review of the literature, suggests that conservative uterine management should be considered whenever possible, even in the presence of a necrotic appearance. Long-term follow-up is essential to assess uterine recovery and potential functional outcomes.
A Cross-Sectional Survey of University Students' Lifetime Experiences of Inappropriate, Disrespectful, and Coercive Behavior During Sensitive Exams.
Walsh AR, Dove-Medows E, Loder CM … +4 more , Kalpakjian C, Moore C, Ernst S, Munro-Kramer ML
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42031136 · Publisher ↗
STUDY OBJECTIVE: To describe university students' lifetime prevalence of inappropriate, disrespectful, and coercive (IDC) experiences during sensitive physical exams and explore differences across sexual orientation and...
STUDY OBJECTIVE: To describe university students' lifetime prevalence of inappropriate, disrespectful, and coercive (IDC) experiences during sensitive physical exams and explore differences across sexual orientation and gender identities (SOGI). METHODS: This cross-sectional study analyzed survey data from a representative sample of students at a large public university (US, 2021, N = 2779). Lifetime prevalence of 13 IDC experiences (eg, painful exams, ungloved exams, attempts to sexually arouse patient) and trust in sensitive exam providers was estimated for the sample and within SOGI groups (gender minority (GM), sexual minority cisgender female/male, heterosexual cisgender female/male). Item prevalence and SOGI associations were assessed with 2-sided t tests and X tests. RESULTS: Lifetime prevalence of sensitive exam IDC experiences ranged from 0.6% (took pictures of patient's body without permission) and 2.5% (genital, pelvic, or rectal exam without gloves) to 19.9% (excessive wait while undressed). Significant associations (P < .05) between SOGI and negative experience prevalence estimates were identified; GM students reported the highest prevalence, and cisgender heterosexual male students the lowest, for all but 1 IDC item. 7.9% of students reported not trusting any healthcare providers during sensitive exams, with 30.9% of GM students compared to 3.1% of heterosexual cisgender men reporting no trust (P < .001). CONCLUSION: GM university students experienced more IDC experiences during sensitive exams and have lower trust in sensitive exam providers than cisgender students, particularly cisgender heterosexual males. Ensuring informed consent, offering chaperones, and clear communication are critical to build trust and ensure continued healthcare engagement and positive long-term health outcomes, particularly for SOGI patients.
Unexpected Virilization in a Patient with Turner Syndrome with Unbalanced Y/7 Translocation in the Gonadal Tissue: Gonadoblastoma Diagnosis.
Marczak E, Szarras-Czapnik M, Walewska-Wolf M … +7 more , Skórka A, Wicher D, Markowska-Krawczyk K, Młynek M, Przywoźna-Zduńczyk K, Chrzanowska K, Moszczyńska E
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42019713 · Publisher ↗
Turner syndrome (TS) may involve tissue-restricted mosaicism, undetectable in standard peripheral blood karyotyping. This poses a diagnostic challenge, particularly when occult Y-chromosome material increases gonadoblast...
Turner syndrome (TS) may involve tissue-restricted mosaicism, undetectable in standard peripheral blood karyotyping. This poses a diagnostic challenge, particularly when occult Y-chromosome material increases gonadoblastoma risk. We report an 18-year-old girl with TS (45,X), short stature on recombinant human growth hormone and severe intellectual disability, who developed virilization at age 12. Laboratory testing showed hypergonadotropic hypogonadism with elevated testosterone. Imaging failed to detect gonads. Bilateral gonadectomy revealed streak gonad tissue and testicular tissue with intratubular germ cell neoplasia and focal gonadoblastoma. High-resolution cytogenetics confirmed gonadal mosaicism with unbalanced Y/7 translocation, absent in lymphocytes. This case highlights that unexplained virilization in TS warrants immediate evaluation and that high-resolution genomic methods and timely gonadectomy are essential for cancer risk reduction.
Iron Overload-Associated Premature Ovarian Insufficiency: A Case Report.
Sutandar Y, Ritonga MA, Rachmawati A … +1 more , Tjahyadi D
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42019712 · Publisher ↗
INTRODUCTION: Primary ovarian insufficiency (POI) is a clinical condition characterized by reduced or loss of ovarian follicle function before age 40. It presents with a broad clinical spectrum and variable natural progr...
