Journal of pediatric and adolescent gynecology最新文献

{"title":"A Cross-Sectional Survey of University Students' Lifetime Experiences of Inappropriate, Disrespectful, and Coercive Behavior During Sensitive Exams.","authors":"Alison R Walsh, Emily Dove-Medows, Charisse M Loder, Claire Kalpakjian, Chloe Moore, Susan Ernst, Michelle L Munro-Kramer","doi":"10.1016/j.jpag.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.04.008","url":null,"abstract":"<p><strong>Study objective: </strong>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).</p><p><strong>Methods: </strong>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 (e.g., 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 (SM) cisgender female/male, heterosexual cisgender female/male). Item prevalence and SOGI associations were assessed with 2-sided t-tests and X² tests.</p><p><strong>Results: </strong>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<0.05) 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<0.001).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron Overload-Associated Premature Ovarian Insufficiency: A Case Report.","authors":"Y Sutandar, M A Ritonga, A Rachmawati, D Tjahyadi","doi":"10.1016/j.jpag.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.04.004","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Case presentation: </strong>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 seven 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 95000/µL. She started estradiol valerate 1 mg daily to induce secondary sexual characteristics.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected virilization in a patient with Turner Syndrome with unbalanced Y/7 translocation in the gonadal tissue: gonadoblastoma diagnosis.","authors":"E Marczak, M Szarras-Czapnik, M Walewska-Wolf, A Skórka, D Wicher, K Markowska-Krawczyk, M Młynek, K Przywoźna-Zduńczyk, K Chrzanowska, E Moszczyńska","doi":"10.1016/j.jpag.2026.04.006","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.04.006","url":null,"abstract":"<p><p>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 (rhGH) 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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoration of Ovarian Function After Unilateral Oophorectomy in McCune-Albright Syndrome.","authors":"Hanine Alarab, Carolina C Di Blasi, Angel Nip, Anne-Marie Amies Oelschlager","doi":"10.1016/j.jpag.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.04.002","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Case: </strong>The patient initially presented with peripheral precocious puberty at age 1 and was treated with aromatase inhibitors and selective estrogen receptor modulator (SERM) 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 (IUD) placement at age 19, resulting in the restoration of ovarian function.</p><p><strong>Summary/conclusion: </strong>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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Characteristics of Adolescent and Young Adult Patients Undergoing Surgery for Deep Endometriosis: A Multicenter Database Study\".","authors":"Fenfen Liu, Ruifang Zhang","doi":"10.1016/j.jpag.2026.03.013","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.013","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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?","authors":"Beth Morrel, Irene A M van der Avoort, Wendy van Dorp, Elodie Mendels","doi":"10.1016/j.jpag.2026.03.012","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.012","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Function in Women with Müllerian Anatomic Differences of the Genitourinary Tract - A Qualitative Evaluation.","authors":"Audrey Aitelli, Joyce Liu, Nicole Loza, Spencer F Sumner, Samantha A White, Jonathan C Routh, Cassandra K Kisby","doi":"10.1016/j.jpag.2026.03.010","DOIUrl":"10.1016/j.jpag.2026.03.010","url":null,"abstract":"<p><strong>Study objective: </strong>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.</p><p><strong>Methods: </strong>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 four months. Interviews were transcribed and qualitative thematic analysis was performed in NVivo to identify themes.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of an immediate postplacental intrauterine device placement program in adolescents and young adults: a retrospective cohort.","authors":"Ciara E Hutchison, Neha K Ali, Nirupama K DeSilva, Courtney C Baker","doi":"10.1016/j.jpag.2026.03.011","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.011","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to retrospectively assess outcomes, including IUD continuation, repeat pregnancy, and complication rates, of immediate postplacental levonorgestrel 52mg IUD (PPIUD) placement in obstetric patients aged 21 and under at a high-volume county hospital.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>285 patients with a mean age of 19 years (range 14-21) had a postplacental IUD 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%).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eating attitudes, sleep quality, and self-esteem in adolescents diagnosed with polycystic ovary syndrome.","authors":"Ozlem Ketenci Altikardesler, Ozlem Dural, Ipek Evruke, Hevra Ekin Ulusoy, Melike Zeynep Tugrul Aksakal, Firdevs Bas","doi":"10.1016/j.jpag.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.009","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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 (RSES).</p><p><strong>Results: </strong>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 = 0.048) and low self-esteem (28.9% vs. 15.4%, p = 0.021) compared to their healthy peers. There were no significant differences between two groups in terms of PSQI total score (p>0.05). In adolescents with PCOS who were at risk for eating disorders, self-esteem was lower (p = 0.033), and the rate of poor sleep quality was higher (p = 0.033). No relationship was found between body mass index (BMI) or hirsutism and the risk of eating disorders, self-esteem and sleep quality.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing Practices for Pre- and Post-Procedural Analgesia During Intrauterine Device Insertion: A National Survey of Providers in the United States.","authors":"Nicole E Friedlich, Hayley M Dunlop, Snehi Shah, Shanna M Combs","doi":"10.1016/j.jpag.2026.03.008","DOIUrl":"https://doi.org/10.1016/j.jpag.2026.03.008","url":null,"abstract":"<p><strong>Background: </strong>The intrauterine device (IUD) is an effective contraceptive, but insertion pain is a significant concern and barrier, especially for nulliparous patients.</p><p><strong>Objective: </strong>To evaluate differences in practice patterns for pre- and post-procedural analgesia during IUD insertion.</p><p><strong>Study design: </strong>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 one-way ANOVA tests assessed differences in analgesia recommendations by provider demographics.</p><p><strong>Results: </strong>Pre-procedurally, 75.9% of providers for nulliparous and 66.2% for multiparous patients frequently prescribed 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}