INTRODUCTION: Primary ovarian insufficiency (POI) is a clinical condition characterized by reduced or loss of ovarian follicle function before age 40. It presents with a broad clinical spectrum and variable natural progression. Chronic iron overload is a known cause of endocrine dysfunction and is suspected to contribute to POI through mechanisms such as oxidative stress and ferroptosis. This report presents a rare case of an 18-year-old female with iron overload suspected due to a history of chronic transfusion during her childhood period, which leads her to POI. CASE PRESENTATION: An 18-year-old 46 XX female presented with primary amenorrhea and absence of secondary sexual characteristics. She had a history of regular blood and platelet transfusions for 7 years during childhood, with no subsequent transfusions. Anthropometry showed normal weight and height. Physical examination revealed Tanner stage 1 breast and pubic hair development. Initial laboratory evaluation revealed hypergonadotropic hypogonadism (FSH 64.15 mIU/mL; Estradiol 22.37 pg/mL; AMH <0.03 ng/mL). Significant iron overload was noted (Ferritin 3435.7 ng/mL; Transferrin saturation 77.52%). Pelvic imaging demonstrated hypoplastic uterus and ovaries. The patient was diagnosed with POI associated with iron overload and Immune Thrombocytopenic Purpura, noting her thrombocytopenia with a platelet count of 95,000/µL. She started estradiol valerate 1 mg daily to induce secondary sexual characteristics. CONCLUSION: Long-term exposure to excess iron may contribute to follicular atresia and ovarian failure. This case underscores the importance of monitoring pubertal development in children with a history of chronic transfusions. The therapeutic strategy for POI focuses on initiating secondary sexual characteristics to foster psychosocial well-being and optimize bone health.
Restoration of Ovarian Function after Unilateral Oophorectomy in McCune-Albright Syndrome.
Alarab H, Blasi CCD, Nip A … +1 more , Oelschlager AA
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 42013948 · Publisher ↗
INTRODUCTION: McCune-Albright syndrome (MAS) is characterized by café-au-lait-skin-pigmentation, polyostotic-fibrous-dysplasia and gonadotropin-independent precocious puberty. We report a female patient whose ovarian fun...
INTRODUCTION: McCune-Albright syndrome (MAS) is characterized by café-au-lait-skin-pigmentation, polyostotic-fibrous-dysplasia and gonadotropin-independent precocious puberty. We report a female patient whose ovarian function normalized following unilateral oophorectomy at young age. CASE: The patient initially presented with peripheral precocious puberty at age 1 and was treated with aromatase inhibitors and selective estrogen receptor modulator until the age of 12 years for pubertal suppression. Cystectomy was performed at age 16 due to persistent right complex ovarian cysts with menorrhagia. Genetic testing of the cyst tissue confirmed GNAS mutation. Persistence of a complex ovarian cyst, extremely elevated estradiol levels, and refractory uterine bleeding led to right salpingo-oophorectomy and levonorgestrel intrauterine device placement at age 19, resulting in the restoration of ovarian function. SUMMARY/CONCLUSION: This report describes a single case of ovarian function restoration after unilateral oophorectomy in a patient with MAS, but should not be generalized to all MAS patients.
Letter to the Editor in Response to Boero et al. on a Standardized Induction Regimen for Pediatric Vulvar Lichen Sclerosus: Should We Settle for One-Size-Fits-All?
Morrel B, van der Avoort IAM, van Dorp W … +1 more , Mendels E
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 41956202 · Publisher ↗
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Comment on "Characteristics of Adolescent and Young Adult Patients Undergoing Surgery for Deep Endometriosis: A Multicenter Database Study".
Liu F, Zhang R
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 41956201 · Publisher ↗
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Outcomes of an Immediate Postplacental Intrauterine Device Placement Program in Adolescents and Young Adults: A Retrospective Cohort.
Hutchison CE, Ali NK, DeSilva NK … +1 more , Baker CC
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 41946396 · Publisher ↗
OBJECTIVE: This study aims to retrospectively assess outcomes, including intrauterine device (IUD) continuation, repeat pregnancy, and complication rates, of immediate postplacental levonorgestrel 52 mg IUD (PPIUD) place...
OBJECTIVE: This study aims to retrospectively assess outcomes, including intrauterine device (IUD) continuation, repeat pregnancy, and complication rates, of immediate postplacental levonorgestrel 52 mg IUD (PPIUD) placement in obstetric patients aged 21 and under at a high-volume county hospital. METHODS: We retrospectively reviewed charts of patients who received a PPIUD between March 1, 2021, and August 15, 2022, at our institution. The primary outcome was continued IUD use. Secondary outcomes were repeat pregnancy, reason for IUD discontinuation, including complete and partial expulsion, pelvic infection, and string complications (strings lost or trimmed). RESULTS: A total of 285 patients with a mean age of 19 years (range 14-21) had a PPIUD placed. Electronic medical record data was collected retrospectively through 8/31/23 to ensure follow-up for at least 1 year following IUD placement or until repeat pregnancy, whichever came first; the median length of data collection after initial IUD placement was 20 months (range 2-30 months). There was continued IUD use in 197 (69.1%). IUD expulsion was the most common reason for discontinuation and occurred in 32 patients; overall expulsion rate was 15.4%. Repeat pregnancy occurred in 25 (8.8%) patients, all of whom had IUD removal or expulsion. No pelvic infections occurred. Strings were not visualized in 63 (21.9%) patients and trimmed in 24 (8.3%). CONCLUSION: Immediate PPIUD placement in adolescents and young adults results in high continuation and low repeat pregnancy rates in this population. Expulsion and infection rates were comparable to prior studies. Patients should be counseled on potential PPIUD string complications.
Sexual Function in Women with Müllerian Anatomic Differences of the Genitourinary Tract-A Qualitative Evaluation.
Aitelli A, Liu J, Loza N … +4 more , Sumner SF, White SA, Routh JC, Kisby CK
J Pediatr Adolesc Gynecol · 2026 Apr · PMID 41946395 · Full text
STUDY OBJECTIVE: Müllerian anomalies are congenital anomalies of the female reproductive tract. Patients with Müllerian anomalies frequently report difficulty with sexual function, yet no standardized patient-reported se...
STUDY OBJECTIVE: Müllerian anomalies are congenital anomalies of the female reproductive tract. Patients with Müllerian anomalies frequently report difficulty with sexual function, yet no standardized patient-reported sexual function tools exist specific to this population. This study aimed to explore sexual function, through qualitative interviews, in women with Müllerian anomalies to identify themes and develop a conceptual model to later be used in the development of a sexual function questionnaire. METHODS: We conducted semi-structured qualitative interviews with 11 female patients with Müllerian anomalies. The interview guide was developed based on expert consultation and extensive literature review to identify what current sexual function questionnaires address and what sexual function concerns related to Müllerian anomalies are reported. Questions explored topics such as sexual pleasure, interpersonal relationships, physical and emotional discomfort during sex, sex education received from healthcare providers, and treatment goals related to sexual function. Interviews were conducted with female-identifying patients with Müllerian anomalies over 4 months. Interviews were transcribed, and qualitative thematic analysis was performed in NVivo to identify themes. RESULTS: Eleven participants were recruited with Müllerian anomalies affecting the uterus, cervix, and/or vagina. Six major themes affecting sexual function were identified from interview transcripts: symptoms, diagnosis, providers, treatment, self-concept, and social context. Major and minor themes were used to develop a conceptual model. CONCLUSION: Women with Müllerian anomalies face unique sexual challenges due to their anatomy and socio-emotional interplay, in addition to those experienced by the general population. Patient education materials and screening tools specific to this population are needed.
Eating Attitudes, Sleep Quality, and Self-Esteem in Adolescents Diagnosed with Polycystic Ovary Syndrome.
Altikardesler OK, Dural O, Evruke I … +3 more , Ulusoy HE, Aksakal MZT, Bas F
J Pediatr Adolesc Gynecol · 2026 Mar · PMID 41933573 · Publisher ↗
OBJECTIVE: To investigate the risk of eating disorders, poor sleep quality, and low self-esteem in adolescents with polycystic ovary syndrome (PCOS) in comparison with a healthy group and to determine how these factors a...
OBJECTIVE: To investigate the risk of eating disorders, poor sleep quality, and low self-esteem in adolescents with polycystic ovary syndrome (PCOS) in comparison with a healthy group and to determine how these factors are related to each other as well as which disease characteristics may influence them. METHODS: The study group consisted of adolescents aged 13-21 who were diagnosed with PCOS based on current international suggestions. The control group comprised age-matched healthy volunteer adolescents. All participants completed three standardized self-report questionnaires: The Eating Attitudes Test (EAT-26), the Pittsburgh Sleep Quality Index (PSQI), and the Rosenberg Self-Esteem Scale. RESULTS: A total of 90 adolescents with PCOS and 110 age-matched healthy peers were recruited. The adolescents with PCOS showed a higher risk of eating disorders (23.3% vs 12.7%, P = .048) and low self-esteem (28.9% vs 15.4%, P = .021) compared to their healthy peers. There were no significant differences between two groups in terms of PSQI total score (P > .05). In adolescents with PCOS who were at risk for eating disorders, self-esteem was lower (P = .033), and the rate of poor sleep quality was higher (P = .033). No relationship was found between body mass index or hirsutism and the risk of eating disorders, self-esteem, and sleep quality. DISCUSSION: The findings of this study suggest that adolescents with PCOS are more likely to experience disturbances in eating attitudes and report low self-esteem. Physicians should be aware of and screen for these psychological and behavioral consequences of PCOS on adolescents.
Prescribing Practices for Pre- and Post-Procedural Analgesia During Intrauterine Device Insertion: A National Survey of Providers in the United States.
Friedlich NE, Dunlop HM, Shah S … +1 more , Combs SM
J Pediatr Adolesc Gynecol · 2026 Mar · PMID 41903736 · Publisher ↗
BACKGROUND: The intrauterine device (IUD) is an effective contraceptive, but insertion pain is a significant concern and barrier, especially for nulliparous patients. OBJECTIVE: To evaluate differences in practice patter...
BACKGROUND: The intrauterine device (IUD) is an effective contraceptive, but insertion pain is a significant concern and barrier, especially for nulliparous patients. OBJECTIVE: To evaluate differences in practice patterns for pre- and post-procedural analgesia during IUD insertion. STUDY DESIGN: A cross-sectional national web-based survey of 652 IUD providers examined demographics and their likelihood of prescribing analgesia to nulliparous and multiparous patients. Linear regression models and 1-way analysis of variance (ANOVA) tests assessed differences in analgesia recommendations by provider demographics. RESULTS: Pre-procedurally, 75.9% of providers for nulliparous and 66.2% for multiparous patients frequently prescribed non-steroidal anti-inflammatory drug (NSAIDs). Post-procedurally, 76.5% for nulliparous and 65.4% for multiparous patients frequently prescribed NSAIDs. Providers with 30+ years of experience and cisgender male providers prescribed NSAIDs and anxiolytics less frequently. CONCLUSIONS: NSAIDs were the most common analgesic pre- and post-IUD insertion. Prescribing practices varied by gender and years in practice. Providers should adopt patient-centered prescribing to reduce IUD insertion pain.
"Hey Guys, How Are Your Vaginas Doing?" Exploring Adolescents' and Young Adult Women Attitudes and Practices Toward Vulvovaginal Health: A Qualitative Study.
Rengifo R, Williams DN, D'Ambrosi G … +3 more , Leahy G, Addison J, Hassan A
J Pediatr Adolesc Gynecol · 2026 Mar · PMID 41887315 · Publisher ↗
STUDY OBJECTIVE: Vaginal self-care and vulvovaginal health trends are frequently viewed by adolescent and young adults (AYA) on social media. This study explored AYA understanding, attitudes, knowledge, and practices reg...
STUDY OBJECTIVE: Vaginal self-care and vulvovaginal health trends are frequently viewed by adolescent and young adults (AYA) on social media. This study explored AYA understanding, attitudes, knowledge, and practices regarding vulvovaginal health with a focus on the positive and negative influences of social media. DESIGN: We recruited AYA using a criteria based purposeful sample from an urban practice. Semi-structured qualitative interviews explored attitudes, practices, and social media use related to vulvovaginal health. Interviews were recorded, transcribed, coded and thematically analyzed using inductive and deductive methods. RESULTS: 28 participants assigned female at birth (range 15-25 years) were interviewed. Four major themes were identified: (1) Vulvovaginal health is viewed as important and often overlooked; (2) AYA engage in vulvovaginal health practices, such as daily vulvar washing with water or gentle soap, shaving, and explored products like wipes, washes, and vajaycials; (3) AYA view vulvovaginal health content on social media and express diverse attitudes toward products and practices; (4) AYA trust healthcare providers as reliable sources of guidance, with older AYA expressing greater skepticism toward social media. AYA trust healthcare providers as reliable sources of guidance. A subtheme suggested that older participants feel particularly cautious about social media content. Several recommendations emerged for effective communication. CONCLUSIONS: Social media is a popular source of vulvovaginal health information. Older AYA Some participants questioned the credibility of content, while also appreciating raised awareness of vaginal health on these platforms. Health care providers should be aware of misinformation and provide evidence based guidance.
A Digital Referral Tool to Link Adolescent Females from the Emergency Department to Sexual and Reproductive Healthcare: A Cohort Study.
Adler T, Tchoungui LP, Garth J … +2 more , Cepin A, Chernick LS
J Pediatr Adolesc Gynecol · 2026 Mar · PMID 41881241 · Publisher ↗
PURPOSE: Emergency departments (EDs) provide a critical access point for adolescents with unmet sexual and reproductive health (SRH) needs; yet, effective connection to follow-up care remains limited. This study aimed to...
PURPOSE: Emergency departments (EDs) provide a critical access point for adolescents with unmet sexual and reproductive health (SRH) needs; yet, effective connection to follow-up care remains limited. This study aimed to develop and pilot test the Dr. Erica Digital Referral Tool (Dr. E-DRT), a patient-facing tool designed to educate adolescent females and facilitate linkage to person-centered sexual healthcare after ED discharge. METHODS: We conducted a prospective cohort study from July 2023 to February 2024 in an urban pediatric ED. Biologically female, English-speaking adolescents aged 14-19 years were screened for eligibility. Enrolled participants completed a baseline survey, interacted with the Dr.E-DRT and were offered the option to schedule a follow-up appointment for SRH care. Two-month follow-up was completed via survey and electronic medical record (EMR) review. Outcomes included feasibility, acceptability, and potential efficacy to increase outpatient follow-up. RESULTS: Of 223 adolescents screened, 31 met eligibility criteria and 25 enrolled. All participants completed the tool and 16 participants (64%) scheduled a follow-up visit at our local family planning practice. Acceptability of Dr. E-DRT was high across multiple dimensions, with mean Likert scores ranging from 4.2 to 4.4 out of 5 for satisfaction, appeal, and likelihood of recommending the tool. At 2-month follow-up, survey completion was 40% (10/25). Only 3 participants attended the follow-up visit. DISCUSSION: Dr.E-DRT was feasible to implement and well accepted by adolescents in the ED. While appointment scheduling was high, visit completion remained low, highlighting the need for additional strategies to support linkage to SRH care after ED visit.
FIGIJ Advocacy Statement on Climate Change.
Slonim M, Simms-Cendan J, Aguilar A … +8 more , Vatapoulou A, Rome E, Labovsky M, Panova DI, Di Nunzio MC, Orti M, Drejza M, Jayasinghe Y
J Pediatr Adolesc Gynecol · 2026 Mar · PMID 41871773 · Publisher ↗
Climate change is an escalating global crisis that disproportionately threatens the health and rights of children and adolescents, with girls facing particularly heightened vulnerability. Increasing temperatures, extreme...
Climate change is an escalating global crisis that disproportionately threatens the health and rights of children and adolescents, with girls facing particularly heightened vulnerability. Increasing temperatures, extreme weather events, food and water insecurity, and exposure to environmental toxins directly and indirectly affect sexual and reproductive health. These impacts include altered timing of menarche, worsened dysmenorrhea, increased risks of subfertility and pregnancy complications, and reduced access to essential reproductive health services. Broader climate-related instability further contributes to malnutrition, disruption of education, child marriage, displacement, and gender-based violence, compounding longstanding gender, socioeconomic, and geographic inequities. FIGIJ affirms climate change as a health emergency and aligns itself with international efforts calling for urgent, coordinated action. FIGIJ supports the development of strong coalitions between governments, health care systems, and communities to amplify the health care sector's voice in global and regional climate advocacy. Protecting the next generation requires coordinated efforts, effective collaboration, and an ongoing commitment to supporting a healthier, more resilient and equitable future.
Clinical and Biochemical Characteristics of Girls With Polycystic Ovary Syndrome Presenting With Amenorrhea.
Mustafa M, Eugster EA
J Pediatr Adolesc Gynecol · 2026 Mar · PMID 41871772 · Publisher ↗
OBJECTIVE: To evaluate the prevalence of polycystic ovary syndrome (PCOS) in girls presenting with amenorrhea and to compare the clinical and biochemical features of those with primary (PA) versus secondary amenorrhea (S...
OBJECTIVE: To evaluate the prevalence of polycystic ovary syndrome (PCOS) in girls presenting with amenorrhea and to compare the clinical and biochemical features of those with primary (PA) versus secondary amenorrhea (SA). METHODS: We performed a retrospective chart review of girls aged 12-18 years seen in the pediatric endocrine clinic for amenorrhea between 2014 and 2024. PA was defined as absent menses by age 15 or ≥3 years after puberty onset, and SA as cessation of menses for ≥6 months 1-year post-menarche. Data collected included demographics, family history, clinical features, laboratory studies, response to a progesterone challenge test and treatment. Non-parametric tests (Mann-Whitney U) and chi-square tests were used for comparisons. RESULTS: Among 377 patients, 126 (33%) were diagnosed with PCOS, of whom 32 (25.4%) had PA and 94 (74.6%) had of SA. Mean age was similar in PA and SA groups (15.2 ± 1.3 vs 15.3 ± 1.5 years). BMI was elevated in both groups (37.1 ± 7.5 vs 36.3 ± 8.4 kg/m²). Family history of PCOS was more frequent in those with PA (31.3% vs 14.9%, P = .042). Failure to bleed after a progesterone challenge failure was more common in girls with PA (36.8% vs 14.0%, P = .041). Androgen levels were higher in girls with PA (P < .05). CONCLUSIONS: PCOS is a frequent cause of both PA and SA in adolescents. Girls with PA exhibit greater hyperandrogenism and are more likely to fail a progesterone challenge, suggesting a more severe phenotype than in those with SA.
Laparoscopic Resection of Vaginal Embryonal Rhabdomyosarcoma in a 16-Month-Old Girl: An Organ-Preserving Surgical Approach.
Xu J
J Pediatr Adolesc Gynecol · 2026 Mar · PMID 41866106 · Publisher ↗
BACKGROUND: Vaginal rhabdomyosarcoma is a rare malignant soft tissue tumor in pediatric patients, and optimal management aims to achieve tumor control while preserving pelvic organs. CASE: We report the case of a 16-mont...
BACKGROUND: Vaginal rhabdomyosarcoma is a rare malignant soft tissue tumor in pediatric patients, and optimal management aims to achieve tumor control while preserving pelvic organs. CASE: We report the case of a 16-month-old girl who presented with a protruding vaginal mass. Imaging studies revealed a vaginal tumor near the cervix without evidence of metastatic disease. Histopathological examination confirmed embryonal rhabdomyosarcoma. The patient received 12 weeks of neoadjuvant VAC/VA chemotherapy, followed by laparoscopic tumor resection to address the limited pelvic space in infancy and preserve surrounding organs. The postoperative course was uneventful, and adjuvant chemotherapy was completed. At 32 months of follow-up, no local recurrence or distant metastasis was observed. SUMMARY AND CONCLUSION: Laparoscopic resection combined with chemotherapy may represent a feasible, organ-preserving treatment option for selected infants with vaginal rhabdomyosarcoma; however, long-term follow-up remains necessary.
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